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Efficacy of inspiratory muscle training in chronic heart failure patients: a systematic review and meta-analysis.
Int J Cardiol 2013; 167(4):1502-7IJ

Abstract

INTRODUCTION

Inspiratory muscle training (IMT) offers an alternative to exercise training (ExT) in the most severely deconditioned heart failure patients who are unable to exercise. We conducted a meta-analysis to determine magnitude of change in peak VO2, six minute walk distance (6MWD), Quality of Life measured by the Minnesota Living with Heart Failure Questionnaire (MLWHFQ), maximal inspiratory pressure (PI max) and ventilatory equivalent for carbon dioxide (VE/VCO2 slope) with IMT.

METHODS

A systematic search was conducted of randomized, controlled trials of IMT therapy in CHF patients using Medline (Ovid) (1950-February 2012), Embase.com (1974-February 2012), Cochrane Central Register of Controlled Trials and CINAHL (1981-February 2012). The search strategy included a mix of MeSH and free text terms for the key concepts heart failure, inspiratory or respiratory muscle training, exercise training

RESULTS

The eleven included studies contained data on 287 participants: 148 IMT participants and 139 sham or sedentary control. Compared to control groups, CHF patients undergoing IMT showed a significant improvement in peak VO2 (+1.83 ml kg(-1) min(-1), 95% C.I. 1.33 to 2.32 ml kg(-1) min(-1), p<0.00001); 6 MWD (+34.35 m, 95% C.I. 22.45 to 46.24 m, p<0.00001); MLWHFQ (-12.25, 95% C.I. -17.08 to -7.43, p<0.00001); PImax (+20.01, 95% C.I. 13.96 to 26.06, p<0.00001); and VE/VCO2 slope (-2.28, 95% C.I. -3.25 to -1.30, p<0.00001).

CONCLUSIONS

IMT improves cardio-respiratory fitness and quality of life to a similar magnitude to conventional exercise training and may provide an initial alternative to the more severely de-conditioned CHF patients who may then transition to conventional ExT.

Authors+Show Affiliations

School of Science and Technology, University of New England, Armidale, NSW 2351, Australia. nsmart2@une.edu.auNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

22560934

Citation

Smart, Neil A., et al. "Efficacy of Inspiratory Muscle Training in Chronic Heart Failure Patients: a Systematic Review and Meta-analysis." International Journal of Cardiology, vol. 167, no. 4, 2013, pp. 1502-7.
Smart NA, Giallauria F, Dieberg G. Efficacy of inspiratory muscle training in chronic heart failure patients: a systematic review and meta-analysis. Int J Cardiol. 2013;167(4):1502-7.
Smart, N. A., Giallauria, F., & Dieberg, G. (2013). Efficacy of inspiratory muscle training in chronic heart failure patients: a systematic review and meta-analysis. International Journal of Cardiology, 167(4), pp. 1502-7. doi:10.1016/j.ijcard.2012.04.029.
Smart NA, Giallauria F, Dieberg G. Efficacy of Inspiratory Muscle Training in Chronic Heart Failure Patients: a Systematic Review and Meta-analysis. Int J Cardiol. 2013 Aug 20;167(4):1502-7. PubMed PMID: 22560934.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of inspiratory muscle training in chronic heart failure patients: a systematic review and meta-analysis. AU - Smart,Neil A, AU - Giallauria,Francesco, AU - Dieberg,Gudrun, Y1 - 2012/05/03/ PY - 2012/02/14/received PY - 2012/04/09/accepted PY - 2012/5/8/entrez PY - 2012/5/9/pubmed PY - 2014/4/12/medline KW - Cardiorespiratory fitness KW - Exercise training KW - Inspiratory muscle training KW - Left ventricular dysfunction KW - Quality of life SP - 1502 EP - 7 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 167 IS - 4 N2 - INTRODUCTION: Inspiratory muscle training (IMT) offers an alternative to exercise training (ExT) in the most severely deconditioned heart failure patients who are unable to exercise. We conducted a meta-analysis to determine magnitude of change in peak VO2, six minute walk distance (6MWD), Quality of Life measured by the Minnesota Living with Heart Failure Questionnaire (MLWHFQ), maximal inspiratory pressure (PI max) and ventilatory equivalent for carbon dioxide (VE/VCO2 slope) with IMT. METHODS: A systematic search was conducted of randomized, controlled trials of IMT therapy in CHF patients using Medline (Ovid) (1950-February 2012), Embase.com (1974-February 2012), Cochrane Central Register of Controlled Trials and CINAHL (1981-February 2012). The search strategy included a mix of MeSH and free text terms for the key concepts heart failure, inspiratory or respiratory muscle training, exercise training RESULTS: The eleven included studies contained data on 287 participants: 148 IMT participants and 139 sham or sedentary control. Compared to control groups, CHF patients undergoing IMT showed a significant improvement in peak VO2 (+1.83 ml kg(-1) min(-1), 95% C.I. 1.33 to 2.32 ml kg(-1) min(-1), p<0.00001); 6 MWD (+34.35 m, 95% C.I. 22.45 to 46.24 m, p<0.00001); MLWHFQ (-12.25, 95% C.I. -17.08 to -7.43, p<0.00001); PImax (+20.01, 95% C.I. 13.96 to 26.06, p<0.00001); and VE/VCO2 slope (-2.28, 95% C.I. -3.25 to -1.30, p<0.00001). CONCLUSIONS: IMT improves cardio-respiratory fitness and quality of life to a similar magnitude to conventional exercise training and may provide an initial alternative to the more severely de-conditioned CHF patients who may then transition to conventional ExT. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/22560934/Efficacy_of_inspiratory_muscle_training_in_chronic_heart_failure_patients:_a_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(12)00450-0 DB - PRIME DP - Unbound Medicine ER -