Ostrom's Combined Respiratory Movement

The patient stands erect with head thrown back and arms extended on a level with his shoulders.
1. Flex the arms slowly under slight resistance (single active), gentle inspiration.
2. Expiration.
3. Raise the flexed arms up so that the points of the elbows reach above the head, with deep inspiration.
4. Expiration while in this position.
5. Bring the still flexed arms downward and backward as far as possible with a deep inspiration. The head should be as far back as possible so as to help expand the chest to its fullest capacity.
6. Expiration.
7. The arms are raised up on a level with the shoulders with deep inspiration.
8. The arms are extended back to their fundamental position slowly, while the patient exhales.
This movement is very strong and consequently rather tiresome to the patient. It should therefore be given carefully in the beginning.