No study of IPPB therapy has conclusively proved its efficacy. Published praise has been based on clinical impressions or statements that patients "feel better." It is questionable whether beneficial results derive from IPPB therapy or from other care such as physical therapy, or whether the effects are psychological in origin. The wide use of IPPB therapy may be unjustified: it is without scientific basis. Part of its use relates to the belief on the part of physicians, therapists, and patients that this treatment is helpful. In addition to being of unproven value, IPPB therapy may conceivably be harmful: thus, the literature has reported the presence of hypoxemia, decreased FRC, increased airway resistance, infection, and pneumothorax after IPPB therapy. Improved pulmonary function after IPPB therapy has not been demonstrated; in addition, treatments are not usually quality controlled. Medical therapy that has not been proven effective should be abandoned. As this is apparently so in the case of IPPB therapy, valuable and expensive respiratory therapists might then devote more time to other, more important modes of respiratory care.
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