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Updated: Jun 13, 2026
Inspiratory Muscle Training as an Adjunct to the Treatment of Weaning Failure in Critically Ill Patients: A Practical Guide
Published on: January 30, 2026
Inspiratory muscle training in a child with nemaline myopathy and organ transplantation
Barbara K Smith1, Mark S Bleiweis, Joni Zauhar
1Department of Physical Therapy University of Florida, Gainesville, FL, USA. bksmithphhp.ufl.edu
Insights
Inspiratory muscle strength training improved breathing in a child with nemaline myopathy after transplantation. This intervention helped wean the patient from ventilatory support, showing promise for similar cases.
Area of Science:
- Pediatric critical care medicine
- Respiratory physiology
- Neuromuscular disorders
Background:
- Nemaline myopathy poses significant cardiorespiratory challenges, particularly post-transplantation.
- Delayed ventilatory recovery is a critical concern in pediatric patients with complex medical histories.
Observation:
- A 16-year-old female with nemaline myopathy experienced prolonged ventilatory insufficiency following cardiac and renal transplantation.
- The patient required continuous noninvasive ventilatory support.
Findings:
- Inspiratory muscle strength training (IMST) was implemented for 2 weeks, 5 days/week.
- Maximal inspiratory pressure significantly improved from -36.7 cm H2O to -77.8 cm H2O.
- The patient was successfully weaned from ventilatory assist to her baseline function.
Implications:
- IMST can be a valuable therapeutic strategy for pediatric patients with nemaline myopathy and ventilatory insufficiency.
- This approach may enhance recovery and reduce reliance on mechanical ventilation in complex pediatric cases.
- Further research into IMST protocols for neuromuscular disorders is warranted.
Objective:
To report the use of inspiratory muscle strength training to treat repeated ventilatory insufficiency in a child with nemaline myopathy who underwent cardiac and renal transplantation.
Design:
Case report.
Setting:
Pediatric intensive care unit of a tertiary care university teaching hospital.
Patient:
A 16-yr-old female with nemaline myopathy affecting cardiorespiratory function, recent organ transplantation, and delayed postoperative ventilatory recovery.
Intervention:
Inspiratory muscle strength training was provided 5 days weekly for 2 wks, accompanied by progressive weaning from noninvasive ventilation.
Measurements And Main Results:
Maximal inspiratory pressure increased from -36.7 cm H2O to -77.8 cm H2O, accompanied by improved inspiratory flow, volume, pressure activation and power. During the training period, the patient was weaned from continuous noninvasive ventilatory assist to her preoperative level of ventilatory function.
Conclusion:
Inspiratory muscle training may be a beneficial component of care for children with nemaline myopathy who experience acute ventilatory insufficiency.
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