Effects of Inspiratory Muscle Training and Positive Expiratory Pressure on Mechanically Ventilated Restrictive Lung Disease Patients

Restrictive lung diseases (RLD) represent a significant cause of morbidity, often necessitating intensive interventions such as mechanical ventilation due to diminished lung compliance (LC) and reduced total lung capacity (TLC). Mechanical ventilation, while vital, is associated with ventilator-induced diaphragmatic dysfunction (VIDD), leading to rapid muscle atrophy and impeding patient recovery. This proposed study aims to evaluate the clinical impact of IMT and PEP on improving respiratory muscle strength, lung compliance and mobilizing secretions (effective cough reflex) in patients with RLD who require mechanical ventilation.

Inclusion Criteria: * Patients aged between 18 and 60 years. * Diagnosed with restrictive lung disease (RLD), including interstitial lung diseases, idiopathic pulmonary fibrosis, chest wall deformities, or neuromuscular diseases. * Admitted to the ICU and requiring invasive mechanical ventilation for more than 48 hours. * Glasgow Coma Scale score over 13, inspiratory pressures below -20 cmH2O, oxygen saturation above 90%, tidal volumes exceeding 5ml/kg, respiratory rates under 35 breaths per minute * Hemodynamically stable at the time of enrolment (as determined by the treating physician). Exclusion Criteria: * Pre-existing chronic obstructive pulmonary disease (COPD) or other primary obstructive pathologies. * Hemodynamic instability (e.g., requiring high-dose vasopressors). * Active pneumothorax or untreated bronchopleural fistula. * History of cranial or facial trauma, recent thoracic or abdominal surgery contraindicating the intervention. * Pre-existing cognitive impairment or inability to comprehend and cooperate with the training protocol.