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Efficacy of inspiratory muscle training in chronic heart failure patients: A systematic review and meta-analysis.
MedLine Citation:
PMID:  22560934     Owner:  NLM     Status:  Publisher    
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 VO(2), 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 (V(E)/VCO(2) 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), (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 VO(2) (+1.83ml kg(-1) min(-1), 95% C.I. 1.33 to 2.32ml kg(-1) min(-1), p<0.00001); 6MWD (+34.35m, 95% C.I. 22.45 to 46.24m, p<0.00001); MLWHFQ (-12.25, 95% C.I. -17.08 to -7.43, p<0.00001); PI(max) (+20.01, 95% C.I. 13.96 to 26.06, p<0.00001); and V(E)/VCO(2) 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.
Neil A Smart; Francesco Giallauria; Gudrun Dieberg
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-3
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.
School of Science and Technology, University of New England, Armidale, NSW 2351, Australia.
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