Effect of Integrated Respiratory and Functional Training on Weaning from Mechanical Ventilation, Respiratory and Peripheral Muscle Strength, Functional Ability, and Pain After Emergency Abdominal Surgery: A Randomized Controlled Trial
In brief
Added functional training raised successful ventilator weaning to 96% after emergency surgery
In a 90-patient randomized trial, adding functional training to inspiratory muscle training and chest physiotherapy raised weaning success from 82% to 96%. Patients also had shorter weaning and ICU stays, less pain, and better strength and function, but inspiratory muscle strength improved similarly in both groups. The results need confirmation beyond two ICUs and this specific surgical population.
- Journal
- Archives of physical medicine and rehabilitation (Q1)
- Published
- 9 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Sherin Hassan Mohammed Mehani, Ayman A Mohamed, Mohamed Sayed Mohamed, Mahmoud Ibrahim Mohamed Mahmoud
- PMID
- 42854888
- DOI
- 10.1016/j.apmr.2026.10.005
Why clinicians should know about it
- Picked for Critical Care and Intensive Care Medicine (top studies of the week, 11 October 2026): Weaning success, functional training improves ICU outcomes
Abstract
OBJECTIVE: To compare the effects of integrated respiratory and functional (multidimensional functional) training versus high-intensity inspiratory muscle training (IMT) plus conventional chest physiotherapy (CPT) on ventilator weaning after emergency abdominal surgery. DESIGN: Prospective, multicenter, parallel-group, randomized controlled trial. SETTING: Two intensive care units. PARTICIPANTS: Ninety mechanically ventilated patients with difficult weaning following emergency abdominal surgery (N=90). INTERVENTIONS: Participants were randomly assigned (1:1) to the study group and control groups. The study group received multidimensional functional training, high-intensity IMT and conventional chest physiotherapy. The control group received high-intensity IMT and conventional chest physiotherapy. MAIN OUTCOME MEASURES: Primary outcomes were weaning success and maximal inspiratory pressure (MIP). Secondary outcomes included rapid shallow breathing index (RSBI), peripheral muscle strength, Functional Independence Measure (FIM), pain, weaning duration, and intensive care unit (ICU) length of stay. RESULTS: Weaning success was significantly higher in the study group (95.6% vs 82.2%; P = .044). Both groups significantly improved MIP, with no between-group difference after treatment (mean difference [MD]=0.30 cmH₂O; 95% confidence interval [CI], -4.11 to 4.72; P=0.89). Compared with control group, the study group demonstrated significantly greater improvements in all peripheral muscle strength measures and FIM domains (all P<0.001), greater reductions in RSBI (MD=-3.92 breaths/min/L; 95% CI, -6.85 to -1.00; P=0.01) and pain (MD=3.22; 95% CI, 3 to 3.44; P<0.001), and shorter weaning duration (MD=-5.82 days; 95% CI, -7.98 to -3.67; P<0.001) and ICU length of stay (MD=-7.74 days; 95% CI, -11.37 to -4.11; P<0.001). CONCLUSIONS: Both training approaches improved MIP, whereas multidimensional functional training resulted in higher weaning success and greater improvements in peripheral muscle strength, functional independence, pain, weaning duration, and ICU length of stay than high-intensity IMT+CPT in patients following emergency abdominal surgery.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.