Our findings differ, however, from those of one randomised trial (Caruso et al 2005). In this trial, inspiratory muscle training was achieved by increasing

the pressure required to trigger pressure support, and the outcomes were the duration of the weaning period and the rate of re-intubation in XAV 939 critically ill patients. The experimental and control groups did not differ significantly in terms of the weaning period (p = 0.24) and the maximum inspiratory pressure final value (p = 0.34). One possible explanation for the discrepancy between the studies is that inspiratory muscle training via reduction of sensitivity of the pressure support trigger only offers an initial resistance to the opening of the valve of the system, while inspiratory muscle training with a threshold device maintains resistance to the respiratory system for the period of the inspiration. Other studies have also reported differences in the clinical efficacy of inspiratory muscle training when delivered by a threshold device versus another method ( Johnson et al 1996). The beneficial effect Selleck LY2835219 of inspiratory muscle training on the index of Tobin in this study indicates a more relaxed breathing pattern. This is consistent with a study of inspiratory muscle training

in 23 healthy adults (Huang et al 2003). After training, a significant increase in maximum inspiratory pressure was observed, which had a significant negative correlation

PDK4 with the significant reduction in respiratory stimulation P0.1. These data suggest that a reduced time of P0.1 results in a reduction in the occurrence of dyspnoea. Inspiratory muscle training in the experimental group was found to contribute to a significant increase in maximum inspiratory pressure and to a reduction in the index of Tobin. These are considered to be good predictors of weaning, which is consistent with our finding that inspiratory muscle training significantly reduces the weaning period in patients who did not die or receive a tracheostomy. We conclude that inspiratory muscle training improves inspiratory muscle strength in older intubated patients. In patients who do not die or receive a tracheostomy, it may also reduce weaning time. eAddenda: Tables 3 and 5 available at www.jop.physiotherapy.asn.au Ethics: Committee of Ethics in Research Involving Human Beings of the Euro-American Network of Human Kinetics – REMH (protocol number: 005/2007). Informed consent was obtained from each participant’s relatives with no refusals, and the experimental procedures were executed in accordance with the Declaration of Helsinki from 1975. Competing interests: None declared. We are grateful to the physiotherapists in the Center of Intensive Therapy for their help with measurement. “
“Hypertension is an important and common co-morbidity associated with stroke, diabetes mellitus, cardiac and renal disease.