TY - JOUR
T1 - Supported arm training in patients recently weaned from mechanical ventilation
AU - Porta, Roberto
AU - Vitacca, Michele
AU - Gilè, Lucia Sonia
AU - Clini, Enrico
AU - Bianchi, Luca
AU - Zanotti, Ercole
AU - Ambrosino, Nicolino
PY - 2005/10
Y1 - 2005/10
N2 - Study objectives: To evaluate the effects of early exercise training in patients recovering from acute respiratory failure needing mechanical ventilation (MV). Design: Prospective, randomized, and controlled study. Setting: Three respiratory intermediate ICUs (RIICUs). Patients: Of 228 patients admitted to an RIICU, 66 patients weaned from MV from > 48 to <96 h were considered eligible and enrolled in the study. Intervention: Sixty-six patients were randomized to either supported arm exercise training plus general physiotherapy (gPT) [group 1, 32 patients] or to gPT alone (group 2, 34 patients). Measurements and results: Twenty-five patients in each group completed the protocol. Group 1 showed a greater improvement in exercise capacity, as assessed by an arm incremental test (IT) [p = 0.003] and an endurance test (ET) [p = 0.021], compared to group 2. Posttraining maximal inspiratory pressure (MIP) significantly improved in both groups (p <0.001 and p = 0.003 in groups 1 and 2 respectively; not significant). IT isoworkload dyspnea improved significantly in both groups (p = 0.005 and p = 0.009 in groups 1 and 2, respectively; not significant between groups), whereas IT isoworkload peripheral muscle fatigue (p <0.001), ET isotime dyspnea (p <0.01), and ET isotime muscular fatigue (p <0.005) improved significantly in group 1 but not in group 2. IT improvers (χ 2 = 0.004) and ET improvers (χ 2 = 0.047) were more frequently observed in group 1 than in group 2. Baseline MIP could discriminate for IT (p = 0.013; odds ratio [OR], 1.116) and ET improvers (p = 0.022; OR, 1.067). Conclusion: Early upper-limb exercise training is feasible in RIICU patients recently weaned from MV and can enhance the effects of gPT. Baseline inspiratory muscle function is related to exercise capacity improvement.
AB - Study objectives: To evaluate the effects of early exercise training in patients recovering from acute respiratory failure needing mechanical ventilation (MV). Design: Prospective, randomized, and controlled study. Setting: Three respiratory intermediate ICUs (RIICUs). Patients: Of 228 patients admitted to an RIICU, 66 patients weaned from MV from > 48 to <96 h were considered eligible and enrolled in the study. Intervention: Sixty-six patients were randomized to either supported arm exercise training plus general physiotherapy (gPT) [group 1, 32 patients] or to gPT alone (group 2, 34 patients). Measurements and results: Twenty-five patients in each group completed the protocol. Group 1 showed a greater improvement in exercise capacity, as assessed by an arm incremental test (IT) [p = 0.003] and an endurance test (ET) [p = 0.021], compared to group 2. Posttraining maximal inspiratory pressure (MIP) significantly improved in both groups (p <0.001 and p = 0.003 in groups 1 and 2 respectively; not significant). IT isoworkload dyspnea improved significantly in both groups (p = 0.005 and p = 0.009 in groups 1 and 2, respectively; not significant between groups), whereas IT isoworkload peripheral muscle fatigue (p <0.001), ET isotime dyspnea (p <0.01), and ET isotime muscular fatigue (p <0.005) improved significantly in group 1 but not in group 2. IT improvers (χ 2 = 0.004) and ET improvers (χ 2 = 0.047) were more frequently observed in group 1 than in group 2. Baseline MIP could discriminate for IT (p = 0.013; odds ratio [OR], 1.116) and ET improvers (p = 0.022; OR, 1.067). Conclusion: Early upper-limb exercise training is feasible in RIICU patients recently weaned from MV and can enhance the effects of gPT. Baseline inspiratory muscle function is related to exercise capacity improvement.
KW - Exercise therapy
KW - Rehabilitation
KW - Respiratory insufficiency
KW - Respiratory intermediate ICUs
KW - Weaning
UR - http://www.scopus.com/inward/record.url?scp=27144514661&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=27144514661&partnerID=8YFLogxK
U2 - 10.1378/chest.128.4.2511
DO - 10.1378/chest.128.4.2511
M3 - Article
C2 - 16236917
AN - SCOPUS:27144514661
VL - 128
SP - 2511
EP - 2520
JO - Chest
JF - Chest
SN - 0012-3692
IS - 4
ER -