Comparing the Effects of Inspiratory Muscle Training and Diaphragmatic Neuromuscular Electrical Stimulation in Mechanically Ventilated Patients: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 32
- 试验地点
- 1
- 主要终点
- Inspiratory muscle strength
研究概览
简要总结
This study aimed to compare the effects of Inspiratory Muscle Training (IMT) and Diaphragmatic Neuromuscular Electrical Stimulation (NMES) on inspiratory muscle strength, mechanical ventilator parameters, and functional levels in intubated intensive care unit (ICU) patients. Thirty-two intubated patients were divided into two groups: the IMT group and the NMES group. In the IMT group, IMT was administered twice a day in addition to routine physiotherapy. In the NMES group, electrical stimulation was applied to the diaphragm muscle for 40 minutes in addition to routine physiotherapy. The primary outcomes of the study are inspiratory muscle strength and physical function level. The secondary outcomes are mechanical ventilator parameters, extubation time, and length of hospital stay.
详细描述
This randomized study aimed to compare the effects of Inspiratory Muscle Training (IMT) and Neuromuscular Electrical Stimulation (NMES) on inspiratory muscle strength, mechanical ventilator parameters, and functional levels in intensive care unit (ICU) patients.
A total of 32 mechanically ventilated patients were randomly assigned to either an IMT group (n=16) or an NMES group (n=16). In addition to routine ICU physiotherapy, the IMT group received inspiratory muscle training using Philips Respironics Threshold IMT devices, while the NMES group received stimulation on the diaphragm with Aussie current using surface electrodes.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Double (Care Provider, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Being intubated
- •Conscious state
- •Ability to trigger mechanical ventilation
- •Capability to execute at least one motor command
排除标准
- •Any neurological or orthopedic diagnosis or deficits
- •Inability to cooperate with the physiotherapist
- •Hemodynamic instability despite medical treatment
- •Excessive secretions requiring aspiration more than once per hour.
研究组 & 干预措施
Inspiratory Muscle Training (IMT)
As a result of randomization, the IMT group consisted of 16 participants with a mean age of 70 ± 9.57 years. IMT was administered to the participants twice a day following routine physiotherapy, which included breathing exercises and mobilization.
干预措施: Inspiratory muscle training (IMT) (Procedure)
Neuromuscular electric stimulation (NMES)
As a result of randomization, the NMES group consisted of 16 participants with a mean age of 65.31 ± 8.38 years. Following routine intensive care physiotherapy, which included breathing exercises and mobilization, NMES was applied to the diaphragm muscle for 40 minutes.
干预措施: Diaphragmatic Neuromuscular Electric Stimulation (NMES) (Procedure)
结局指标
主要结局
Inspiratory muscle strength
时间窗: Baseline, 1 hour before extubation, 1 hour before discharge
Inspiratory muscle strength (Pimax) was assessed by a desktop spirometer with Pimax module (Pony Fx, COSMED, Rome, Italy). A catheter mount piece was placed in front of the pressure measurement part of spirometer to perform the measurement in intubated participants. Participants were encouraged throughout the measurements to achieve maximum strength and coordination. The measurements were repeated three times, and the average of these values was recorded. To prevent respiratory muscle fatigue, at least a one-minute break was provided between trials. Results were reported in cmH2O units.
Physical Functions
时间窗: Baseline, 1 hour before discharge
Physical function levels of patients were evaluated by Physical Function Intensive Care Unit Test-scored (PFIT-s). Physical Function Intensive Care Unit Test-scored has 4 test components; shoulder flexion strength, knee extension strength, sit to stand assistance, step cadence. Before the test, the participant was expected to correctly answer 2 of 5 questions to assessing the cooperation. Participants' vital signs were noted before and after the test. Participants are scored on a total scale ranging from 0 to 10. A score of 0 signifies total dependence and poor muscle strength, whereas a score of 10 represents functional independence and optimal muscle strength.
次要结局
- Mechanical Ventilatory Parameters - Tidal Volumes(Baseline, 1 hour before extubation)
- Mechanical Ventilatory Parameter - Minute Ventilation(Baseline, 1 hour before extubation)
- Length of time intubated(12 hours after extubation)
- Hospital stay length(2 hours after discharge)
研究者
Ali Yalman
Assistant Proffesor
Mustafa Kemal University