@article{Grigoriadis2021,

title = {Handgrip Force and Maximum Inspiratory and Expiratory Pressures in Critically Ill Patients With a Tracheostomy},

author = {K. Grigoriadis and I. Efstathiou and Z. Dimitriadis and G. Konstantopoulou and A. Grigoriadou and G. Vasileiadis and M. Micha and I. Tsagaris and A. Armaganidis},

doi = {doi: 10.4037/ajcc2021248},

year  = {2021},

date = {2021-09-01},

journal = {Am J Crit Care},

volume = {30},

number = {2},

pages = {e48-e53},

abstract = {Background: 

The association between peripheral striated muscle strength and respiratory muscle strength has been confirmed in a number of disorders. However, this association is unknown in intensive care unit patients with tracheostomies.



Objective: 

To examine correlations between handgrip force, maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP) in intensive care unit patients with tracheostomies.



Methods: 

Twenty patients (7 women, 13 men) with tracheostomies, in the intensive care unit longer than 11 days, in stable condition, with functional limbs, and with Glasgow Coma Scale scores of 15 were recruited. Both MIP and MEP were measured with a membrane manometer; handgrip force was measured with a hydraulic hand dynamometer.



Results: 

Handgrip force was significantly correlated with MIP (r = 0.45, P = .04) and MEP (r = 0.78, P = .001). Handgrip force was significantly predicted by MIP and MEP when the effect of sex was controlled for (P < .05). However, when MIP and MEP were included as predictors in a regression model, MEP was the only significant predictor (R = 0.80, R2 = 0.63, adjusted R2 = 0.57).



Conclusions: 

Strength of the hand flexors and strength of the expiratory muscles (abdominal) were significantly correlated in intensive care unit patients. Handgrip strength appears to be an easy, fast way to evaluate expiratory muscle strength by using a simple handhold command without special equipment. A strong handhold may also correspond to strong expiratory muscles. ClinicalTrials.gov: NCT03457376.

},

keywords = {patient, physiotherapy, tracheostomy},

pubstate = {published},

tppubtype = {article}

}

@article{Koumantakis2020,

title = {Addressing Fear Avoidance and Self-efficacy Beliefs to Reduce Disability in Patients with Non-specific Low Back Pain: From Theory to Application},

author = {G.A. Koumantakis},

doi = {doi: 10.31080/ASOR.2020.03.0238},

year  = {2020},

date = {2020-09-01},

journal = {AS Orthopaedics},

volume = {3},

number = {12},

pages = {43-51},

keywords = {low back pain, patient, physical therapy},

pubstate = {published},

tppubtype = {article}

}

@article{Patsaki2020,

title = {The combination of inspiratory muscle training and high-flow nasal cannula oxygen therapy for promoting weaning outcomes in difficult-to-wean patients: protocol for a randomised controlled trial},

author = {I. Patsaki and A. Christakou and E. Papadopoulos and M. Katartzi and A. Kouvarakos and I. Siempos and D. Tsimouris and A. Skoura and A. Xatzimina and S. Malachias and Ν. Koulouris and E. Grammatopoulou and S. Zakinthinos and E. Ischaki},

doi = {doi: 10.1183/23120541.00088-2020 },

year  = {2020},

date = {2020-09-01},

journal = {ERJ Open Res},

volume = {6},

number = {3},

abstract = {Background:

According to the literature, 20–30% of intubated patients are difficult to wean off mechanical ventilation and have a prolonged intensive care unit (ICU) stay with detrimental effects on muscle strength, functional ability and quality of life. Inspiratory muscle training (IMT) via a threshold device has been proposed as an effective exercise for minimising the effects of mechanical ventilation on respiratory muscles of critically ill patients with prolonged weaning. In addition, high-flow nasal cannula (HFNC) oxygen has been proved to provide efficient support for both high- and low-risk patients after extubation, thus preventing re-intubation.



Material and methods: 

A randomised controlled trial was designed to assess the efficacy of combining IMT and HFNC as therapeutic strategies for patients with high risk for weaning failure. Once patients with prognostic factors of difficult weaning are awake, ventilated with support settings and cooperative, they will be randomised to one of the two following study groups: intervention group (IMT and HFNC) and control group (IMT and Venturi mask). IMT will start as soon as possible. Each allocated oxygen delivery device will be applied immediately after extubation. IMT intervention will continue until patients' discharge from ICU. The primary outcome is the rate of weaning failure. Secondary outcomes are maximal inspiratory and expiratory strength, endurance of respiratory muscles, global muscle strength, functional ability and quality of life along with duration of ventilation (days) and ICU and hospital length of stay.



Conclusion:

The present study could significantly contribute to knowledge of how best to treat patients with difficult weaning and high risk of re-intubation.},

keywords = {high-flow nasal cannula oxygen, inspiratory muscle, patient},

pubstate = {published},

tppubtype = {article}

}