Inspiratory Muscle Training and Expiratory Muscle Thickness

Istanbul Demiroglu Bilim University

Status: Completed

Conditions: Rehabilitation; Muscle Weakness; Intensive Care Unit Syndrome

Treatments: Other: conventional physiotherapy+ IMT; Other: conventional physiotherapy

Study type: Interventional

Funder types: Other

Identifiers

NCT06251791

IMT on abdominal muscle

Details and patient eligibility

About

the specific effect of IMT on expiratory muscle strength and abdominal wall thickness during weaning remains unclear. To address this significant research gap, the primary objective of our study was to evaluate the effect of IMT after extubation on expiratory muscle strength and abdominal muscle thickness in respiratory ICU patients. On the other hand the investigators established reference values for ultrasonographic measurements in healthy control subjects as a comparative arm. To the best of our knowledge, this is the first study to examine the ultrasonographic effects of IMT on the expiratory muscle thickness after extubation. The investigators believe that our study may contribute to related literature in this context and guide future research as a pioneer with its unique value.

Full description

the specific effect of IMT on expiratory muscle strength and abdominal wall thickness during weaning remains unclear. To address this significant research gap, the primary objective of our study was to evaluate the effect of IMT after extubation on expiratory muscle strength and abdominal muscle thickness in respiratory ICU patients. On the other hand the investigators established reference values for ultrasonographic measurements in healthy control subjects as a comparative arm. To the best of our knowledge, this is the first study to examine the ultrasonographic effects of IMT on the expiratory muscle thickness after extubation. The investigators believe that our study may contribute to related literature in this context and guide future research as a pioneer with its unique value. In this single-blind randomized controlled study, 20 patients were divided into two groups: IMT and conventional physiotherapy(CP). In order to establish normative data for abdominal muscle thickness, ten healthy controls were included in the study. The CP group received CP and the IMT group received CP+IMT for five days following extubation. The thicknesses of the external oblique abdominal(EOA),internal oblique sbdominal(IOA), transversus abdominus (TRA) and rectus abdominis (RA) muscleswere evaluated The maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) were recorded.

Enrollment: 30 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• For Patients Group Inclusion Criteria:

  • Needing mechanical ventilation support longer than 2 days,
  • Alert and Riker Sedation Agitation Score >4
  • Being hemodynamically stable (HR<140 beats/min, BP stable)
  • Dobutamine and minimal vasopressor use
  • Fever of 36.5-38.5
  • Body Mass Index <40 m2/cm,
  • FiO2 of 0.5 or less,
  • Absence of myocardial ischemia.

Exclusion criteria

• For Patients Group Exclusion Criteria:

  • Noncooperation
  • Phrenic nerve damage
  • Chest wall trauma and/or deformity to prevent diaphragmatic movement
  • Progressive neuromuscular disease with respiratory involvement
  • There is enough secretion to require more than one aspiration every hour.
  • Patients using sedative drugs continuously
  • High-dose cortisol use
  • Using a home mechanical ventilator before mechanical ventilation in intensive care unit

For Healthy Group Inclusion Criteria:

• With the control and intervention group, age, characteristics and characteristics,
• Chronic system and no ongoing treatment,
• Body mass index not 40 kg/m2,
• 18-80 years old

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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30 participants in 3 patient groups

Experimental

Experimental group

Description:

Experimental: Conventional Physiotherapy In the intensive care unit and who had mechanical ventilation for more than 48 hours and who were extubated. In this group addition to conventional physiotherapy inspiratory muscle training will be performed with the threshold-loaded inspiratory muscle training device, starting at 30% of the maximum inspiratory mouth pressure value, during 5 days, in 2 sessions, 4 sets per day, 6-8 breaths in each set and 2 minutes of rest between sets.

Treatment:

Other: conventional physiotherapy+ IMT

Conventional

Experimental group

Description:

In this group will apply only conventional physiotherapy. Conventional physiotherapy to contain breathing and,thoracal expansion exercises, bronchial hygiene techniques and gradual mobilization. Conventional physiotherapy apply for 5 days after extubation period 1 time a day.

Treatment:

Other: conventional physiotherapy

Healthy controls

No Intervention group

Description:

There is no intervention in this group. Baseline measurements are to compare with experimental groups.