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| Effect of abdominal weight training with and without cough machine assistance on lung function in the patients with prolonged mechanical ventilation: a randomized trial |
| Hung T-Y, Wu W-L, Kuo H-C, Liu S-F, Chang C-L, Chang H-C, Tsai Y-C, Liu J-F |
| Critical Care 2022 May 25;26(153):Epub |
| clinical trial |
| 5/10 [Eligibility criteria: Yes; Random allocation: No; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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PURPOSE: The patients with prolonged mechanical ventilation (PMV) have the risk of ineffective coughing and infection due to diaphragm weakness. This study aimed to explore the effect of abdominal weight training (AWT) intervention with/without cough machine (CM) assistance on lung function, respiratory muscle strength and cough ability in these patients. METHODS: Forty patients with PMV were randomly assigned to three groups: AWT group (n = 12), AWT plus CM group (n = 14) and control group (n = 14). Change of maximum inspiratory pressure (MIP), Maximum expiratory pressure (MEP) and peak cough flow (PCF) between 1 day before and 2 weeks after the intervention were compared among these three groups. RESULTS: MIP before and after intervention in AWT group (30.50 +/- 11.73 versus 36.00 +/- 10.79; p < 0.05) and AWT plus CM group (29.8 +/- 12.14 versus 36.14 +/- 10.42; p < 0.05) compared with control group (28.43 +/- 9.74 versus 26.71 +/- 10.77; p > 0.05) was significantly improved. MEP before and after intervention in AWT group (30.58 +/- 15.19 versus 41.50 +/- 18.33; p < 0.05) and AWT plus CM group (27.29 +/- 12.76 versus 42.43 +/- 16.96; p < 0.05) compared with control group (28.86 +/- 10.25 versus 29.57 +/- 14.21; p > 0.05) was significantly improved. PCF before and after intervention in AWT group in AWT group (105.83 +/- 16.21 versus 114.17 +/- 15.20; p < 0.05) and AWT plus CM group (108.57 +/- 18.85 versus 131.79 +/- 38.96; p < 0.05) compared to control group (108.57 +/- 19.96 versus 109.86 +/- 17.44; p > 0.05) showed significant improvements. AWT plus CM group had significantly greater improvements than control group in MIP and peak cough flow than control group (13.71 +/- 11.28 versus 19.64 +/- 29.90, p < 0.05). CONCLUSION: AWT can significantly improve lung function, respiratory muscle strength, and cough ability in the PMV patients. AWT plus CM can further improve their expiratory muscle strength and cough ability. TRIAL REGISTRATION: ClinicalTrials.gov NCT0529538 retrospectively registered on March 3, 2022.
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