Tatiana Satie Kawauchi1, Iracema Ioco Kikuchi Umeda2, Lays Magalhães Braga1, Antonio de Pádua Mansur3, João Manoel Rossi-Neto2, Amanda Guerra de Moraes Rego Sousa2, Mário Hiroyuki Hirata2, Lawrence P Cahalin4, Naomi Kondo Nakagawa5. 1. Department of Physiotherapy, LIM-34, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 Room 1150, São Paulo, SP, 01246-930, Brazil. 2. Dante Pazzanese Institute of Cardiology São Paulo State, Av. Dr. Dante Pazzanese, 500, São Paulo, SP, Brazil. 3. Heart Institute - HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 44, São Paulo, SP, Brazil. 4. Department of Physical Therapy, University of Miami, Coral Gables, FL, USA. 5. Department of Physiotherapy, LIM-34, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455 Room 1150, São Paulo, SP, 01246-930, Brazil. naomikondo@uol.com.br.
Abstract
BACKGROUND:Inspiratory and peripheral muscle training improves muscle strength, exercise tolerance, and quality of life in patients with chronic heart failure (HF). However, studies investigating different workloads for these exercise modalities are still lacking. OBJECTIVE: To examine the effects of low and moderate intensities on muscle strength, functional capacity, and quality of life. DESIGN: A randomized controlled trial. METHODS:Thirty-five patients with stable HF (aged >18 years, NYHA II/III, LVEF <40%) were randomized to: non-exercise control group (n = 9), low-intensity training group (LIPRT, n = 13, 15% maximal inspiratory workload, and 0.5 kg of peripheral muscle workload) or moderate-intensity training group (MIPRT, n = 13, 30% maximal inspiratory workload and 50% of one maximum repetition of peripheral muscle workload). The outcomes were: respiratory and peripheral muscle strength, pulmonary function, exercise tolerance by the 6-minute walk test, symptoms based on the NYHA functional class, and quality of life using the Minnesota Living with Heart Failure Questionnaire. RESULTS: All groups showed similar quality-of-life improvements. Low and moderate intensities training programs improved inspiratory muscle strength, peripheral muscle strength, and walking distance. However, only moderate intensity improved expiratory muscle strength and NYHA functional class in HF patients. CONCLUSIONS: The low-intensity inspiratory and peripheral resistance muscle training improved inspiratory and peripheral muscle strength and walking distance, demonstrating that LIPRT is an efficient rehabilitation method for debilitated HF patients. In addition, the moderate-intensity resistance training also improved expiratory muscle strength and NYHA functional class in HF patients.
RCT Entities:
BACKGROUND: Inspiratory and peripheral muscle training improves muscle strength, exercise tolerance, and quality of life in patients with chronic heart failure (HF). However, studies investigating different workloads for these exercise modalities are still lacking. OBJECTIVE: To examine the effects of low and moderate intensities on muscle strength, functional capacity, and quality of life. DESIGN: A randomized controlled trial. METHODS: Thirty-five patients with stable HF (aged >18 years, NYHA II/III, LVEF <40%) were randomized to: non-exercise control group (n = 9), low-intensity training group (LIPRT, n = 13, 15% maximal inspiratory workload, and 0.5 kg of peripheral muscle workload) or moderate-intensity training group (MIPRT, n = 13, 30% maximal inspiratory workload and 50% of one maximum repetition of peripheral muscle workload). The outcomes were: respiratory and peripheral muscle strength, pulmonary function, exercise tolerance by the 6-minute walk test, symptoms based on the NYHA functional class, and quality of life using the Minnesota Living with Heart Failure Questionnaire. RESULTS: All groups showed similar quality-of-life improvements. Low and moderate intensities training programs improved inspiratory muscle strength, peripheral muscle strength, and walking distance. However, only moderate intensity improved expiratory muscle strength and NYHA functional class in HF patients. CONCLUSIONS: The low-intensity inspiratory and peripheral resistance muscle training improved inspiratory and peripheral muscle strength and walking distance, demonstrating that LIPRT is an efficient rehabilitation method for debilitated HF patients. In addition, the moderate-intensity resistance training also improved expiratory muscle strength and NYHA functional class in HF patients.
Authors: W von Scheidt; C Zugck; M Pauschinger; R Hambrecht; O Bruder; A Hartmann; M Rauchhaus; R Zahn; J Brachmann; U Tebbe; T Neumann; R H Strasser; M Böhm; S Störk; M Hochadel; P Heidemann; J Senges Journal: Clin Res Cardiol Date: 2014-07-23 Impact factor: 5.460
Authors: Hugo Fernández-Rubio; Ricardo Becerro-de-Bengoa-Vallejo; David Rodríguez-Sanz; César Calvo-Lobo; Davinia Vicente-Campos; Jose López Chicharro Journal: Int J Environ Res Public Health Date: 2021-02-10 Impact factor: 3.390