Impact of inspiratory muscle training and early mobilization program during the peri-weaning period on body composition in critically ill surgical patients: A pilot randomized controlled trial
Attalekha Thammata, Salinee Worraphan, กวีศักดิ์ จิตตวัฒนรัตน์, Kanokkarn Juntaping, Mujalin Prasannarong*
Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai Province, Thailand; E-mail:
Background: A long period of mechanical ventilation and bed rest cause alterations in body composition which are associated with higher mortality. In particular there is an association with loss in muscle mass. Inspiratory muscle training (IMT) and early mobilization (EM) have been used to increase muscle activity, which leads to improvement in muscle mass and strength. IMT and EM have been shown to prevent intensive care unit-acquired weakness in critically ill patients. However, it is still not known whether they have any effect on body composition in critically ill patients.  
Objectives: To evaluate the effects of IMT and EM on body composition in critically ill surgical patients.
Materials  and  methods: Surgical patients at a single center in whom there had been failure at the first attempt of short weaning were randomized into two groups, a control group (n=12) and an experimental group (n=15). Usual care, IMT, and EM were provided in the experimental group, and only usual care was provided for the control group. Both groups were treated twice a day until 48 hours after extubation. The body composition was measured by bioelectrical impedance analysis before and after the treatment.
Results: After treatment, there were significant decreases from baseline in skeletal muscle mass (SMM), segmental lean of right arm (SLRA), segmental lean of left arm (SLLA), and segmental lean of trunk (SLTR) in the experimental group. In the control group, SLRA and SLTR showed significant decreases from baseline. However, there were no significant changes in segmental lean of right leg (SLRL), and segmental lean of left leg (SLLL), fat mass, and percent of body fat (PBF) in either group from baseline to after treatment. The multivariate regression analysis with adjustment for confounding factors showed no significant differences between the groups as regards body composition.
Conclusion: Inspiratory muscle training and early mobilization in conjunction with usual care did not improve body composition when compared to solely usual care in critically ill surgical patients.
Journal of Associated Medical Sciences ปี 2564, January-April ปีที่: 54 ฉบับที่ 1 หน้า 58-66
Mechanical ventilation, Respiratory muscle training, Body composition, early mobilization