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This randomized, single-blind trial examined the effectiveness of incentive spirometry versus deep breathing exercises in 180 patients undergoing respiratory physiotherapy following thoracotomy and lung resection. The primary endpoint was the percentage decrease in FEV1 on post-operative day 4; secondary endpoints included FEV1 % predicted on post-operative day 4, frequency of post-operative pulmonary complications, post-operative length of stay, high dependency unit length of stay, sputum retention, ICU admission and in-hospital mortality. FEV1 was measured using a Vitalograph spirometer.