Key result
Respiratory muscle training markedly boosts MIP and VO2 peak vs control in chronic heart failure.
Why the study?
The optimal respiratory muscle training mode for patients with functional class II-III chronic heart failure and preserved diaphragm muscle mass remained to be evaluated.
Does a combination of static and dynamic respiratory muscle training improve maximum inspiratory pressure and peak oxygen consumption in patients with class II-III chronic heart failure and preserved diaphragm mass?
RCT (n=53)
Randomized by random numbers method
No
Does a combination of static and dynamic respiratory muscle training improve maximum inspiratory pressure and peak oxygen consumption in patients with class II-III chronic heart failure and preserved diaphragm mass?
Absolute Event Rate: 23.6% vs 1.5%
p-value: p=<0.01
A combination of static and dynamic respiratory muscle training is the most effective mode for improving physical endurance and inspiratory muscle strength in patients with chronic heart failure.
May support combined respiratory muscle training to boost capacity in class II-III heart failure; extends limited RCT data on optimal RMT protocols.
Aim To study the effect of various types of respiratory muscle training (RMT) in patients with functional class (FC) II-III chronic heart failure (CHF) and more than 70% preserved diaphragm muscle mass.Material and methods 53 patients (28 men and 25 women) aged 50-75 years with NYHA FC II-III ischemic heart disease (IHD) and arterial hypertension with more than 70% preserved diaphragm muscle mass of >70% were randomized to one of four RMT types: static loads, dynamic loads, their combination, and breathing without applied resistance as a control. Peak oxygen consumption (VO2 peak) and maximum inspiratory pressure (MIP) were evaluated at baseline and in 6 months.Results All study groups showed significant improvement of physical endurance indexes compared to baseline values (р<0.05). In pairwise comparison, the groups significantly differed (р<0.01). The greatest improvement was observed for patients of dynamic and combined training groups. Furthermore, in the combined training group, results were significantly higher than in the group of isolated dynamic loads. The most significant (р <0.01), positive changes in the force of inspiratory muscles were observed in groups of dynamic and combined trainings with the best results displayed by patients of the combined training group.Conclusion With preserving more than 70 % of diaphragm muscle tissue (as determined by MIP >60 cm H2O), a combination of static and dynamic RMT is most effective for patients with FC II-III CHF.
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Arutyunov et al. (2021) conducted an RCT in Class II-III chronic heart failure with >70% preserved diaphragm muscle mass (n=53). Combined static and dynamic respiratory muscle training vs. Breathing without applied resistance (control) was evaluated on Mean change in maximum inspiratory pressure (MIP) at 6 months (p=<0.01). Combined static and dynamic respiratory muscle training significantly improved maximum inspiratory pressure and VO2 peak compared to control in patients with class II-III chronic heart failure.
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