Effect of Rib Mobilization on Weaning Parameters From Mechanical Ventilator in Patients With Pneumonia

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-10

Study Completion Date

2026-05-20

Brief Summary

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this study will be conducted to distinguish between effect of rib mobilization and routine chest physiotherapy on weaning parameters from mechanical ventilator in patients with pneumonia •

HYPOTHESES:

It will be hypothesized that there may be significant effect of rib mobilization on weaning parameters from mechanical ventilator in patients with pneumonia.

RESEARCH QUESTION:

Does rib mobilization have an effect on weaning parameters from mechanical ventilator in patients with pneumonia? measuring weaning parameters: on screen of mechanical ventilator : measuring respiratory rate, Tidal volume (TV), FiO2.

* Arterial blood gases (ABG) analyzer machine ABG is recorded daily (PH- PaO2 - PaCO2)
* Length of ICU stay: calculated by (admission date - discharge date
* Weaning success rate

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Detailed Description

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Ventilator-associated pneumonia (VAP) represents a significant sub-set of (HAP) remains the most frequent intensive care unit (ICU)-acquired infection its incidence ranges from 9% to 27% of ventilated patients ,VAP is associated with an increased length of stay, mortality and health care costs, Pneumonia can result in chest wall stiffness, decreased mobility, limiting the range of motion during breathing and decreased lung compliance and impaired respiratory function , Rib mobilization: is an articular , non-invasive, passive technique that can be useful with acutely ill, hospitalized patients emphasizes the placement of a repetitive force to increase the range of motion of the posterior rib articulations and chest wall , lessening somatic dysfunction of the spine, stretches myofascial structures and improve respiratory mechanics So, this study will be conducted to distinguish between effect of rib mobilization and routine chest physiotherapy on weaning parameters among intubated pneumonic patients on mechanical vent.

Conditions

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Pneumonia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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rib mobilization technique and routine chest physiotherapy group

1.rib mobilization technique and routine chest physio therapy group: the patients will receive rib mobilization technique in addition to their medical treatment and routine chest physiotherapy for at least 30 minutes once daily for ten consecutive days

Group Type EXPERIMENTAL

rib mobilization technique

Intervention Type OTHER

rib mobilization technique The patient in experimental group will be relaxed in semi- fowler position while connected to mechanical ventilator, therapist will seat at the patient "side, his fingers pads are placed at the position of the patient's rib angles , pulling upward and the lateral position the position is held while wait for the soft tissues to release this take from 15 seconds .Release of the diaphragm through manual contact with hypothenar region of therapist thumb inferior laterally xiphoid process and rest along Antero lateral costal margin below rib7 during exhalation the therapist thumb give pressure posteriorly repeat this steps for 3 to5 respiratory cycle • routine chest physiotherapy percussion on chest wall its frequency should be 3-7 beats per sec. vibration applying a light pressure with hand on affected segment for about 5 min modified postural drainage R. and L. side. U\&L limb passive ex. for R.10 x3 set

.this program for 30 minutes once daily for ten days

routine chest physiotherapy

Intervention Type OTHER

routine chest physiotherapy the patient will be laid in half supine position connected to a ventilator applying

* percussion on chest wall its frequency should be 3-7 beats per second or 180-420 beats per minute
* vibration applying a light pressure with flattened hand on affected segment for about 5 minutes
* modified postural drainage (right and left sidling 10 min for each side
* upper and lower limb exercise for 4 limbs (3 sets and each set has 10 repetition
* this program for 30 minutes once daily
* for 10 consecutive days

routine chest physiotherapy group

routine chest physiotherapy group : the patients in this group will receive routine chest physical therapy for at least 30 minutes once daily for 10 consecutive days

Group Type ACTIVE_COMPARATOR

routine chest physiotherapy

Intervention Type OTHER

routine chest physiotherapy the patient will be laid in half supine position connected to a ventilator applying

* percussion on chest wall its frequency should be 3-7 beats per second or 180-420 beats per minute
* vibration applying a light pressure with flattened hand on affected segment for about 5 minutes
* modified postural drainage (right and left sidling 10 min for each side
* upper and lower limb exercise for 4 limbs (3 sets and each set has 10 repetition
* this program for 30 minutes once daily
* for 10 consecutive days

Interventions

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rib mobilization technique

rib mobilization technique The patient in experimental group will be relaxed in semi- fowler position while connected to mechanical ventilator, therapist will seat at the patient "side, his fingers pads are placed at the position of the patient's rib angles , pulling upward and the lateral position the position is held while wait for the soft tissues to release this take from 15 seconds .Release of the diaphragm through manual contact with hypothenar region of therapist thumb inferior laterally xiphoid process and rest along Antero lateral costal margin below rib7 during exhalation the therapist thumb give pressure posteriorly repeat this steps for 3 to5 respiratory cycle • routine chest physiotherapy percussion on chest wall its frequency should be 3-7 beats per sec. vibration applying a light pressure with hand on affected segment for about 5 min modified postural drainage R. and L. side. U\&L limb passive ex. for R.10 x3 set

.this program for 30 minutes once daily for ten days

Intervention Type OTHER

routine chest physiotherapy

routine chest physiotherapy the patient will be laid in half supine position connected to a ventilator applying

* percussion on chest wall its frequency should be 3-7 beats per second or 180-420 beats per minute
* vibration applying a light pressure with flattened hand on affected segment for about 5 minutes
* modified postural drainage (right and left sidling 10 min for each side
* upper and lower limb exercise for 4 limbs (3 sets and each set has 10 repetition
* this program for 30 minutes once daily
* for 10 consecutive days

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Patient's age ranged from 40- 50 years old from both genders.
2. Diagnosed with pneumonia and need invasive mechanical ventilation support.
3. Stable oxygen saturation (SpO2 more than 85, (FiO2) 0.6 or less, PEEP less than 10 Cm H2O).
4. mean arterial pressure \> 75 mmHg and urine output \> 1 mL/kg/h;
5. Patients with Glasgow coma scale (GCS) \> 8T
6. Unconscious and semi-conscious patients. -

Exclusion Criteria

1. Unstable hemodynamics
2. Unstable neurological problems e.g. (epileptic seizures -hyperthermia).
3. Unstable chest wall e.g. (multiple rib or vertebral fractures)
4. Increase intracranial pressure (\>20 mmHg for \>5 min).
5. Undrained pneumothorax, recent pulmonary surgery

Minimum Eligible Age

40 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No