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Inspiratory Resistive Exercises (3.54)

Inspiratory Resistive Exercises (3.54) - Policies, Clinical, UWHC Clinical, Department Specific, Respiratory Care Services, Special Procedures

3.54

3.54 Inspiratory Resistive Exercises
Category: UWHC Clinical Policy
Effective Date: December 1, 2016
Version: Revision
Section: Respiratory Care - Special Procedures


I. PURPOSE:

To improve the strength and endurance of intact inspiratory muscles of patients with spinal cord injuries (SCI) at
thoracic vertebra 10 or above, who have a vital capacity (VC) less than 60% of predicted or negative inspiratory
force (NIF) less than 60cmH
2
O (with a leak). Inspiratory muscles are trained by having the patient inspire at a
constant preset pressure load.

II. POLICY:

A All patients will be assessed by the Respiratory Care Practitioner (RCP).
B. Therapy will be provided in accordance with a provider’s order
C. SCI patients will have a respiratory assessment done per Respiratory Therapy (RT) Protocol.

III. EQUIPMENT:

A. Inspiratory Muscle Trainer
B. NIF Meter with leak, one-way valve, mouthpiece, spirometer, nose clips

IV. PROCEDURE:

A. Review and acknowledge the provider’s order.
B. Review patient’s chart.
C. Obtain the appropriate equipment.
D. Introduce yourself to the patient and/or family. Explain the reason for the procedure.
E. Position the patient supine with their abdominal binder removed or loosened.
F. Measure the patient’s VC/NIF and compare to predicted values.
G. Adjust the threshold device to create a pressure equal to one half of the patient's maximal NIF.
H. Instruct the patient to breathe continuously, through the threshold device for 5 minutes.
1. This should be done at a steady, slow rate.
2. Nose clips may be beneficial.
3. Re-evaluate the set threshold if the patient cannot tolerate therapy for a full 5 minutes.
4. Therapy should be done twice a day for 5 min.
I. Assess the patient throughout the procedure.
1. The patient may be allowed to take short breaks.
2. The procedure may be revised to meet a specific patient’s needs.
J. Measure the patient's VC and NIF every Monday to monitor the patient's progress and adjust the
threshold as needed at that time.

V. REFERENCES:

A. Inspiratory Muscle Trainer instruction pamphlets.
B. Inspiratory Resistive Exercises HFFY #4914.
C. RT Protocol for SCI Follow Up Algorithm


Approved by the Director and Medical Director of Respiratory Care.
A copy of this Policy & Procedure is available in the Respiratory Care Office [E5/489].