Document Detail


Inspiratory muscle training using an incremental endurance test alleviates dyspnea and improves functional status in patients with chronic heart failure.
MedLine Citation:
PMID:  15580060     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The benefits of inspiratory muscle training (IMT) in patients with chronic heart failure (CHF) have been inadequately studied. DESIGN AND METHODS: Using a prospective, age and sex-matched controlled study, we investigated 35 patients with moderate to severe CHF (NYHA class II-III and left ventricular ejection fraction 24.4+/-1.3% [mean+/-SEM]). An incremental respiratory endurance test using a fixed respiratory workload was provided by software with an electronic mouth pressure manometer interfaced with a computer. The training group (n=20) exercised at 60% of individual sustained maximal inspiratory pressure (SMIP) and the control group (n=15) at 15% of SMIP. All patients exercised three times weekly for 10 weeks. Pulmonary function, exercise capacity, dyspnea and quality of life were assessed, pre- and post-training. RESULTS: The training group significantly increased both maximum inspiratory pressure (Pimax), (111+/-6.8 versus 83+/-5.7 cmH2O, P<0.001), and SMIP (527822+/-51358 versus 367360+/-41111 cmH2O/sec x 10(-1), P<0.001). Peak VO2 increased after training (17.8+/-1.2 versus 15.4+/-0.9 ml/kg/min, P<0.005), as did the six-minute walking distance (433+/-16 versus 367+/-22 meters, P<0.001). Perceived dyspnea assessed using the Borg scale was reduced for both the treadmill (12.7+/-0.57 versus 14.2+/-0.48, P<0.005) and the walking (9+/-0.48 versus 10.5+/-0.67, P<0.005) exercise tests and the quality of life score was also improved (21.1+/-3.5 versus 25.2+/-4, P<0.01). Resting heart rate was significantly reduced with training (77+/-3.3 versus 80+/-3 beats/min, P<0.05). The control group significantly increased Pimax (86.6+/-6.3 versus 78.4+/-6.9 cmH2O, P<0.05), but decreased SMIP (274972+/-32399 versus 204661+/-37184 cmH2O/sec x 10(1), P<0.005). No other significant effect on exercise capacity, heart rate, dyspnea, or quality of life was observed in this group. CONCLUSION: Inspiratory muscle training using an incremental endurance test, successfully increases both inspiratory strength and endurance, alleviates dyspnea and improves functional status in CHF.
Authors:
Ioannis Laoutaris; Athanasios Dritsas; Margaret D Brown; Athanasios Manginas; Peter A Alivizatos; Dennis V Cokkinos
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology     Volume:  11     ISSN:  1741-8267     ISO Abbreviation:  Eur J Cardiovasc Prev Rehabil     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-12-06     Completed Date:  2005-04-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101192000     Medline TA:  Eur J Cardiovasc Prev Rehabil     Country:  England    
Other Details:
Languages:  eng     Pagination:  489-96     Citation Subset:  IM    
Affiliation:
Onassis Cardiac Surgery Centre, Athens, Greece. ylaoutaris@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Breathing Exercises*
Dyspnea / physiopathology,  rehabilitation*
Exercise Test*
Female
Forced Expiratory Volume / physiology
Heart Failure / physiopathology,  rehabilitation*
Heart Rate / physiology
Humans
Inspiratory Capacity / physiology
Male
Manometry
Middle Aged
Oxygen Consumption / physiology
Physical Endurance / physiology*
Prospective Studies
Quality of Life
Respiratory Muscles / physiopathology
Stroke Volume / physiology
Treatment Outcome
Ventricular Dysfunction, Left / physiopathology,  rehabilitation
Vital Capacity / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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