Silvia Correa Bacelar

Inspiratory muscle training improves maximal inspiratory pressure and may assist weaning in older intubated patients: a randomised trial

QUESTIONS Does inspiratory muscle training improve maximal inspiratory pressure in intubated older people? Does it improve breathing pattern and time to wean from mechanical ventilation? DESIGN Randomised trial with concealed allocation and intention-to-treat analysis. PARTICIPANTS 41 elderly, intubated adults who had been mechanically ventilated for at least 48 hr in an intensive care unit. INTERVENTION The experimental group received usual care plus inspiratory muscle training using a threshold device, with an initial load of 30% of their maximal inspiratory pressure, increased by 10% (absolute) daily. Training was administered for 5 min, twice a day, 7 days a week from the commencement of weaning until extubation. The control group received usual care only. OUTCOME MEASURES The primary outcome was the change in maximal inspiratory pressure during the weaning period. Secondary outcomes were the weaning time (ie, from commencement of pressure support ventilation to successful extubation), and the index of Tobin (ie, respiratory rate divided by tidal volume during a 1-min spontaneous breathing trial). RESULTS Maximal inspiratory pressure increased significantly more in the experimental group than in the control group (MD 7.6 cmH(2)0, 95% CI 5.8 to 9.4). The index of Tobin decreased significantly more in the experimental group than in the control group (MD 8.3 br/min/L, 95% CI 2.9 to 13.7). In those who did not die or receive a tracheostomy, time to weaning was significantly shorter in the experimental group than in the control group (MD 1.7 days, 95% CI 0.4 to 3.0). CONCLUSIONS In intubated older people, inspiratory muscle training improves maximal inspiratory pressure and the index of Tobin, with a reduced weaning time in some patients. TRIAL REGISTRATION NCT00922493.

Programas de treinamento muscular respiratório: impacto na autonomia funcional de idosos

.A crescente proporcao de idosos com incapacidades e fragi-lizados nas capitais brasileiras, a reducao da disponibilidade de cuidado familiar e transferencias intergeracionais no contexto urbano, a inexistencia de servicos de apoio social e de saude, o alto custo do cuidado domiciliar, moradias com espaco fisico reduzidos e estruturas com riscos para quedas e a violencia contra o idoso sao considerados fatores de risco para a institucionalizacao

Efectos crónicos de un programa de alargamiento pasivo sobre los valores de la presión arterial sanguínea y el estrés en adultos con hipertensión arterial. (Chronics effects of a passive stretching program on the blood pressures and stress levels of hypertensions adults).

Purpose of this study was verifier the chronics effects of passive stretching programs on the stress and blood pressure levels of adults with arterial hype...