Treinamento muscular inspiratório em pacientes com insuficiência cardíaca: metanálise de estudos randomizados

Abstract

Patients with chronic heart failure (CHF) may have lower inspiratory muscle strength and endurance, which may contribute to exercise intolerance. Inspiratory muscle training (IMT) can have beneficial effects on these patients. Thus, the aim of this study was to systematically review the effects of IMT compared to control groups (placebo-IMT or another intervention) in patients with CHF. A search of databases (MEDLINE, Cochrane CENTRAL and PEDro) and references of published studies, from 1960 to 2011, was conducted. Randomized trials comparing IMT to control groups in the treatment of patients with CHF were included. The GRADE approach was used to determine the quality of evidence for each outcome. Of 119 articles identified, 7 studies were included. IMT increased the distance walked in the six-minute walk test [69 m (95% CI: 7.21 to 130.79)] (very low evidence) and maximal static inspiratory pressure [23.36 cmH20 (95% CI: 11.71 to 35.02)] (low evidence) compared to control groups. However, IMT provides a significant improvement in peak oxygen consumption only in the studies that performed IMT for 12 weeks against no inspiratory load in patients with inspiratory muscle weakness [3.02 ml/kg/min-1 (95% CI: 0.43 to 5.61)]. IMT improves functional capacity and inspiratory muscle strength thereby deserving consideration as an additional intervention in patients with CHF. Larger and better-designed studies, however, are needed to clarify the potential benefit of IMT in this patient population.

Effects of High-Intensity Inspiratory Muscle Training Associated with Aerobic Exercise in Patients Undergoing CABG: Randomized Clinical Trial

“…Many studies corroborate this finding both in the use of low-load IMT as in the studies of Gosselink et al [21] , with chronic obstructive pulmonary disease, or of Hermes et al [22] , postoperative node of CABG, or in the systematic reviews of patients with CHF of Montemezzo et al [12] , Plentz et al [13] , and Smart et al. [14] , as well as in high-intensity use observed in the study by Adamopoulos et al.…”

Use of Powerbreathe® in inspiratory muscle training for athletes: systematic review

“…Physical training is crucial for optimization of exercise performance, either to gain strength and power, or to prevent musculoskeletal injuries (3,4). Cardiovascular conditioning focuses on maximizing perfusion capacity, thereby preventing lactic acidosis, which knowingly compromises performance (4,5). However, a forgotten facet is respiratory training (6,7).…”

Efeitos Do Treinamento Muscular Inspiratório Associado Ao Aeróbico Na Capacidade Funcional Em Paciente Com Insuficiência Cardíaca Crônica: Relato De Caso

“…O grupo do treinamento muscular inspiratório melhorou a hipertrofia do diafragma, fluxo sanguíneo em repouso e a capacidade de exercício aumentando o tempo para chegar à fadiga. (8) Dall'Ago et al (9) realizaram um estudo com 32 pacientes com diagnóstico de insuficiência cardíaca crônica e fraqueza muscular inspiratória (Pimax < 70% do predito), dividido em 2 grupos de 16 pacientes. Um grupo realizou treinamento muscular inspiratório e o outro grupo de controle não realizou treinamento.…”

“…Nossa pesquisa resultou num incremento de 50% da Pimáx, 10% na Pemáx e 22,7% da distância percorrida no teste de caminhada de seis minutos em apenas 4 semanas de intervenção, durante 3 dias semanais, e duração de 20 minutos do TMI por sessão. Possivelmente, houve um incremento menor da Pimáx, quando comparado ao estudo de Dall'Ago et al (9) porque nosso estudo utilizou menor período e menos frequência na semana e menor duração do TMI por sessão.…”