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Moderate-to-high intensity inspiratory muscle training improves the effects of combined training on exercise capacity in patients after coronary artery bypass graft surgery: A randomized clinical trial.
Int J Cardiol. 2019 Mar 15; 279:40-46.IJ

Abstract

BACKGROUND

The effects of adding moderate-to-high intensity inspiratory muscle training (IMT) to short-term aerobic and resistance exercise (combined training [CT]), after coronary artery bypass grafting (CABG) are not established. This study aimed to determine the effects of moderate-to-high intensity IMT + CT on exercise capacity, respiratory muscle strength, inspiratory muscle endurance, quality of life (QoL), and laboratory biomarkers in patients after CABG who were participants of a phase II cardiac rehabilitation program.

METHODS

Twenty-four patients were randomly assigned to either the IMT + CT group (n = 12), who performed moderate-to-high intensity IMT with CT or the sham-IMT + CT group (n = 12). Patients completed two sessions per week for 12 weeks. Each patient underwent a cardiopulmonary exercise test, six-minute walk test (6MWT), respiratory muscle strength and endurance evaluation, QoL questionnaire, and serum advanced oxidation protein products, ferric reducing antioxidant power [FRAP], nitrate/nitrate, and high-sensitivity C-reactive protein, before and after the 12-week intervention.

RESULTS

The IMT + CT group showed significantly greater improvements in peak oxygen uptake (1.3 mL∙kg-1∙min-1; 95% confidence interval [95% CI], 0.5 to 2.2), distance covered during the 6MWT (78.8 m; 95% CI, 28.1 to 129.5), maximal inspiratory pressure (23.0 cmH2O; 95% CI, 9.3 to 36.7), QoL (-15.1 points; 95% CI, -26.9 to -3.3), and FRAP (83.7 μmol/L; 95% CI, 20.2 to 147.1) compared to the sham-IMT + CT group as a result of the intervention.

CONCLUSIONS

Short-term moderate-to-high intensity IMT with CT provided additional benefits in exercise capacity, inspiratory muscle strength, QoL, and antioxidant profile in patients after CABG. Trial Registration clinicaltrials.gov Identifier: NCT02885077.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Dos Santos TD
Functional Rehabilitation Graduate Program, Department of Physiotherapy and Rehabilitation, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil.
Pereira SN
Cardiology Service of Hospital Universitário de Santa Maria (HUSM), Empresa Brasileira de Serviços Hospitalares (EBSERH), Santa Maria, Rio Grande do Sul, Brazil.
Portela LOC
Laboratory of Performance in Simulated Environment, Department of Collective Sports, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil.
Cardoso DM
Pneumological Sciences Graduate Program, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil.
Lago PD
Research Group on Cardiopulmonary Interaction (GPIC), Health Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.
Dos Santos Guarda N
Laboratory of Clinical Biochemistry, Department of Clinical and Toxicological Analysis, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil.
Moresco RN
Laboratory of Clinical Biochemistry, Department of Clinical and Toxicological Analysis, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil.
Pereira MB
Functional Rehabilitation Graduate Program, Department of Physiotherapy and Rehabilitation, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil; Hospital Universitário de Santa Maria (HUSM), Empresa Brasileira de Serviços Hospitalares (EBSERH), Santa Maria, Rio Grande do Sul, Brazil.
de Albuquerque IM
Functional Rehabilitation Graduate Program, Department of Physiotherapy and Rehabilitation, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil. Electronic address: albuisa@gmail.com.

MeSH

AgedBreathing ExercisesCoronary Artery BypassDouble-Blind MethodExerciseExercise TestFemaleHumansInhalationMaleMiddle AgedMuscle StrengthPhysical EndurancePostoperative CareRespiratory MusclesTreatment Outcome

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

30581100

Clinical Trial Links

Clinical trial which this article describes

Citation

Dos Santos, Tamires Daros, et al. "Moderate-to-high Intensity Inspiratory Muscle Training Improves the Effects of Combined Training On Exercise Capacity in Patients After Coronary Artery Bypass Graft Surgery: a Randomized Clinical Trial." International Journal of Cardiology, vol. 279, 2019, pp. 40-46.
Dos Santos TD, Pereira SN, Portela LOC, et al. Moderate-to-high intensity inspiratory muscle training improves the effects of combined training on exercise capacity in patients after coronary artery bypass graft surgery: A randomized clinical trial. Int J Cardiol. 2019;279:40-46.
Dos Santos, T. D., Pereira, S. N., Portela, L. O. C., Cardoso, D. M., Lago, P. D., Dos Santos Guarda, N., Moresco, R. N., Pereira, M. B., & de Albuquerque, I. M. (2019). Moderate-to-high intensity inspiratory muscle training improves the effects of combined training on exercise capacity in patients after coronary artery bypass graft surgery: A randomized clinical trial. International Journal of Cardiology, 279, 40-46. https://doi.org/10.1016/j.ijcard.2018.12.013
Dos Santos TD, et al. Moderate-to-high Intensity Inspiratory Muscle Training Improves the Effects of Combined Training On Exercise Capacity in Patients After Coronary Artery Bypass Graft Surgery: a Randomized Clinical Trial. Int J Cardiol. 2019 Mar 15;279:40-46. PubMed PMID: 30581100.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Moderate-to-high intensity inspiratory muscle training improves the effects of combined training on exercise capacity in patients after coronary artery bypass graft surgery: A randomized clinical trial. AU - Dos Santos,Tamires Daros, AU - Pereira,Sergio Nunes, AU - Portela,Luiz Osório Cruz, AU - Cardoso,Dannuey Machado, AU - Lago,Pedro Dal, AU - Dos Santos Guarda,Naiara, AU - Moresco,Rafael Noal, AU - Pereira,Marisa Bastos, AU - de Albuquerque,Isabella Martins, Y1 - 2018/12/10/ PY - 2018/03/14/received PY - 2018/11/22/revised PY - 2018/12/04/accepted PY - 2018/12/26/pubmed PY - 2019/12/18/medline PY - 2018/12/25/entrez KW - Combined training KW - Coronary artery bypass grafting KW - Functional capacity KW - Inspiratory muscle training KW - Respiratory function SP - 40 EP - 46 JF - International journal of cardiology JO - Int J Cardiol VL - 279 N2 - BACKGROUND: The effects of adding moderate-to-high intensity inspiratory muscle training (IMT) to short-term aerobic and resistance exercise (combined training [CT]), after coronary artery bypass grafting (CABG) are not established. This study aimed to determine the effects of moderate-to-high intensity IMT + CT on exercise capacity, respiratory muscle strength, inspiratory muscle endurance, quality of life (QoL), and laboratory biomarkers in patients after CABG who were participants of a phase II cardiac rehabilitation program. METHODS: Twenty-four patients were randomly assigned to either the IMT + CT group (n = 12), who performed moderate-to-high intensity IMT with CT or the sham-IMT + CT group (n = 12). Patients completed two sessions per week for 12 weeks. Each patient underwent a cardiopulmonary exercise test, six-minute walk test (6MWT), respiratory muscle strength and endurance evaluation, QoL questionnaire, and serum advanced oxidation protein products, ferric reducing antioxidant power [FRAP], nitrate/nitrate, and high-sensitivity C-reactive protein, before and after the 12-week intervention. RESULTS: The IMT + CT group showed significantly greater improvements in peak oxygen uptake (1.3 mL∙kg-1∙min-1; 95% confidence interval [95% CI], 0.5 to 2.2), distance covered during the 6MWT (78.8 m; 95% CI, 28.1 to 129.5), maximal inspiratory pressure (23.0 cmH2O; 95% CI, 9.3 to 36.7), QoL (-15.1 points; 95% CI, -26.9 to -3.3), and FRAP (83.7 μmol/L; 95% CI, 20.2 to 147.1) compared to the sham-IMT + CT group as a result of the intervention. CONCLUSIONS: Short-term moderate-to-high intensity IMT with CT provided additional benefits in exercise capacity, inspiratory muscle strength, QoL, and antioxidant profile in patients after CABG. Trial Registration clinicaltrials.gov Identifier: NCT02885077. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/30581100/Moderate_to_high_intensity_inspiratory_muscle_training_improves_the_effects_of_combined_training_on_exercise_capacity_in_patients_after_coronary_artery_bypass_graft_surgery:_A_randomized_clinical_trial_ DB - PRIME DP - Unbound Medicine ER -