NCT06597136

Brief Summary

Investigation of the effects of respiratory muscles on the early functional system and respiratory function in the kinesiological period in intensive care patients.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
48

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Sep 2024

Shorter than P25 for not_applicable

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 1, 2024

Completed
5 months until next milestone

Study Start

First participant enrolled

September 15, 2024

Completed
4 days until next milestone

First Posted

Study publicly available on registry

September 19, 2024

Completed
12 days until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2024

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

November 10, 2024

Completed
Last Updated

September 19, 2024

Status Verified

September 1, 2024

Enrollment Period

16 days

First QC Date

May 1, 2024

Last Update Submit

September 12, 2024

Conditions

Keywords

intensive carerespiratory muscle strengthrespiratory functionkinesiotape

Outcome Measures

Primary Outcomes (20)

  • Respiratory Muscle Strength

    Maximal inspiratory pressure (MIP) is a measure of the strength of inspiratory muscles, primarily the diaphragm, and allows for the assessment of ventilatory failure, restrictive lung disease and respiratory muscle strength. MIP is measured at residual volume of lung.

    3 days

  • Respiratory Muscle Strength

    For respiratory muscle strength, maximal expiratory pressure (MEP) will evaluate using an electronic pressure transducer. MEP is measured from total lung capacity.particularly the diaphragm, while MEPs measure the strength of abdominal and intercostal muscles. For respiratory muscle strength, maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) were evaluated using an electronic pressure transducer. MIP was measured at residual volume, and MEP was measured from total lung capacity

    3 days

  • Richmond Agitation-Sedation Scale

    Interrater reliability. In many intensive care units, the Richmond Agitation-Sedation Scale(RASS) is used to assess the level of sedation. This scale is designed with a three-step procedure that can help give a RASS score range of -5 to +4.The RASS score ranges from -5 (unarousable) to +4 (combative), with 0 meaning alert and calm.

    3 days

  • SOFA (Sequential Organ Failure Assessment)

    It evaluates morbidity through six systems (liver, central nervous system, respiratory system, cardiovascular system,renal and coagulation). For each system, points between 1 and 4 are given and the total score is evaluated between 6 and 24. In this score, as the score increases for each system, organ failure is considered to occur.

    3 days

  • Visuel Anaolog Scale

    A Visual Analogue Scale (VAS) is one of the pain rating scales used for the first time in 1921 by Hayes and Patterson\[1\]. It is often used in epidemiologic and clinical research to measure the intensity or frequency of various symptoms.For pain intensity according to VAS, "no pain" is usually rated as 0 points and "worst pain imaginable" as 10 points. Ranges for pain intensity; \<3. mild pain, 3-6 moderate pain, \>6 severe pain

    3 days

  • The Glasgow Coma Scale

    It is a tool that healthcare providers use to measure decreases in consciousness. The scores from each section of the scale are useful for describing disruptions in nervous system function and also help providers track changes. It's the most widely used tool for measuring comas and decreases in consciousness.The components of the Glasgow Coma Scale include 4 different scores for the eye-opening response, 5 for the verbal response, and 6 for the motor response. The total score has values between 3 and 15. Three is the worst and 15 is the highest.

    3 days

  • APACHE II Score

    It is a general measure of disease severity based on current physiologic measurements, age \& previous health conditions. The score can help in the assessment of patients to determine the level \& degree of diagnostic \& therapeutic intervention.APACHE II total score consists of three subheadings: acute physiology score, age and chronic health assessment; the highest value is 71. Mortality is 25% when the total score is 25, and increases to 80% when the total score is 35 and above.

    3 days

  • Chelsea Critical Care Physical Assessment Tool (CPAx)

    İt is a test used on male and female patients in the intensive care unit (ICU) to assess physical and respiratory function impairments and morbidity.

    3 days

  • Body temperature

    The average normal body temperature is generally accepted as 37°C. Some studies have shown that the "normal" body temperature can have a wide range, from 36.1°C to 37.2°C

    3 days

  • Blood pressure

    Normal blood pressure for most adults is defined as a systolic pressure of less than 120 and a diastolic pressure of less than 80. Elevated blood pressure is defined as a systolic pressure between 120 and 129 with a diastolic pressure of less than 80.

    3 days

  • Respiratory rate

    The normal range of breathing rate per minute in an average adult, for a person at rest, is 12 - 20 breaths per minute. Any person having a breathing rate under 12 or over 25 is considered to be breathing abnormally.

    3 days

  • Pulse rate

    The normal pulse for healthy adults ranges from 60 to 100 beats per minute. The pulse rate may fluctuate and increase with exercise, illness, injury, and emotions.

    3 days

  • The Physical Function in ICU Test

    The PFIT-s is a battery outcome measure involving four components: sit to stand assistance, marching on the spot cadence, shoulder flexor and knee extensor strength.

    3 days

  • Hand Strength

    Hand muscle strength will be measured with a jamar device

    3 days

  • Modified Borg Dyspnea Scale

    It is a categorical scale with a score from 0 to 10, where 0 represents normal breathing and 10 represents maximum dyspnea.

    3 days

  • Pa02

    It is the partial pressure of oxygen in arterial blood. It is used to evaluate oxygenation.Normal values are 80-100 mmHg.

    3 days

  • PaC02

    It is the partial pressure of carbon dioxide in arterial blood. It is an indicator of alveolar ventilation. Normal values are 35-45 mmHg.

    3 days

  • HCO3

    It is the serum concentration of bicarbonate ion. It is an important buffer in the blood and is used to evaluate the metabolic component of acid-base balance. Standard bicarbonate: It is the bicarbonate value that should be present in the blood under standard conditions (37°C temperature and 40 mmHg PCO2). Normally it is 22-26 mEq/L.

    3 days

  • Ph

    It is used to determine the H+ status of the blood. It shows that the patient is in acidosis or alkalosis, but it is not possible to understand the type by pH. Normal values are 7.35-7.45.

    3 days

  • Confusion Assessment Method for the ICU

    The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) is a tool used to assess delirium among patients in the intensive care unit. The CAM-ICU assesses for the four features of delirium:Feature 1 is an acute change in mental status or a fluctuating mental status, Feature 2, is inattention, Feature 3,is altered level of consciousness and Feature 4, is disorganized thinking. patients in the intensive care unit

    3 days

Study Arms (4)

Diaphragmatic kinesiology taping

EXPERIMENTAL

The taping on the diaphragm from the abdomen was performed when the participant was standing and breathed-out and the body was in extension. The base of the tape was about 1 inch below the xiphoid process area. Then the arms were lifted above the head and, with maximum deep inspiration and after maximum rib cage expansion, the tails were applied with 10% tension on the rib cage. Diaphragmatic kinesiology taping will be applied in addition to conventional treatment for 3 days. To evaluate the effectiveness of the application, vital signs, respiratory muscle strength, grip strength, blood gas analysis, dyspnea and fatigue will be evaluated. Additionally, Richmond Agitation Sedation Scale (RASS), Non-Verbal Pain Scale, Glaskow coma scale, Physical Function Test in Intensive Care (PFIT)- CPax (Chelsea Critical Care Physical Assessment Tool) scales will be used.

Other: Diaphragmatic kinesiology taping

Accessory respiratory muscle kinesiology taping

EXPERIMENTAL

Tapings of the accessory inspiratory muscles were applied in a sitting posture. Sternocleidomastoideus taping was applied when the neck of the participant was in lateral flexion to the opposite side to be taped and in rotation to the same side; and anterior and medius scalene tapings were applied when the neck of the participant was in the lateral flexion position to the opposite side to be taped. Tapings were repeated on the opposite side.Taping was applied to accessory expiratory muscles in the supine position. While the participant was supporting one leg in the hip and knee flexion position on the bed, the other leg was extended from the bed and the hip was kept in the extension position. The obliquus externus muscle was taped on the side with hip-knee flexion and the obliquus internus muscle was taped on the side with hip extension.In addition to conventional treatment, kinesiology taping will be applied to the accessory respiratory muscles for 3 days.

Other: Accessory respiratory muscle kinesiology taping

Sham kinesiology taping

SHAM COMPARATOR

Sham kinesiology taping will be applied for 3 days. Sham KT was performed with the same taping material. A 2-blocked I strip was applied vertically to the sternum. The same procedures were followed. To evaluate the effectiveness of the application, vital signs, respiratory muscle strength, grip strength, blood gas analysis, dyspnea and fatigue will be evaluated. Additionally, Richmond Agitation Sedation Scale (RASS), Non-Verbal Pain Scale, Glaskow coma scale, Physical Function Test in Intensive Care (PFIT)- CPax (Chelsea Critical Care Physical Assessment Tool) scales will be used.

Other: Sham kinesiology taping

Control Group

NO INTERVENTION

Conventional treatment will be applied in the control group. Participants' vital signs, respiratory muscle strength, grip strength, blood gas analysis, dyspnea and fatigue will be evaluated. Additionally, Richmond Agitation Sedation Scale (RASS), Non-Verbal Pain Scale, Glaskow coma scale, Physical Function Test in Intensive Care (PFIT)- CPax (Chelsea Critical Care Physical Assessment Tool) scales will be used.

Interventions

The taping on the diaphragm from the abdomen was performed when the participant was standing and breathed-out and the body was in extension. The base of the tape was about 1 inch below the xiphoid process area. Then the arms were lifted above the head and, with maximum deep inspiration and after maximum rib cage expansion, the tails were applied with 10% tension on the rib cage. Diaphragmatic kinesiology taping will be applied in addition to conventional treatment for 3 days.

Diaphragmatic kinesiology taping

Tapings of the accessory inspiratory muscles were applied in a sitting posture. Sternocleidomastoideus taping was applied when the neck of the participant was in lateral flexion to the opposite side to be taped and in rotation to the same side; and anterior and medius scalene tapings were applied when the neck of the participant was in the lateral flexion position to the opposite side to be taped. Tapings were repeated on the opposite side.Taping was applied to accessory expiratory muscles in the supine position. While the participant was supporting one leg in the hip and knee flexion position on the bed, the other leg was extended from the bed and the hip was kept in the extension position. The obliquus externus muscle was taped on the side with hip-knee flexion and the obliquus internus muscle was taped on the side with hip extension.In addition to conventional treatment, kinesiology taping will be applied to the accessory respiratory muscles for 3 days.

Accessory respiratory muscle kinesiology taping

Sham kinesiology taping will be applied for 3 days. Sham KT was performed with the same taping material. A 2-blocked I strip was applied vertically to the sternum. The same procedures were followed.

Sham kinesiology taping

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Individuals receiving inpatient treatment in intensive care who volunteer to participate in the research or who are allowed by their first-degree relatives if they are unconscious,
  • Being over 18 years of age
  • Being eligible to receive physiotherapy and rehabilitation from an intensive care physician
  • Are in clinically stable condition

You may not qualify if:

  • Patients with coagulation disorders (PT (Prothrombin Time); INR (International Normalized Ratio) value higher than 1.5 and platelet amount less than 50,000 m³)
  • Patients with signs of increased intracranial pressure
  • Skin wounds, ulcerations, allergic reactions
  • Patients in contact isolation due to infection
  • In shock
  • Having malignancy
  • Having multiple organ failure
  • Having visual impairment
  • Patients who are unconscious

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (12)

  • Berger D, Bloechlinger S, von Haehling S, Doehner W, Takala J, Z'Graggen WJ, Schefold JC. Dysfunction of respiratory muscles in critically ill patients on the intensive care unit. J Cachexia Sarcopenia Muscle. 2016 Sep;7(4):403-12. doi: 10.1002/jcsm.12108. Epub 2016 Mar 9.

    PMID: 27030815BACKGROUND
  • Makhabah DN, Martino F, Ambrosino N. Peri-operative physiotherapy. Multidiscip Respir Med. 2013 Jan 23;8(1):4. doi: 10.1186/2049-6958-8-4.

    PMID: 23343253BACKGROUND
  • Yousefnia-Darzi F, Hasavari F, Khaleghdoost T, Kazemnezhad-Leyli E, Khalili M. Effects of thoracic squeezing on airway secretion removal in mechanically ventilated patients. Iran J Nurs Midwifery Res. 2016 May-Jun;21(3):337-42. doi: 10.4103/1735-9066.180374.

    PMID: 27186214BACKGROUND
  • Kalanuria AA, Ziai W, Mirski M. Ventilator-associated pneumonia in the ICU. Crit Care. 2014 Mar 18;18(2):208. doi: 10.1186/cc13775. No abstract available.

    PMID: 25029020BACKGROUND
  • Ratnovsky A, Elad D, Halpern P. Mechanics of respiratory muscles. Respir Physiol Neurobiol. 2008 Nov 30;163(1-3):82-9. doi: 10.1016/j.resp.2008.04.019. Epub 2008 May 15.

    PMID: 18583200BACKGROUND
  • Castro-Avila AC, Seron P, Fan E, Gaete M, Mickan S. Effect of Early Rehabilitation during Intensive Care Unit Stay on Functional Status: Systematic Review and Meta-Analysis. PLoS One. 2015 Jul 1;10(7):e0130722. doi: 10.1371/journal.pone.0130722. eCollection 2015.

    PMID: 26132803BACKGROUND
  • Parker A, Sricharoenchai T, Needham DM. Early Rehabilitation in the Intensive Care Unit: Preventing Physical and Mental Health Impairments. Curr Phys Med Rehabil Rep. 2013 Dec;1(4):307-314. doi: 10.1007/s40141-013-0027-9.

    PMID: 24436844BACKGROUND
  • Morris D, Jones D, Ryan H, Ryan CG. The clinical effects of Kinesio(R) Tex taping: A systematic review. Physiother Theory Pract. 2013 May;29(4):259-70. doi: 10.3109/09593985.2012.731675. Epub 2012 Oct 22.

    PMID: 23088702BACKGROUND
  • Jang MH, Shin MJ, Shin YB. Pulmonary and Physical Rehabilitation in Critically Ill Patients. Acute Crit Care. 2019 Feb;34(1):1-13. doi: 10.4266/acc.2019.00444. Epub 2019 Feb 28.

    PMID: 31723900BACKGROUND
  • Zeng R, Tian K, Xiao Z. Effectiveness of thoracic kinesio taping on respiratory function and muscle strength in patients with chronic obstructive pulmonary disease: A protocol of randomized, double-blind placebo-controlled trial. Medicine (Baltimore). 2021 Apr 9;100(14):e25269. doi: 10.1097/MD.0000000000025269.

    PMID: 33832089BACKGROUND
  • Denehy L, de Morton NA, Skinner EH, Edbrooke L, Haines K, Warrillow S, Berney S. A physical function test for use in the intensive care unit: validity, responsiveness, and predictive utility of the physical function ICU test (scored). Phys Ther. 2013 Dec;93(12):1636-45. doi: 10.2522/ptj.20120310. Epub 2013 Jul 25.

    PMID: 23886842BACKGROUND
  • Corner EJ, Wood H, Englebretsen C, Thomas A, Grant RL, Nikoletou D, Soni N. The Chelsea critical care physical assessment tool (CPAx): validation of an innovative new tool to measure physical morbidity in the general adult critical care population; an observational proof-of-concept pilot study. Physiotherapy. 2013 Mar;99(1):33-41. doi: 10.1016/j.physio.2012.01.003. Epub 2012 Mar 30.

    PMID: 23219649BACKGROUND

MeSH Terms

Conditions

Respiratory Aspiration

Condition Hierarchy (Ancestors)

Respiration DisordersRespiratory Tract DiseasesPathologic ProcessesPathological Conditions, Signs and Symptoms

Study Officials

  • Yasemin Çırak, Prof Dr.

    İstinye University

    STUDY DIRECTOR

Central Study Contacts

ELİF ÖRSELOĞLU, Msc

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Masking Details
In the 1st group, only conventional treatment will be applied, in the 2nd group, diaphragmatic kinesiology taping will be applied in addition to conventional treatment, in the 3rd group, kinesiological taping will be applied to the auxiliary respiratory muscles in addition to conventional treatment, and in the 4th group, sham taping will be applied.
Purpose
SUPPORTIVE CARE
Intervention Model
SEQUENTIAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

May 1, 2024

First Posted

September 19, 2024

Study Start

September 15, 2024

Primary Completion

October 1, 2024

Study Completion

November 10, 2024

Last Updated

September 19, 2024

Record last verified: 2024-09

Data Sharing

IPD Sharing
Will not share

Study Protocol, Statistical Analysis Plan (SAP), Informed Consent Form (ICF), Clinical Study Report (CSR) might be considered to be shared with clinicians studying in the same field one year after the publication of the study