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Is there any benefit using low-intensity inspiratory and peripheral muscle training in heart failure? A randomized clinical trial.
Clin Res Cardiol. 2017 Sep; 106(9):676-685.CR

Abstract

BACKGROUND

Inspiratory and peripheral muscle training improves muscle strength, exercise tolerance, and quality of life in patients with chronic heart failure (HF). However, studies investigating different workloads for these exercise modalities are still lacking.

OBJECTIVE

To examine the effects of low and moderate intensities on muscle strength, functional capacity, and quality of life.

DESIGN

A randomized controlled trial.

METHODS

Thirty-five patients with stable HF (aged >18 years, NYHA II/III, LVEF <40%) were randomized to: non-exercise control group (n = 9), low-intensity training group (LIPRT, n = 13, 15% maximal inspiratory workload, and 0.5 kg of peripheral muscle workload) or moderate-intensity training group (MIPRT, n = 13, 30% maximal inspiratory workload and 50% of one maximum repetition of peripheral muscle workload). The outcomes were: respiratory and peripheral muscle strength, pulmonary function, exercise tolerance by the 6-minute walk test, symptoms based on the NYHA functional class, and quality of life using the Minnesota Living with Heart Failure Questionnaire.

RESULTS

All groups showed similar quality-of-life improvements. Low and moderate intensities training programs improved inspiratory muscle strength, peripheral muscle strength, and walking distance. However, only moderate intensity improved expiratory muscle strength and NYHA functional class in HF patients.

CONCLUSIONS

The low-intensity inspiratory and peripheral resistance muscle training improved inspiratory and peripheral muscle strength and walking distance, demonstrating that LIPRT is an efficient rehabilitation method for debilitated HF patients. In addition, the moderate-intensity resistance training also improved expiratory muscle strength and NYHA functional class in HF patients.

Authors+Show Affiliations

Department of Physiotherapy, LIM-34, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 Room 1150, São Paulo, SP, 01246-930, Brazil.Dante Pazzanese Institute of Cardiology São Paulo State, Av. Dr. Dante Pazzanese, 500, São Paulo, SP, Brazil.Department of Physiotherapy, LIM-34, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 Room 1150, São Paulo, SP, 01246-930, Brazil.Heart Institute - HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 44, São Paulo, SP, Brazil.Dante Pazzanese Institute of Cardiology São Paulo State, Av. Dr. Dante Pazzanese, 500, São Paulo, SP, Brazil.Dante Pazzanese Institute of Cardiology São Paulo State, Av. Dr. Dante Pazzanese, 500, São Paulo, SP, Brazil.Dante Pazzanese Institute of Cardiology São Paulo State, Av. Dr. Dante Pazzanese, 500, São Paulo, SP, Brazil.Department of Physical Therapy, University of Miami, Coral Gables, FL, USA.Department of Physiotherapy, LIM-34, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 Room 1150, São Paulo, SP, 01246-930, Brazil. naomikondo@uol.com.br.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28255812

Citation

Kawauchi, Tatiana Satie, et al. "Is There Any Benefit Using Low-intensity Inspiratory and Peripheral Muscle Training in Heart Failure? a Randomized Clinical Trial." Clinical Research in Cardiology : Official Journal of the German Cardiac Society, vol. 106, no. 9, 2017, pp. 676-685.
Kawauchi TS, Umeda IIK, Braga LM, et al. Is there any benefit using low-intensity inspiratory and peripheral muscle training in heart failure? A randomized clinical trial. Clin Res Cardiol. 2017;106(9):676-685.
Kawauchi, T. S., Umeda, I. I. K., Braga, L. M., Mansur, A. P., Rossi-Neto, J. M., Guerra de Moraes Rego Sousa, A., Hirata, M. H., Cahalin, L. P., & Nakagawa, N. K. (2017). Is there any benefit using low-intensity inspiratory and peripheral muscle training in heart failure? A randomized clinical trial. Clinical Research in Cardiology : Official Journal of the German Cardiac Society, 106(9), 676-685. https://doi.org/10.1007/s00392-017-1089-y
Kawauchi TS, et al. Is There Any Benefit Using Low-intensity Inspiratory and Peripheral Muscle Training in Heart Failure? a Randomized Clinical Trial. Clin Res Cardiol. 2017;106(9):676-685. PubMed PMID: 28255812.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is there any benefit using low-intensity inspiratory and peripheral muscle training in heart failure? A randomized clinical trial. AU - Kawauchi,Tatiana Satie, AU - Umeda,Iracema Ioco Kikuchi, AU - Braga,Lays Magalhães, AU - Mansur,Antonio de Pádua, AU - Rossi-Neto,João Manoel, AU - Guerra de Moraes Rego Sousa,Amanda, AU - Hirata,Mário Hiroyuki, AU - Cahalin,Lawrence P, AU - Nakagawa,Naomi Kondo, Y1 - 2017/03/02/ PY - 2016/11/01/received PY - 2017/02/08/accepted PY - 2017/3/4/pubmed PY - 2018/7/14/medline PY - 2017/3/4/entrez KW - Cardiac rehabilitation KW - Functional capacity KW - Heart failure KW - Resistance exercise KW - Respiratory muscles SP - 676 EP - 685 JF - Clinical research in cardiology : official journal of the German Cardiac Society JO - Clin Res Cardiol VL - 106 IS - 9 N2 - BACKGROUND: Inspiratory and peripheral muscle training improves muscle strength, exercise tolerance, and quality of life in patients with chronic heart failure (HF). However, studies investigating different workloads for these exercise modalities are still lacking. OBJECTIVE: To examine the effects of low and moderate intensities on muscle strength, functional capacity, and quality of life. DESIGN: A randomized controlled trial. METHODS: Thirty-five patients with stable HF (aged >18 years, NYHA II/III, LVEF <40%) were randomized to: non-exercise control group (n = 9), low-intensity training group (LIPRT, n = 13, 15% maximal inspiratory workload, and 0.5 kg of peripheral muscle workload) or moderate-intensity training group (MIPRT, n = 13, 30% maximal inspiratory workload and 50% of one maximum repetition of peripheral muscle workload). The outcomes were: respiratory and peripheral muscle strength, pulmonary function, exercise tolerance by the 6-minute walk test, symptoms based on the NYHA functional class, and quality of life using the Minnesota Living with Heart Failure Questionnaire. RESULTS: All groups showed similar quality-of-life improvements. Low and moderate intensities training programs improved inspiratory muscle strength, peripheral muscle strength, and walking distance. However, only moderate intensity improved expiratory muscle strength and NYHA functional class in HF patients. CONCLUSIONS: The low-intensity inspiratory and peripheral resistance muscle training improved inspiratory and peripheral muscle strength and walking distance, demonstrating that LIPRT is an efficient rehabilitation method for debilitated HF patients. In addition, the moderate-intensity resistance training also improved expiratory muscle strength and NYHA functional class in HF patients. SN - 1861-0692 UR - https://www.unboundmedicine.com/medline/citation/28255812/Is_there_any_benefit_using_low_intensity_inspiratory_and_peripheral_muscle_training_in_heart_failure_A_randomized_clinical_trial_ L2 - https://dx.doi.org/10.1007/s00392-017-1089-y DB - PRIME DP - Unbound Medicine ER -