Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction

Palau, Patricia; Domínguez, Eloy; Núñez, Eduardo; Schmid, Jean‐Paul; Vergara, Pedro; Ramón, José; Mascarell, Beatriz; Sanchís, Juan; Chorro, Francisco J.; Núñez, Julio

doi:10.1177/2047487313498832

Cited by 77 publications

(151 citation statements)

References 30 publications

(47 reference statements)

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“…In both groups early mobilization was applied. Inhalation spirometry and the improvement of inspiratory muscle strength is one of the methods described in many studies [10][11][12][13]. It has been proved that this method is effective, but there are more effective programmes, that offer variety of techniques such as expiratory promoting, early mobilization, aerobic exercises [10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Physiotherapy following cardiac surgery: Program comparison

et al. 2018

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Abstract. The objective is to examine and compare the usability of two physiotherapy programmes, analyzing respiratory function in patients before and after cardiac surgery in hospital during seven postoperative days (POD). Quantitative randomized prospective study of 157 patients before and after the valve replacement surgery, coronary artery bypass graft and combined surgeries, who moved independently. Participants were randomized into two groups (1 and 2) with different physiotherapy programmes. The routine physiotherapy of breath-enhancing techniques, micro-circulation improvement were used for the first group, for the second groupmodified physiotherapy -the improvement of inspiration muscles, mm. quadriceps. gluteus max strength. Anthropometric measurements were defined for both groups on the day before surgery and during spirographydynamic indicators -forced vital capacity (FVC), forced expiratory volume in the 2 nd second (FEV1), Tiffeneau index (FEV1/VC (%)), peak expiratory flow (PEF), operation parameters. By comparing the postoperative respiratory parameters between the two groups and using independent samples t test, it was found out that the difference in FVC between groups is 1.71 [95% CI: -8.25 to 4.8] and it is not statistically significant (t (155) = -0.52; p = 0.60). Based on the Leuven test results FVC the distribution variance is not statistically notably different for group 1 and group 2 (F = 0.27, p = 0.60). Using routine and modified physiotherapy and comparing postoperative dynamic respiratory performance of the two groups, there was no statistically significant difference, proving that the two models are equally effective.

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Section: Discussionmentioning

confidence: 99%

Physiotherapy following cardiac surgery: Program comparison

et al. 2018

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“…26 Changes in ventilatory efficiency were evaluated in four studies. In two, continuous endurance 26 and respiratory training 27 were associated with a significant improvement in the pattern of ventilatory efficiency. However, no significant differences were found in other two studies (Table 4).…”

Section: Echocardiographicmentioning

confidence: 94%

“…To this end, we qualitatively summarised eight eligible studies in order to extract useful information despite the fact that these studies were heterogeneous in outcomes measures, sample size and type of the intervention (Tables 1-4). [21][22][23][24][25][26][27][28] Physical therapies in HF Current guidelines recommend the implementation of exercise training in chronic HF as an evidence-based recommendation (class I, level of evidence A). 19,20 This evidence is based on RCTs performed in HFrEF.…”

Section: Methodsmentioning

confidence: 99%

“…[21][22][23][24][25][26][27] The identification and characteristics of these studies are summarised in Tables 1 and 2. These studies included a total of 279 patients with HFpEF in which 157 were allocated to exercise training and 122 to the control arm. All patients were classified as symptomatic HF based on the scale of the New York Heart Association (NYHA) functional class (from I-III) and a LVEF !45%.…”

Section: Exercise Trainingmentioning

confidence: 99%

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Physical therapy in heart failure with preserved ejection fraction: A systematic review

Palau

Núñez

Domínguez

et al. 2014

Eur J Prev Cardiolog

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About 50% of patients with heart failure (HF) have preserved ejection fraction (HFpEF) which is especially common in elderly people with highly prevalent co-morbid conditions. HFpEF is usually defined as an ejection fraction equal to or greater than 50%, although some studies have used a limit as low as 40%. The prevalence of this syndrome is expected to increase over the next decades. The associated impact on mortality and hospital readmissions has made of this entity a major public health issue. Despite the fact that mortality and re-hospitalisation rates of HFpEF are similar to the syndrome of HF with reduced ejection fraction (HFrEF), currently there is no available evidence-based therapy as effective as is the case for HFrEF. Exercise intolerance is the principal clinical feature in HFpEF. The pathophysiological mechanisms behind impaired exercise capacity in these patients are complex and not yet fully elucidated. Current guidelines and consensus documents recommend the implementation of exercise training in HFpEF; however, they are based mostly on results from a few small trials evaluating surrogate endpoints such as exercise capacity and quality of life. The aim of this work was to review the current evidence that supports the effect of the different modalities of physical therapies in HFpEF.

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“…1 According to their results, in heart failure patients with preserved ejection fraction (HFpEF) associated with very low exercise capacity and normal maximal inspiratory pressure (MIP), inspiratory muscle training (IMT) improved aerobic capacity, ventilatory efficiency (VE/VCO 2 slope) and quality of life.…”

mentioning

confidence: 99%

No signs of ventilatory inefficiency in patients with heart failure with preserved ejection fraction and very low oxygen consumption: how is this possible?

Stein

Silveira

2013

Eur J Prev Cardiolog

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Effects of inspiratory muscle training in patients with heart failure with preserved ejection fraction

Abstract: In HFpEF patients with low aerobic capacity and non-reduced MIP, IMT was associated with marked improvement in exercise capacity and QoL.

Cited by 77 publications

References 30 publications

Physiotherapy following cardiac surgery: Program comparison

Physiotherapy following cardiac surgery: Program comparison

Physical therapy in heart failure with preserved ejection fraction: A systematic review

No signs of ventilatory inefficiency in patients with heart failure with preserved ejection fraction and very low oxygen consumption: how is this possible?

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