title: Effects of exercise training on pulmonary mechanics and functional status in patients with prolonged mechanical ventilation.
abstract: BACKGROUND
  The functional status and outcomes in patients with prolonged mechanical ventilation (PMV) are often limited by poor endurance and pulmonary mechanics, which result from the primary diseases or prolonged time bedridden. We evaluate the impact of exercise training on pulmonary  mechanics, physical functional status, and hospitalization outcomes in PMV patients.
  
  
  METHODS
  Twenty-seven subjects with PMV in our respiratory care center (RCC) were divided randomly into an exercise training group (n = 12) and a control group (n = 15). The exercise program  comprised 10 sessions of exercise training. The measurement of pulmonary mechanics and physical functional status (Functional Independence Measurement and Barthel index) were performed pre-study and post-study. The hospitalization outcomes included: days of mechanical ventilation, hospitalization  days, and weaning and mortality rates during RCC stay.
  
  
  RESULTS
  The training group had significant improvement in tidal volume (143.6 mL vs 192.5 mL, P = .02) and rapid shallow breathing index after training (162.2 vs 110.6, P = .009). No significant change was found in the control  group except respiratory rate. Both groups had significant improvement in functional status during the study. However, the training group had greater changes in FIM score than the control group (44.6 vs 34.2, P = .024). The training group also had shorter RCC stay and higher weaning  and survival rates than the control group, although no statistical difference was found.
  
  
  CONCLUSIONS
  Subjects with PMV in our RCC demonstrated significant improvement in pulmonary mechanics and functional status after exercise training. The application of exercise training may be helpful  for PMV patients to improve hospitalization outcomes.
authors.affiliation: Department of Respiratory Care, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Yen-Huey
authors.initials: YH
authors.lastname: Chen
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Lin
authors.forename: Hsiu-Feng
authors.initials: HF
authors.lastname: Hsiao
authors.forename: Lan-Ti
authors.initials: LT
authors.lastname: Chou
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Kao
authors.forename: Chung-Chi
authors.initials: CC
authors.lastname: Huang
authors.forename: Ying-Huang
authors.initials: YH
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015444:Exercise; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology*; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D015656:Respiratory Mechanics / Q000502:physiology*; D015996:Survival Rate; D013990:Tidal Volume / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome