Respiratory Muscle Training and Elastic Band Resistance Exercise to Duration of Mechanical Ventilation in Respiratory Care Center (RCC): A Preliminary Study in Taiwan Medical Center

Abstract

Background:

Although traditional rehabilitation exercise has been performed to improve respiratory muscle endurance and has been also applied to the weaning for the mechanical ventilation in patients with difficult weaning in ICU to refer RCC for dependent ventilator patients, practice is complicated. Elastic band resistance training easy to learn, not limited by space, but whether the affect to respiratory muscles will improve or how little is unclear. The study want to specific quantitative evidence-based training results and workups to support it in order to survey the strength, endurance of respiratory for short-term effectiveness, rather to increase the weaning rate in RCC.

Methods:

We picked up RCC units in Taiwan middle medical center arbitrarily and recruited their residents under continuous mechanical ventilation. Nineteen subjects were randomly enrolled who exclusion criteria were as follows: GCS≤8 with unable to match a command, life-threatening hypoxemia when measured weaning profile or practice elastic band resistance exercise. Our patients sit in semi-sitting position and composed of 6 movements of upper with lower extremity joints (flexion and extension exercise). It is performed for 10th of every movement during 4 weeks by 7th for a week, with band pull-up for 15 min for every time. The training program lasted for 28th or until the weaning ventilator completed. On the first and 28th, the respiratory muscle strength (PI max and PEmax), RSI were collected. Furthermore, we measured weaning profile parameter and recorded at the pre and post elastic band resistance exercise.

Results:

After having completed the elastic band resistance training intervention in the enroll patients, we find characteristic is: There were 13 (68%) men and 6 (32%) women with a mean age of 74.6 y (SD ± 9.00). The success weaning ventilator were 15 patients and mean duration length of stay is 43.3 days (ICU plus RCC). Compared with pre and post exercise and measure weaning profile in Table 1.

Conclusions:

Elastic band resistance exercise can extend respiratory muscle tolerance especially patients used mechanical ventilation and increase weaning rate (78%). Although pre and post are no difference in RSI, present patients accept well treatment in ICUs then refer RCC for further care for weaning program. This study need a large population should be carried out to confirm the favorable results cause it is still progress. By the way, if intervention in ICU perhaps increase weaning rate from mechanical ventilation.