IMT Outcomes in Sufferers of Severe Walking Disabilities and Intensive Care Unit Acquired Weakness

Not Applicable

Recruiting

Interventions: Behavioral: Threshold IMT and traditional physical therapy program
Behavioral: traditional physiotherapy program

Brief Summary: Intensive care unit-acquired weakness (ICU-acquired weakness) may be caused by a variety of different causes. Several studies have shown that ICU-acquired weakness occurs in up to 30% of critically ill patients. It affects daily activities, walking, and functional performance

Detailed Description: Forty ICU-acquired weakness elderly patients will be randomly assigned to group A and group B, 20 elderly for each. Both groups will receive chest physiotherapy (cough training, vibration, percussion, rib springing, and postural drainage), 30 minutes of resisted training on upper- and lower-limb muscles (15 min on upper limb and 15 min on lower limb), and 30 minutes of neuromuscular electrical stimulation of lower- and upper-limb muscles (triceps and wrist extensors, dorsiflexors, and quadriceps). sessions will be executed 5 times weekly). Group A only will receive 3-set IMT (two sessions daily via threshold IMT, the set contain 10 repetitions) 5 times weekly. The study duration will be 1 month.

Recruitment & Eligibility

Inclusion Criteria

sufferers with intensive care unit acquired weakness
Older sufferers patients with severe walking disability detected by Modified Functional Ambulation Category test,

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
group A	Threshold IMT and traditional physical therapy program	twenty ICU-acquired weakness elderly patients will receive chest physiotherapy (cough training, vibration, percussion, rib springing, and postural drainage), 30 minutes of resisted training on upper- and lower-limb muscles (15 min on upper limb and 15 min on lower limb), and 30 minutes of neuromuscular electrical stimulation of lower- and upper-limb muscles (triceps and wrist extensors, dorsiflexors, and quadriceps). sessions will be executed 5 times weekly). this Group will receive 3-set IMT (two sessions daily via threshold IMT, the set contain 10 repetitions) 5 times weekly. The study duration will be 1 month.
group B	traditional physiotherapy program	twenty ICU-acquired weakness elderly patients will receive chest physiotherapy (cough training, vibration, percussion, rib springing, and postural drainage), 30 minutes of resisted training on upper- and lower-limb muscles (15 min on upper limb and 15 min on lower limb), and 30 minutes of neuromuscular electrical stimulation of lower- and upper-limb muscles (triceps and wrist extensors, dorsiflexors, and quadriceps). sessions will be executed 5 times weekly). The study duration will be 1 month.

Primary Outcome Measures

Name	Time	Method
Modified Functional Ambulation Category Test	it will be measured after 1 month	it is a category test used to assess walking disability

Secondary Outcome Measures

Name	Time	Method
inspiratory muscle strength	It will be measured after 1 month	it will be measure in cm H2O
six-minute walk test,	It will be measured after 1 month	distance walked in 6 minute
physical division of short form 36	It will be measured after 1 month	it assess physical component of short form 36 quality of life questionnare
Partial Pressure of carbon dioxide	It will be measured after 1 month	it is an arterial blood gas test
Oxygen saturation	It will be measured after 1 month	it is an arterial blood gas test
expiratory muscle strength	It will be measured after 1 month	it will be measure in cm H2O
time up and go test	It will be measured after 1 month	it is time used to walk a three-meter distance
functional vital capacity	It will be measured after 1 month	the percentage of predicted value of functional vital capacity will be assessed
10-meter walking test	It will be measured after 1 month	it is time used to walk a 10-meter distance
mental division of short form 36	It will be measured after 1 month	it assess mental component of short form 36 quality of life questionnare
forced expiatory volume in the first second of expiration	It will be measured after 1 month	the percentage of predicted value of FEV1 will be assessed
Partial Pressure of Oxygen	It will be measured after 1 month	it is an arterial blood gas test
30-second sit to stand	It will be measured after 1 month	number of (sit to stand) done in 30 seconds