Inspiratory Muscle Training and Its Impact on Weaning Success in Mechanically Ventilated ICU Patients: A Systematic Review
Abstract
1. Introduction
2. Materials and Methods
2.1. Eligibility Criteria
2.2. Outcome Measures
2.3. Data Sources and Search Strategy
2.4. Data Screening and Extraction
2.5. Quality Assessment
3. Results
3.1. Characteristics of the Included Studies
3.2. Risk of Bias of the Included Studies
3.3. Effect of IMT on Weaning Success, MIP, and RSBI
4. Discussion
4.1. Limitations
4.2. Future Directions
5. Conclusions
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
References
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Author (Year) | Study Design | Population | Sample Size | Intervention | Control Group | Outcomes | Results |
---|---|---|---|---|---|---|---|
Cader et al. (2010) [23] | RCT | Intubated elderly (at least 70 years old), mechanically ventilated for at least 48 h in ICU | n = 41 | n = 21 (57% F) Mean age: 83 ± 3 IMT using a threshold device with an initial load of 30% of MIP, 5 min 2×/day, everyday +usual care | n = 20 (50% F) Mean age: 82 ± 7 usual care only | MIP (vacuum manometer) RSBI (ventilometer) | MIP increased significantly more in the intervention group compared to the control group (p < 0.00001). RSBI decreased significantly more in the intervention group compared to the control group (p = 0.00259). |
Condessa et al. (2013) [17] | RCT | Adults receiving pressure support ventilation for at least 48 h | n = 92 | n = 45 (49% F) Mean age: 64 ± 17 IMT using threshold device with an initial load of 40% of MIP, 5 sets of 10 breaths 2×/day, every day +usual care | n = 47 (40% F) Mean age: 65 ± 15 Usual care only | MIP (vacuum manometer) RSBI (ventilometer) | Significant increase in MIP in the intervention group (p = 0.000089). No significant change in RSBI in both groups (p = 0.107). |
Sandoval Moreno et al. (2019) [18] | RCT | Adults in mechanical ventilation for at least 48 h or more | n = 126 Mean age: 57 | n = 62 (46.8% F) IMT with threshold IMT device adjusted to 50% of MIP, 3 series of 6–10 repetitions with 2 min rest between series, 2×/day, every day +conventional respiratory management | n = 64 (40.6% F) Conventional respiratory management | Weaning success MIP (digital manovacuometer) | No significant change in weaning success. (p = 0.54) No significant difference in the change of MIP between groups. (p = 0.48) |
Cader et al. (2012) [22] | RCT | Elderly intubated in an ICU for at least 48 h | n = 28 | n = 14 (57,14 F) Mean age: 82 ± 4 IMT with a threshold device initially adjusted to 30% of MIP, 5 min 2×/day, everyday +conventional physiotherapy | n = 14 (50% F) Mean age: 81 ± 6 Conventional physiotherapy | Weaning success MIP (vacuum manometer) RSBI (ventilometer) | No significant difference in weaning success between groups. (p = 0.20) MIP increased (p = 0.001), and RSBI decreased (p = 0.001) significantly in the intervention group compared to the control group. |
Caruso et al. (2015) [19] | RCT | Critically ill adults, mechanically ventilated for at least 72 h | n = 25 | n = 12 (33% F) Mean age: 67 ± 10 IMT performed by threshold device adjusted to 20% of MIP | n = 13 (31% F) Mean age: 66 ± 17 No respiratory muscle training | MIP (unidirectional valve) | Increase in MIP in the intervention group and a decrease in the control group, but not a significant (p = 0.34) |
Da Silva Guimarães et al. (2020) [24] | RCT | Adults under mechanical ventilation for at least 48 h | n = 101 | n = 48 (50% F) Mean age: 63 ± 16 IMT with EIMT with K-5 electronic Powerbreathe device + early mobilisation | n = 53 (53% F) Mean age: 69 ± 16 traditional T-piece protocol + early mobilisation | Weaning success MIP (digital vacuometer) | The intervention group had significantly better weaning success rates than the control group (p = 0.001). Significant increase in MIP in the intervention group compared to the control group (p = 0.003). |
Roceto Ratti et al. (2022) [20] | RCT | Critically ill adults receiving invasive mechanical ventilation for at least 48 h | n = 104 (26% F) Mean age: 55 ± 17 | n = 51 Subdivided into automatic EIMT (n = 25) and manual EIMT (n = 26) EIMT with KH2 electronic Powerbreathe device, 2x/day, every day, 3 sets of 10 repetitions with 1 min rest + usual care | n = 53 SB with T-piece + usual care | Weaning success MIP RSBI | No significant change in weaning success between groups (p = 0.45). Significant increase in MIP in both groups (p < 0.001). Significant decrease in RSBI in the control group (p = 0.03). |
Author (Year) | Random Sequence Generation | Deviations from the Intended Interventions | Missing Outcome Data | Measurement of Outcomes | Selection of the Reported Results | Overall Risk of Bias |
---|---|---|---|---|---|---|
Cader et al. (2010) [23] | Low risk | Low risk | Low risk | Low risk | Low risk | Low risk |
Condessa et al. (2013) [13] | Low risk | Low risk | Low risk | Low risk | Low risk | Low risk |
Sandoval Moreno et al. (2019) [18] | Low risk | Low risk | Low risk | Low risk | Low risk | Low risk |
Cader et al. (2012) [22] | Low risk | Some concerns | Low risk | Low risk | Low risk | Some concerns |
Caruso et al. (2005) [19] | Low risk | Some concerns | Low risk | Low risk | Some concerns | Some concerns |
Da Silva Guimarães et al. (2020) [24] | Some concerns | Low risk | Low risk | Low risk | Low risk | Some concerns |
Roceto Ratti et al. (2022) [20] | Low risk | Low risk | Low risk | Low risk | Low risk | Some concerns |
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Alonso-Pérez, J.L.; Riquelme-Aguado, V.; Rodríguez-Prieto, D.; López-Mejías, A.; Romero-Morales, C.; Rossettini, G.; Villafañe, J.H. Inspiratory Muscle Training and Its Impact on Weaning Success in Mechanically Ventilated ICU Patients: A Systematic Review. J. Funct. Morphol. Kinesiol. 2025, 10, 111. https://doi.org/10.3390/jfmk10020111
Alonso-Pérez JL, Riquelme-Aguado V, Rodríguez-Prieto D, López-Mejías A, Romero-Morales C, Rossettini G, Villafañe JH. Inspiratory Muscle Training and Its Impact on Weaning Success in Mechanically Ventilated ICU Patients: A Systematic Review. Journal of Functional Morphology and Kinesiology. 2025; 10(2):111. https://doi.org/10.3390/jfmk10020111
Chicago/Turabian StyleAlonso-Pérez, José Luís, Víctor Riquelme-Aguado, Daniel Rodríguez-Prieto, Alejandro López-Mejías, Carlos Romero-Morales, Giacomo Rossettini, and Jorge Hugo Villafañe. 2025. "Inspiratory Muscle Training and Its Impact on Weaning Success in Mechanically Ventilated ICU Patients: A Systematic Review" Journal of Functional Morphology and Kinesiology 10, no. 2: 111. https://doi.org/10.3390/jfmk10020111
APA StyleAlonso-Pérez, J. L., Riquelme-Aguado, V., Rodríguez-Prieto, D., López-Mejías, A., Romero-Morales, C., Rossettini, G., & Villafañe, J. H. (2025). Inspiratory Muscle Training and Its Impact on Weaning Success in Mechanically Ventilated ICU Patients: A Systematic Review. Journal of Functional Morphology and Kinesiology, 10(2), 111. https://doi.org/10.3390/jfmk10020111