• Salinee Worraphan, Attalekha Thammata, Kaweesak Chittawatanarat, Surasak Saokaew, Kirati Kengkla, and Mujalin Prasannarong.
• Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai.
• Arch Phys Med Rehabil. 2020 Nov 1; 101 (11): 2002-2014.

ObjectiveTo compare the effectiveness and rank order of physical therapy interventions, including conventional physical therapy (CPT), inspiratory muscle training (IMT), and early mobilization (EM) on mechanical ventilation (MV) duration and weaning duration.Data SourcesPubMed, The Cochrane Library, Scopus, and CINAHL complete electronic databases were searched through August 2019.Study SelectionRandomized controlled trials (RCTs) investigating the effect of IMT, EM, or CPT on MV duration and the weaning duration in patients with MV were included. Studies that were determined to meet the eligibility criteria by 2 independent authors were included. A total of 6498 relevant studies were identified in the search, and 18 RCTs (934 participants) were included in the final analysis.Data ExtractionData were extracted independently by 2 authors and assessed the study quality by the Cochrane risk-of-bias tool. The primary outcomes were MV duration and weaning duration.Data SynthesisVarious interventions of physical therapy were identified in the eligible studies, including IMT, IMT+CPT, EM, EM+CPT, and CPT. The data analysis demonstrated that compared with CPT, IMT+CPT significantly reduced the weaning duration (mean difference; 95% confidence interval) (-2.60; -4.76 to -0.45) and EM significantly reduced the MV duration (-2.01; -3.81 to -0.22). IMT+CPT and EM had the highest effectiveness in reducing the weaning duration and MV duration, respectively.ConclusionIMT or EM should be recommended for improving the weaning outcomes in mechanically ventilated patients. However, an interpretation with caution is required due to the heterogeneity.Copyright © 2020 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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