# Respiratory Muscle Training in Mechanically Ventilated Adult Patients: Toward a Precise Prescription Based on Current Evidence: A Scoping Review

## TL;DR

This review examines how respiratory muscle training is prescribed for ventilated adults, aiming to standardize the approach based on current evidence.

## Contribution

The study provides a structured overview of RMT prescription protocols in mechanically ventilated patients, highlighting a commonly used and effective regimen.

## Key findings

- A threshold load training protocol at 40–50% of maximal inspiratory pressure was most frequently reported.
- Training was administered twice daily, every day, with 30 repetitions per session.
- The intervention improved inspiratory muscle strength and showed potential benefits for weaning success.

## Abstract

Respiratory muscle training (RMT) has been proposed as a supportive strategy for adults receiving invasive mechanical ventilation; however, the way RMT is prescribed—mode, intensity, frequency, and volume—remains highly heterogeneous. Objectives: This study aimed to describe the current evidence regarding the prescription of respiratory muscle strengthening in terms of frequency, intensity, method, and volume in adult patients under mechanical ventilation in intensive care units. Methods: A scoping review was conducted following the PRISMA-ScR guidelines based on searches in electronic databases including Scopus, SciELO, ScienceDirect, PubMed, LILACS, Springer, Web of Science, Google Scholar, PEDro, Dialnet, and Cochrane. Results: Seven studies met the established inclusion criteria and described prescription protocols for respiratory muscle strengthening in adult patients under mechanical ventilation in intensive care units. Conclusions: The most frequently reported protocol involved threshold load training at 40–50% of maximal inspiratory pressure, administered twice daily, every day of the week, with a volume of 30 repetitions. This intervention showed promising results in improving inspiratory muscle strength, with potential additional benefits in weaning success and pulmonary function.