SynthesisAnnals of the American Thoracic Society2018
Inspiratory Muscle Rehabilitation in Critically Ill Adults. A Systematic Review and Meta-Analysis.
Synthesis in Annals of the American Thoracic Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 73 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Can High Intensity Inspiratory Muscle Training Improve Inspiratory Muscle Strength and Accelerate Weaning in Medical Patients With Difficulty on Weaning Admitted in the Intensive Care Unit?
Improving Our Understanding of Respiratory Muscle Training to Facilitate Weaning From Mechanical Ventilation in the ICU
Muscle Recruitment During Neck Flexion and Inspiratory Muscle Training in Difficult and Prolonged Weaning Patients: a Physiological Study - The FLEX Study
Effect of Early Extracorporeal Diaphragm Pacing （EDP） Combined With Tilt Table Verticalization （TTV) on Diaphragm Function in Critically Ill Patients With Mechanical Ventilation: a Randomized Controlled Trial.
Who cites it
73 citing papers in PubMed, 12 syntheses or guidelines pooled it, 186 citations in OpenAlex.
- Respiratory muscle dysfunction in mechanical ventilation: a systematic review and meta-analysis of biological mechanisms.Journal of applied physiology (Bethesda, Md. : 1985) · 2026Pooled it
- The Effects of Inspiratory Muscle Training in Critically ill Adults: A Systematic Review and Meta-Analysis.Journal of intensive care medicine · 2026Pooled it
- The effect of respiratory training on lung function in intensive care unit patients: a systematic review and meta-analysis.BMC pulmonary medicine · 2026Pooled it
- The intensive care medicine research agenda for the management of ICU acquired weakness: a multinational, interprofessional perspective.Intensive care medicine · 2025Pooled it
- Pooled it
- Inspiratory muscle training for chronic critically ill patients: a systematic review and meta-analysis of randomized controlled trials.Einstein (Sao Paulo, Brazil) · 2025Pooled it
- Low-Medium and High-Intensity Inspiratory Muscle Training in Critically Ill Patients: A Systematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2024Pooled it
- Effectiveness of Nonpharmacological Interventions in the Field of Ventilation: An Umbrella Review.International journal of environmental research and public health · 2023Pooled it
- Non-Pharmacological Interventions for Minimizing Physical Restraints Use in Intensive Care Units: An Umbrella Review.Frontiers in medicine · 2022Pooled it
- Efficacy of Physiotherapy Interventions on Weaning in Mechanically Ventilated Critically Ill Patients: A Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- ICU-acquired weakness.Intensive care medicine · 2020Pooled it
- Joint Statement on the Role of Respiratory Rehabilitation in the COVID-19 Crisis: The Italian Position Paper.Respiration; international review of thoracic diseases · 2020Guideline
- Intermittent neck flexion induces greater sternocleidomastoid deoxygenation than inspiratory threshold loading.European journal of applied physiology · 2024Trial
- Transcutaneous electrical diaphragmatic stimulation in mechanically ventilated patients: a randomised study.Critical care (London, England) · 2023Trial
- Randomized Clinical Study of Temporary Transvenous Phrenic Nerve Stimulation in Difficult-to-Wean Patients.American journal of respiratory and critical care medicine · 2022Trial
- Safety and feasibility of inspiratory muscle training for hospitalized patients undergoing hematopoietic stem cell transplantation: a randomized controlled study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020Trial
- Abdominal functional electrical stimulation to assist ventilator weaning in critical illness: a double-blinded, randomised, sham-controlled pilot study.Critical care (London, England) · 2019Trial
- Effects of a respiratory and neurological rehabilitation treatment plan in post Covid-19 affected university students. Randomized clinical study.Chronic respiratory diseaseTrial
- ASSOBRAFIR clinical practice guidelines in intensive care physical therapy: Rehabilitation strategies in critically ill adults.Brazilian journal of physical therapy · 2026Review
- Lung- and diaphragm-protective mechanical ventilation in acute respiratory distress syndrome.Intensive care medicine · 2026Review
13 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors at 10 institutions in 7 countries.
Funding
Abstract
rationaleRespiratory muscle weakness is common in critically ill patients; the role of targeted inspiratory muscle training (IMT) in intensive care unit rehabilitation strategies remains poorly defined.
objectivesThe primary objective of the present study was to describe the range and tolerability of published methods for IMT. The secondary objectives were to determine whether IMT improves respiratory muscle strength and clinical outcomes in critically ill patients.
methodsWe conducted a systematic review to identify randomized and nonrandomized studies of physical rehabilitation interventions intended to strengthen the respiratory muscles in critically ill adults. We searched the MEDLINE, Embase, HealthSTAR, CINAHL, and CENTRAL databases (inception to September Week 3, 2017) and conference proceedings (2012 to 2017). Data were independently extracted by two authors and collected on a standardized report form.
resultsA total of 28 studies (N = 1,185 patients) were included. IMT was initiated during early mechanical ventilation (8 studies), after patients proved difficult to wean (14 studies), or after extubation (3 studies), and 3 other studies did not report exact timing. Threshold loading was the most common technique; 13 studies employed strength training regimens, 11 studies employed endurance training regimens, and 4 could not be classified. IMT was feasible, and there were few adverse events during IMT sessions (nine studies; median, 0%; interquartile range, 0-0%). In randomized trials (n = 20), IMT improved maximal inspiratory pressure compared with control (15 trials; mean increase, 6 cm H
conclusionsMost studies of IMT in critically ill patients have employed inspiratory threshold loading. IMT is feasible and well tolerated in critically ill patients and improves both inspiratory and expiratory muscle strength. The impact of IMT on clinical outcomes requires future confirmation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.