Which ICU patients benefit most from inspiratory muscle training? Retrospective analysis of a randomized trial

Bernie BISSETT, Jiali Wang, Teresa Neeman, Isabel Leditschke, Robert Boots, Jennifer Paratz

Research output: Contribution to journalArticle

Abstract

Background: Inspiratory muscle training (IMT) increases inspiratory muscle strength and improves quality of life in intensive care unit (ICU) patients who have been invasively mechanically ventilated for ≥7 days. The purpose of this study was to identify which patients benefit most from IMT following weaning from mechanical ventilation. Methods: Secondary analysis of a randomized trial of supervised daily IMT in 70 patients (mean age 59 years) in a 31-bed ICU was carried out. Changes in inspiratory muscle strength (maximum inspiratory pressure, MIP) between enrolment and 2 weeks (ΔMIP) were analyzed to compare the IMT group (71% male) and the control group (58% male). Linear regression models explored which factors at baseline were associated with ΔMIP. Results: Thirty-four participants were allocated to the IMT group where baseline MIP was associated with an increase in ΔMIP, significantly different from the control group (p = 0.025). The highest ΔMIP was associated with baseline MIP ≥ 28 cmH2O. In the IMT group, higher baseline quality of life (EQ5D) scores were associated with positive ΔMIP, significantly different from the control group (p = 0.029), with largest ΔMIP for those with EQ5D ≥ 40. Conclusions: Physiotherapists should target ICU patients with moderate inspiratory muscle weakness (MIP ≥28 cmH2O) and moderate to high quality of life (EQ5D>40) within 48 h of ventilatory weaning as ideal candidates for IMT following prolonged mechanical ventilation.
Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalPhysiotherapy Theory and Practice
DOIs
Publication statusPublished - 1 Jan 2019

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Intensive Care Units
Muscles
Quality of Life
Muscle Strength
Artificial Respiration
Control Groups
Linear Models
Maximal Respiratory Pressures
Physical Therapists
Muscle Weakness
Weaning

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BISSETT, Bernie ; Wang, Jiali ; Neeman, Teresa ; Leditschke, Isabel ; Boots, Robert ; Paratz, Jennifer. / Which ICU patients benefit most from inspiratory muscle training? Retrospective analysis of a randomized trial. In: Physiotherapy Theory and Practice. 2019 ; pp. 1-6.
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Which ICU patients benefit most from inspiratory muscle training? Retrospective analysis of a randomized trial. / BISSETT, Bernie; Wang, Jiali; Neeman, Teresa; Leditschke, Isabel; Boots, Robert; Paratz, Jennifer.

In: Physiotherapy Theory and Practice, 01.01.2019, p. 1-6.

Research output: Contribution to journalArticle

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