The Impact of Inspiratory Muscle Strength Training

Study Overview
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Brief Summary
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The study is a pre-post test with quasi experimental design. Forty-two intubated-adults who had been mechanically ventilated for more than 21 days were selected on the basis of inclusion criteria in respiratory care ward. These patients were classified equally into study group and control group. The experimental group received the intervention of respiratory muscles training 5 times/ a week for 6 weeks. The control group received normal care. The intervention was adjusted trigger sensitivity to 10% of the first recorded Maximal Inspiratory Pressure at the start of training, then increased the ventilator trigger sensitivity and training duration weekly. The largest of ventilator trigger sensitivity is not over 40% of the initial Maximal Inspiratory Pressure and the timing of training duration is no longer than 30 minutes.

Official Title
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The Impact of Inspiratory Muscle Strength Training on Weaning Parameters Among Ventilator-dependent Patients

Conditions
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Ventilator Dependency

Intervention / Treatment
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* Device: inspiratory muscle strength training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age >20y/o Vital signs stable MIP <20cmH2O Ventilator FiO2<40%, PEEP <8 Ventilator mode:PSV or SIMV Exclusion Criteria: Patient or family refuse
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control group<br>as usual care | |
| Experimental: experimental group<br>The intervention of inspiratory muscle strength training | Device: inspiratory muscle strength training<br>* The experimental group received the intervention of inspiratory muscles training 5times/week for 6 weeks, 5days/ per cycle; the patients stayed in the semi-recumbent position, recorded the initial/first measurement of MIP. The trigger sensitivity was adjusted to 10% of the first recorded MIP at the start of training, then reducing the ventilator trigger sensitivity and training duration weekly.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maximal inspiratory pressure | a measure of the strength of inspiratory muscles, measurement by cmH2O. | 7 weeks | 
| Tidal volume | the volume of air that is transported into and out of the lungs with each respiratory cycle, measurement by mL per inspiration | 7 weeks | 
| Minute ventilation volume | the quantity of air moved into and out of the lungs in a minute, measurement by l.min | 7 weeks | 
| Rapid shallow breathing index | the ratio of respiratory frequency to tidal volume (f/VT) | 7 weeks | 
| Oxygenation index. | Oxygenation index OI = FiO2 x 100 x M AP/PaO2, where FiO2 is the fraction of inspired oxygen, MAP is the mean airway pressure, and PaO2 is the partial pressure of oxygen in arterial blood, calculated at the end of the first day of standardized preoperative stabilization | 7 weeks |