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Muscle strength and endurance as predictors of successful extubation in mechanically ventilated patients : a pilot study
Dissertation (MPhysT (Physiotherapy))--University of Pretoria, 2016.
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| Format: | Thesis |
| Language: | English |
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2026
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| _version_ | 1867613712782721024 |
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| access_status_str | Open Access |
| author2 | van Rooijen, A.J. |
| author_browse | van Rooijen, A.J. |
| author_facet | van Rooijen, A.J. |
| collection | Thesis |
| description | Dissertation (MPhysT (Physiotherapy))--University of Pretoria, 2016. |
| format | Thesis |
| id | oai:repository.up.ac.za:2263/110024 |
| institution | University of Pretoria (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:40:30.710Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| record_format | dspace |
| source_str | UPSpace — University of Pretoria Institutional Repository |
| spelling | oai:repository.up.ac.za:2263/110024 Muscle strength and endurance as predictors of successful extubation in mechanically ventilated patients : a pilot study van Rooijen, A.J. crdebeer@gmail.com Pretorius, J.P. De Beer, Rubine prolonged mechanical ventilation Intensive care unit (ICU) extubation failure weaning from mechanical ventilation respiratory muscle strength peripheral muscle strength muscle endurance measuring muscle strength measuring muscle endurance. Dissertation (MPhysT (Physiotherapy))--University of Pretoria, 2016. Prolonged mechanical ventilation is detrimental to the human body. It increases the risk of critical illness myopathy / polyneuropathy and decreases the patient’s functional ability. Weaning patients from mechanical ventilation is time consuming. Delay in the weaning process increases the complication rate of mechanical ventilation as well as the cost involved. On the other hand a too aggressive weaning process and early extubation can lead to an increase in re-intubation. Patients are usually extubated after successfully completing the spontaneous breathing trial (SBT), yet 10% to 20% of those patients that complete the SBT successfully still fail extubation. Extubation failure is associated with an increased length of stay in the Intensive care unit (ICU), increased financial expenditure and mortality rate. The mortality rate increases with 20% to 50% when patients are reintubated after failed extubation. A variety of parameters including respiratory rate (RR), tidal volume (VT), rapid shallow breathing index (RSBI), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), partial pressure of arterial oxygen to fraction of inspired oxygen ratio (PaO2/FiO2 ratio) and cough strength are used as predictors of extubation readiness. Determining extubation readiness is very complex and no test in isolation can predict the extubation outcome. Previous studies showed an association between peripheral and respiratory muscle weakness. Currently no study has determined the association between muscle strength (Deltoid, Sternocleidomastoid and Trapezius), endurance and extubation readiness. The aim of this study was to determine if muscle strength and endurance can be used as indicators of successful extubation in mechanically ventilated patients. A pilot study of 30 patients was conducted to test the muscle strength and endurance of mechanically ventilated patients. The patients’ level of cooperation and cognition were determined with a combination of the Richmond AgitationSedation Scale (RASS), Confusion Assessment Method for ICU (CAM-ICU) and v the Five Point Questionnaire before muscle strength and endurance testing were commenced. The muscle strength of the Deltoid, Sternocleidomastoid and Trapezius muscles were tested with the Oxford grading scale. Muscle endurance was determined by riding the MOTOmed® letto2 cycle ergometer for five minutes. The respiratory muscle strength was tested by using the MIP and MEP measurements with the ventilators. The patients’ subjective experience of pain was evaluated with the Numeric Rating Scale (NRS). Exploratory data analysis was used to determine the differences in parameters between the patients who failed extubation and the patients who were successfully extubated. As the numbers were small, continuous data were analysed nonparametrically. Proportions were evaluated with a Chi square test as well as a nonparametric test for linear trend. Data were analysed using R3.1.1 and STATA version 13 software. P-values ≤ 0.05 were regarded as statistically significant. The results demonstrated that muscle strength (Deltoid and Sternocleidomastoid muscles) and muscle endurance were associated with successful extubation. Patients ventilated for more than three days with a grade three muscle strength of Deltoid and Sternocleidomastoid muscles respectively had a 100% chance of successful extubation (p = 0.038). The results of the Trapezius muscle strength testing were not associated with successful extubation (p = 0.366). Patients not riding the MOTOmed® letto2 cycle ergometer actively with the upper limbs for 4.5 min and covering a distance of 0.5 km showed a high chance (p = 0.006) to fail extubation. The results also showed that the number of days a patient was admitted to ICU was associated with successful extubation. Patients admitted for 11 and more days were prone to fail extubation (p = 0.012). The number of days a patient was ventilated did not show significant results for an association between ventilated days and successful extubation. Developing indicators (possible predictors) of successful extubation is essential to improve the safety of extubation. Indicators such as muscle strength and endurance will assist the treating physician to assess the patient’s readiness for extubation. It will also assist the physiotherapist in planning rehabilitation programs needed for preparation of extubation. Successful safe extubation will decrease the vi ICU length of stay, the hospital length of stay, the total cost involved and it will increase the patient’s functional ability and quality of life post hospital discharge. Physiotherapy MPhysT (Physiotherapy) 2026-05-15T17:26:06Z 2026-05-15T17:26:06Z 16/07/12 2016 Dissertation http://hdl.handle.net/2263/110024 en application/pdf |
| spellingShingle | prolonged mechanical ventilation Intensive care unit (ICU) extubation failure weaning from mechanical ventilation respiratory muscle strength peripheral muscle strength muscle endurance measuring muscle strength measuring muscle endurance. Muscle strength and endurance as predictors of successful extubation in mechanically ventilated patients : a pilot study |
| title | Muscle strength and endurance as predictors of successful extubation in mechanically ventilated patients : a pilot study |
| title_full | Muscle strength and endurance as predictors of successful extubation in mechanically ventilated patients : a pilot study |
| title_fullStr | Muscle strength and endurance as predictors of successful extubation in mechanically ventilated patients : a pilot study |
| title_full_unstemmed | Muscle strength and endurance as predictors of successful extubation in mechanically ventilated patients : a pilot study |
| title_short | Muscle strength and endurance as predictors of successful extubation in mechanically ventilated patients : a pilot study |
| title_sort | muscle strength and endurance as predictors of successful extubation in mechanically ventilated patients a pilot study |
| topic | prolonged mechanical ventilation Intensive care unit (ICU) extubation failure weaning from mechanical ventilation respiratory muscle strength peripheral muscle strength muscle endurance measuring muscle strength measuring muscle endurance. |
| url | http://hdl.handle.net/2263/110024 |