Abstract
INTRODUCTION: Blowing devices, resources, and incentive screens are routinely used in respiratory physiotherapy, but evidence of their effects remains scarce. This study aimed to investigate the effects of blowing strategies on various clinical outcomes during physiotherapy in individuals with respiratory disorders. METHOD: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (CRD42022370442) and included experimental and quasi-experimental studies, including pilot studies, on the effects of blowing strategy interventions. Were considered studies published in English, Spanish, or Portuguese with no date restrictions. RESULTS: The database search identified 838 records, of which 17 studies published between 1985 and 2024 were selected. The total sample included 823 individuals aged between 3 and 95 years. The blowing strategies used were the blowing bottle, balloon, party whistle, pinwheel, and visual feedback interfaces. Positive effects on various clinical outcomes were observed: five studies reported increased peripheral oxygen saturation after using the blowing bottle, pinwheel, balloon, and party whistle; three studies reported reduced respiratory rates after using the party whistle, balloon, and bubble blowing; two studies reported lower heart rates after using the party whistle and bubble blowing; two studies reported a reduction in dyspnea after using the blowing bottle and balloon; one study reported increased interest in physiotherapy treatment after using visual feedback blowing; and one study found a shorter hospital stay after using the blowing bottle. CONCLUSION: Blowing strategies are used in physiotherapy across different populations, which contributes to the heterogeneity of findings. These strategies have positive effects on certain clinical outcomes, such as peripheral oxygen saturation and respiratory and heart rates. However, the results vary for pulmonary function, dyspnea, and length of hospital stay, depending on the type of device and the target population, which suggests the need for further studies for its use in clinical practice.