Effect of post-extubation inspiratory muscle training on diaphragmatic function in mechanically ventilated patients: A randomized controlled trial.

IF 2.1 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Advances in Clinical and Experimental Medicine Pub Date : 2024-10-01 DOI:10.17219/acem/174815
Reyhan Kaygusuz Benli, Ufuk Yurdalan, Barış Yılmaz, Nalan Adıgüzel
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Abstract

Background: Diaphragmatic dysfunction is a common problem in patients who have been mechanically ventilated.

Objectives: The study aimed to evaluate the effectiveness of inspiratory muscle training (IMT) on diaphragm muscle thickness and function in mechanically ventilated patients.

Material and methods: A single-blind trial was conducted. Twenty patients were randomly assigned to either the conventional physiotherapy (CP) group or to the IMT group for 5 days following extubation. The CP group received only CP, while the IMT group received CP in addition to IMT. Ten healthy controls (HCs) underwent IMT. Maximum inspiratory pressure (MIP) and physical function were recorded. Diaphragm excursion (DE), diaphragm thickness at the end of inspiration (Tdi), diaphragm thickness at the end of expiration (Tde), peak contraction velocity (PCV), and peak relaxation velocity (PRV) were evaluated with ultrasonography before and after the intervention.

Results: The IMT group and HCs showed significant improvements in DE (p = 0.005; p = 0.005, respectively), PCV (p = 0.028; p = 0.015, respectively) and PRV (p = 0.029; p = 0.020, respectively) after 5 days of IMT. A significant increase in MIP was recorded in all groups after the intervention (CP: p = 0.044; IMT: p = 0.005; HC: p < 0.001). There was a significant improvement in the Medical Research Council (MRC) and the Physical Function in Intensive Care Test (PFIT) scores in both the CP and IMT groups (p < 0.001 and p < 0.001, respectively).

Conclusions: Inspiratory muscle training improves diaphragmatic functions, including MIP, diaphragm excursion, PCV, and PRV. We think that IMT applied after extubation may serve as a tool to prevent and facilitate the recovery of diaphragmatic function.

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拔管后吸气肌肉训练对机械通气患者膈肌功能的影响:随机对照试验。
背景:膈肌功能障碍是机械通气患者的常见问题:膈肌功能障碍是机械通气患者的常见问题:研究旨在评估吸气肌训练(IMT)对机械通气患者膈肌厚度和功能的影响:进行了单盲试验。20 名患者在拔管后被随机分配到传统物理治疗(CP)组或吸气肌训练(IMT)组,为期 5 天。CP 组仅接受 CP,而 IMT 组除 IMT 外还接受 CP。10 名健康对照组(HC)接受了 IMT。记录最大吸气压力(MIP)和身体功能。通过超声波检查评估了干预前后的膈肌偏移(DE)、吸气末膈肌厚度(Tdi)、呼气末膈肌厚度(Tde)、收缩峰值速度(PCV)和松弛峰值速度(PRV):接受 IMT 5 天后,IMT 组和 HCs 的 DE(p = 0.005;p = 0.005,分别为 0.005)、PCV(p = 0.028;p = 0.015,分别为 0.028;p = 0.015)和 PRV(p = 0.029;p = 0.020,分别为 0.020)均有明显改善。干预后,所有组的 MIP 都有明显增加(CP:p = 0.044;IMT:p = 0.005;HC:p < 0.001)。CP 组和 IMT 组的医学研究委员会(MRC)和重症监护测试(PFIT)评分均有明显改善(分别为 p < 0.001 和 p < 0.001):结论:吸气肌肉训练可改善膈肌功能,包括MIP、膈肌偏移、PCV和PRV。我们认为,在拔管后应用 IMT 可作为预防和促进膈肌功能恢复的一种工具。
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来源期刊
Advances in Clinical and Experimental Medicine
Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
3.70
自引率
4.80%
发文量
153
审稿时长
6-12 weeks
期刊介绍: Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.
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