Effects of physical training on functional status in patients with prolonged mechanical ventilation.
OBJECTIVE
Patients requiring prolonged mechanical ventilation (PMV) are frequently deconditioned because of respiratory failure precipitated by the underlying disease, the adverse effects of medications, and a period of prolonged immobilization. The effects of 6 weeks of physical training on the strength of respiratory and limb muscles, on ventilator-free time, and on functional status in patients requiring PMV were examined.


METHODS
Thirty-nine patients with PMV were initially enrolled in the study and were assigned to either a treatment group (n=20) or a control group (n=19). Three subjects in the treatment group and 4 subjects in the control group died during the 6-week intervention period and thus their data were excluded from the final analysis.


METHODS
Subjects in the treatment group received physical training 5 days a week for 6 weeks. Strength of respiratory and limb muscles, ventilator-free time, and functional status, which was measured by the Barthel Index of Activities of Daily Living (BI) and Functional Independence Measure (FIM), were examined at baseline and at the third and sixth weeks of the study period.


RESULTS
Respiratory and limb muscle strength improved significantly at the third and sixth weeks in the treatment group compared with baseline measurements. Total BI and FIM scores increased significantly in the treatment group and remained unchanged in the control group. Effect sizes of the BI and FIM scores were 2.02 and 1.93, respectively, at the sixth week.


CONCLUSIONS
The results show that a 6-week physical training program may improve limb muscle strength and ventilator-free time and thus improve functional outcomes in patients requiring PMV.
Chiang
Ling-Ling
LL
School of Respiratory Therapy, Taipei Medical University, Taipei, Taiwan.
Wang
Li-Ying
LY
Wu
Chin-Pyng
CP
Wu
Huey-Dong
HD
Wu
Ying-Tai
YT
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001945:Breathing Exercises; D004185:Disability Evaluation; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D012121:Respiration, Artificial; D034941:Upper Extremity / Q000503:physiopathology*; D016138:Walking / Q000502:physiology