Inspiratory muscle training to enhance recovery from mechanical ventilation: A randomised trial

Bernie BISSETT, Isabel Anne Leditschke, Teresa Neeman, Robert Boots, Jennifer Paratz

Research output: Contribution to journalArticle

21 Citations (Scopus)
2 Downloads (Pure)

Abstract

Background In patients who have been mechanically ventilated, inspiratory muscles remain weak and fatigable following ventilatory weaning, which may contribute to dyspnoea and limited functional recovery. Inspiratory muscle training may improve inspiratory muscle strength and endurance following weaning, potentially improving dyspnoea and quality of life in this patient group. Methods We conducted a randomised trial with assessor-blinding and intention-to-treat analysis. Following 48? €...hours of successful weaning, 70 participants (mechanically ventilated =7 days) were randomised to receive inspiratory muscle training once daily 5 days/week for 2 weeks in addition to usual care, or usual care (control). Primary endpoints were inspiratory muscle strength and fatigue resistance index (FRI) 2 weeks following enrolment. Secondary endpoints included dyspnoea, physical function and quality of life, post-intensive care length of stay and in-hospital mortality. Results 34 participants were randomly allocated to the training group and 36 to control. The training group demonstrated greater improvements in inspiratory strength (training: 17%, control: 6%, mean difference: 11%, p=0.02). There were no statistically significant differences in FRI (0.03 vs 0.02, p=0.81), physical function (0.25 vs 0.25, p=0.97) or dyspnoea ('0.5 vs 0.2, p=0.22). Improvement in quality of life was greater in the training group (14% vs 2%, mean difference 12%, p=0.03). In-hospital mortality was higher in the training group (4 vs 0, 12% vs 0%, p=0.051). Conclusions Inspiratory muscle training following successful weaning increases inspiratory muscle strength and quality of life, but we cannot confidently rule out an associated increased risk of in-hospital mortality. Trial registration number ACTRN12610001089022, results.
Original languageEnglish
Pages (from-to)812-819
Number of pages8
JournalThorax
Volume71
Issue number9
DOIs
Publication statusPublished - 2016

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Weaning
Artificial Respiration
Dyspnea
Muscle Strength
Hospital Mortality
Quality of Life
Muscles
Muscle Fatigue
Intention to Treat Analysis
Resistance Training
Critical Care
Fatigue
Length of Stay

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BISSETT, Bernie ; Leditschke, Isabel Anne ; Neeman, Teresa ; Boots, Robert ; Paratz, Jennifer. / Inspiratory muscle training to enhance recovery from mechanical ventilation: A randomised trial. In: Thorax. 2016 ; Vol. 71, No. 9. pp. 812-819.
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abstract = "Background In patients who have been mechanically ventilated, inspiratory muscles remain weak and fatigable following ventilatory weaning, which may contribute to dyspnoea and limited functional recovery. Inspiratory muscle training may improve inspiratory muscle strength and endurance following weaning, potentially improving dyspnoea and quality of life in this patient group. Methods We conducted a randomised trial with assessor-blinding and intention-to-treat analysis. Following 48? €...hours of successful weaning, 70 participants (mechanically ventilated =7 days) were randomised to receive inspiratory muscle training once daily 5 days/week for 2 weeks in addition to usual care, or usual care (control). Primary endpoints were inspiratory muscle strength and fatigue resistance index (FRI) 2 weeks following enrolment. Secondary endpoints included dyspnoea, physical function and quality of life, post-intensive care length of stay and in-hospital mortality. Results 34 participants were randomly allocated to the training group and 36 to control. The training group demonstrated greater improvements in inspiratory strength (training: 17{\%}, control: 6{\%}, mean difference: 11{\%}, p=0.02). There were no statistically significant differences in FRI (0.03 vs 0.02, p=0.81), physical function (0.25 vs 0.25, p=0.97) or dyspnoea ('0.5 vs 0.2, p=0.22). Improvement in quality of life was greater in the training group (14{\%} vs 2{\%}, mean difference 12{\%}, p=0.03). In-hospital mortality was higher in the training group (4 vs 0, 12{\%} vs 0{\%}, p=0.051). Conclusions Inspiratory muscle training following successful weaning increases inspiratory muscle strength and quality of life, but we cannot confidently rule out an associated increased risk of in-hospital mortality. Trial registration number ACTRN12610001089022, results.",
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Inspiratory muscle training to enhance recovery from mechanical ventilation: A randomised trial. / BISSETT, Bernie; Leditschke, Isabel Anne; Neeman, Teresa; Boots, Robert; Paratz, Jennifer.

In: Thorax, Vol. 71, No. 9, 2016, p. 812-819.

Research output: Contribution to journalArticle

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T1 - Inspiratory muscle training to enhance recovery from mechanical ventilation: A randomised trial

AU - BISSETT, Bernie

AU - Leditschke, Isabel Anne

AU - Neeman, Teresa

AU - Boots, Robert

AU - Paratz, Jennifer

PY - 2016

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N2 - Background In patients who have been mechanically ventilated, inspiratory muscles remain weak and fatigable following ventilatory weaning, which may contribute to dyspnoea and limited functional recovery. Inspiratory muscle training may improve inspiratory muscle strength and endurance following weaning, potentially improving dyspnoea and quality of life in this patient group. Methods We conducted a randomised trial with assessor-blinding and intention-to-treat analysis. Following 48? €...hours of successful weaning, 70 participants (mechanically ventilated =7 days) were randomised to receive inspiratory muscle training once daily 5 days/week for 2 weeks in addition to usual care, or usual care (control). Primary endpoints were inspiratory muscle strength and fatigue resistance index (FRI) 2 weeks following enrolment. Secondary endpoints included dyspnoea, physical function and quality of life, post-intensive care length of stay and in-hospital mortality. Results 34 participants were randomly allocated to the training group and 36 to control. The training group demonstrated greater improvements in inspiratory strength (training: 17%, control: 6%, mean difference: 11%, p=0.02). There were no statistically significant differences in FRI (0.03 vs 0.02, p=0.81), physical function (0.25 vs 0.25, p=0.97) or dyspnoea ('0.5 vs 0.2, p=0.22). Improvement in quality of life was greater in the training group (14% vs 2%, mean difference 12%, p=0.03). In-hospital mortality was higher in the training group (4 vs 0, 12% vs 0%, p=0.051). Conclusions Inspiratory muscle training following successful weaning increases inspiratory muscle strength and quality of life, but we cannot confidently rule out an associated increased risk of in-hospital mortality. Trial registration number ACTRN12610001089022, results.

AB - Background In patients who have been mechanically ventilated, inspiratory muscles remain weak and fatigable following ventilatory weaning, which may contribute to dyspnoea and limited functional recovery. Inspiratory muscle training may improve inspiratory muscle strength and endurance following weaning, potentially improving dyspnoea and quality of life in this patient group. Methods We conducted a randomised trial with assessor-blinding and intention-to-treat analysis. Following 48? €...hours of successful weaning, 70 participants (mechanically ventilated =7 days) were randomised to receive inspiratory muscle training once daily 5 days/week for 2 weeks in addition to usual care, or usual care (control). Primary endpoints were inspiratory muscle strength and fatigue resistance index (FRI) 2 weeks following enrolment. Secondary endpoints included dyspnoea, physical function and quality of life, post-intensive care length of stay and in-hospital mortality. Results 34 participants were randomly allocated to the training group and 36 to control. The training group demonstrated greater improvements in inspiratory strength (training: 17%, control: 6%, mean difference: 11%, p=0.02). There were no statistically significant differences in FRI (0.03 vs 0.02, p=0.81), physical function (0.25 vs 0.25, p=0.97) or dyspnoea ('0.5 vs 0.2, p=0.22). Improvement in quality of life was greater in the training group (14% vs 2%, mean difference 12%, p=0.03). In-hospital mortality was higher in the training group (4 vs 0, 12% vs 0%, p=0.051). Conclusions Inspiratory muscle training following successful weaning increases inspiratory muscle strength and quality of life, but we cannot confidently rule out an associated increased risk of in-hospital mortality. Trial registration number ACTRN12610001089022, results.

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KW - Length of Stay/statistics & numerical data

KW - Male

KW - Inhalation/physiology

KW - Breathing Exercises/methods

KW - Quality of Life

KW - Adult

KW - Female

KW - Aged

KW - Respiration, Artificial/adverse effects

KW - Patient Compliance

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