Effects of transcutaneous electrical nerve stimulation on pain, pulmonary function, and respiratory muscle strength in the postoperative period of thoracic surgery in an intensive care unit

Abstract Background: Respiratory muscle weakness is one of the primary factors associated with difficulty of ventilatory weaning in critically ill patients. In this sense, inspiratory muscle training (IMT) is a possible facilitator of successful weaning. One of the devices used for IMT is the POWERbreathe®, because it provides a linear pressure load, with the possibility of gradual increments. The effectiveness of early IMT in this population is not yet well known. The aim of this study is to assess the effects of early IMT with a mechanical loading device on the weaning time of patients on invasive mechanical ventilation (primary outcome), respiratory muscle strength, length of stay in the intensive care unit and in the success rate of weaning (secondary outcomes).Methods: This randomised controlled trial, a single blind evaluation, will be conducted in the intensive care unit of a university hospital on 42 adults, who will be randomly and blindly categorised into the control group, comprising patients who undergo routine physical therapy only, and the training group, comprising patients who undergo routine physical therapy associated with IMT twice a day, with load adjusted daily at 50% of maximum inspiratory pressure, three series of 10 repetitions with one minute rest in between. Both groups will be assessed when patients are eligible for the study and before the ventilatory support withdrawal. Effects of the training will be analysed from the collected data using intention-to-treat analysis. Between-group differences will be measured using generalised estimating equations for data analysis.Discussion: Results of this trial will likely provide valuable new information on the effects of IMT on weaning time, respiratory muscle strength, length of stay in the intensive care unit and the success rate of weaning in critically ill patients.Registration: ClinicalTrials.gov, NCT03758573. 29th November 2018.

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Early effects of inspiratory muscle training in critical patients submitted to mechanical ventilation: A study protocol for a randomised controlled trial

10.21203/rs.3.rs-257982/v1 ◽

2021 ◽

Author(s):

Franciele Borges de Oliveira ◽

Fabrício Olinda de Souza Mesquita ◽

Jéssica Mascena de Medeiros ◽

Hálisson Alves Ribeiro ◽

Paula Tamara Fonseca de Oliveira ◽

...

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Randomised Controlled Trial ◽

Muscle Strength ◽

Respiratory Muscle ◽

Controlled Trial ◽

Respiratory Muscle Strength ◽

Muscle Training ◽

Randomised Controlled

Abstract Background: Respiratory muscle weakness is one of the primary factors associated with difficulty of ventilatory weaning in critically ill patients. In this sense, inspiratory muscle training (IMT) is a possible facilitator of successful weaning. One of the devices used for IMT is the POWERbreathe®, because it provides a linear pressure load, with the possibility of gradual increments. The effectiveness of early IMT in this population is not yet well known. The aim of this study is to assess the effects of early IMT with a mechanical loading device on the weaning time of patients on invasive mechanical ventilation (primary outcome), respiratory muscle strength, length of stay in the intensive care unit and in the success rate of weaning (secondary outcomes).Methods: This randomised controlled trial, a single blind evaluation, will be conducted in the intensive care unit of a university hospital on 42 adults, who will be randomly and blindly categorised into the control group, comprising patients who undergo routine physical therapy only, and the training group, comprising patients who undergo routine physical therapy associated with IMT twice a day, with load adjusted daily at 50% of maximum inspiratory pressure, three series of 10 repetitions with one minute rest in between. Both groups will be assessed when patients are eligible for the study and before the ventilatory support withdrawal. Effects of the training will be analysed from the collected data using intention-to-treat analysis. Between-group differences will be measured using generalised estimating equations for data analysis.Discussion: Results of this trial will likely provide valuable new information on the effects of IMT on weaning time, respiratory muscle strength, length of stay in the intensive care unit and the success rate of weaning in critically ill patients.Registration: ClinicalTrials.gov, NCT03758573. 29th November 2018.

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Monitoring respiratory muscle strength assists in early diagnosis of respiratory dysfunction as opposed to the isolated use of pulmonary function evaluation in amyotrophic lateral sclerosis

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2013000300004 ◽

2013 ◽

Vol 71 (3) ◽

pp. 146-152 ◽

Cited By ~ 6

Author(s):

Guilherme Fregonezi ◽

Palomma Russelly Saldanha Araújo ◽

Tathiana Lindemberg Ferreira Macêdo ◽

Mario Emilio Dourado Junior ◽

Vanessa Regiane Resqueti ◽

...

Keyword(s):

Amyotrophic Lateral Sclerosis ◽

Muscle Strength ◽

Early Diagnosis ◽

Pulmonary Function ◽

Healthy Subjects ◽

Respiratory Muscle ◽

Function Evaluation ◽

Respiratory Muscle Strength ◽

Respiratory Dysfunction ◽

Lateral Sclerosis

ObjectiveIt was study the relationship between respiratory muscle strength and forced vital capacity (FVC) in patients with amyotrophic lateral sclerosis (ALS) versus healthy subjects.MethodsPulmonary function and respiratory muscle strength [maximal inspiratory (PImax), maximal expiratory (PEmax) and sniff nasal inspiratory pressure (SNIP)] were assessed in patients with ALS and healthy subjects, matched using cutoffs established in the literature for impaired pulmonary function and respiratory muscle weakness.ResultsTwenty-eight ALS patients and 28 healthy subjects were studied. We found sensitivity and specificity for PImax, PEmax and SNIP of 75/58%, 81/67% and 75/67%. The Receiver Operating Characteristic curve (ROC curve) indicated that the variables PImax, PEmax and SNIP can identify differences in respiratory muscle strength between ALS and healthy individuals at 0.89, 0.9 and 0.82, respectively. A positive correlation was recorded between FVC (%) versus SNIP, PImax and PEmax.ConclusionIn ALS, monitoring respiratory muscle strength assists in early diagnosis of respiratory dysfunction as opposed to the isolated use of FVC.

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Influence of a Six-Week Swimming Training with Added Respiratory Dead Space on Respiratory Muscle Strength and Pulmonary Function in Recreational Swimmers

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165743 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5743 ◽

Cited By ~ 1

Author(s):

Stefan Szczepan ◽

Natalia Danek ◽

Kamil Michalik ◽

Zofia Wróblewska ◽

Krystyna Zatoń

Keyword(s):

Muscle Strength ◽

Pulmonary Function ◽

Dead Space ◽

Respiratory Muscle ◽

Moderate Intensity ◽

Respiratory Muscle Strength ◽

Swimming Training ◽

Respiratory Muscle Fatigue ◽

Front Crawl ◽

Respiratory Dead Space

The avoidance of respiratory muscle fatigue and its repercussions may play an important role in swimmers’ health and physical performance. Thus, the aim of this study was to investigate whether a six-week moderate-intensity swimming intervention with added respiratory dead space (ARDS) resulted in any differences in respiratory muscle variables and pulmonary function in recreational swimmers. A sample of 22 individuals (recreational swimmers) were divided into an experimental (E) and a control (C) group, observed for maximal oxygen uptake (VO2max). The intervention involved 50 min of front crawl swimming performed at 60% VO2max twice weekly for six weeks. Added respiratory dead space was induced via tube breathing (1000 mL) in group E during each intervention session. Respiratory muscle strength variables and pulmonary and respiratory variables were measured before and after the intervention. The training did not increase the inspiratory or expiratory muscle strength or improve spirometric parameters in any group. Only in group E, maximal tidal volume increased by 6.3% (p = 0.01). The ARDS volume of 1000 mL with the diameter of 2.5 cm applied in moderate-intensity swimming training constituted too weak a stimulus to develop respiratory muscles and lung function measured in the spirometry test.

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