Inspiratory Muscle training in patients with traumatic brain injury undergoing prolonged mechanical ventilation: Randomized controlled trial study

INTERVENTION: Device E02.190.525.186 The patients will be enrolled in this study by random allocation done by www.randomization.com. In the intervention group, 30 patients will do inspiratory muscle training through K5 eletronic device with load of 50% of maximal inspiratory pressure, 6 sets with 5 breath each set , with 2 minutes recovery interval.In the control group, 30 patients just will do conventional physical therapy (bronquial clearance techniques, motor physical therapy and bed positioning) CONDITION: C10.900.300 E02.041.625 individuals with traumatic head injury with invasive mechanical ventilation at least 72 hours ; C10.900.300 ; E02.041.625 PRIMARY OUTCOME: Increase of maximum inspiratory pressure measured by manovacuometer in cm H2O with occlusion valve after 14 days of muscular training proposed in this study, through a variation of 10% pre and post intervention Increased of ciaphragm muscle thickness in centimeters assessed by ultrasonography 14 days after training, through a variation of 10% pre and post intervention SECONDARY OUTCOME: Increase of peripheral muscle strength by medical research council sum score MRC, with a change of 20% pre and post intervention. Increase of the weaning success rate assessed by the percentage of patients who remained without mechanical ventilation for more than 48 hours in patients who underwent the inspiratory muscle training, with a change of 20% pre and post intervention. INCLUSION CRITERIA: adults (aged from 18 to 60 years); traumatic brain injury individuals with mechanical ventilation stay at least 72 hours