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Inspiratory Muscle Training in Patients With Heart Failure and Inspiratory Muscle Weakness

A Randomized Trial

Pedro Dall’Ago, PT, ScD^_*,, Gaspar R.S. Chiappa, PT, MSc, Henrique Guths, PT, MSc, Ricardo Stein, MD, ScD and Jorge P. Ribeiro, MD, ScD^,,_*

^_* Department of Physiological Sciences, Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Porto Alegre, Brazil
School of Physical Therapy, UNILASALLE, Canoas, Brazil
Cardiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
Department of Medicine, Faculty of Medicine, UFRGS, Porto Alegre, Brazil.

View larger version (13K): [in a new window]   Figure 1 Weekly values of maximal inspiratory pressure (PImax, mean ± SD) for the placebo-inspiratory muscle training group (P-IMT) and for the inspiratory muscle training group (IMT). After 12 weeks in the program, all training was stopped, and 11 patients from each group were re-evaluated at 48 weeks. *Two-way ANOVA for repeated measures: p < 0.01 for group, training, and interaction effects. Significantly (p < 0.05) different from baseline evaluation by the Tukey test.

View larger version (13K): [in a new window]   Figure 2 The PImax values (mean ± SD) at rest and on the 5th and the 10th min of recovery after maximal cardiopulmonary exercise test. (A) Values before and (B) after intervention for the placebo inspiratory muscle training group (P-IMT) and the inspiratory muscle training group (IMT). Two-way ANOVA for repeated measurements: IMT versus P-IMT (p < 0.01 for group, training, and interaction effects). Multiple comparisons by the Tukey test: *5th minute versus rest (p < 0.05); 10th minute versus rest (p < 0.05); 10th minute versus 5th min (p < 0.05).

View larger version (15K): [in a new window]   Figure 3 Values of the oxygen uptake kinetics during the first 3 min of recovery (mean ± SD) after maximal cardiopulmonary exercise test before (A) and after (B) intervention for the placebo inspiratory muscle training group (P-IMT) and the inspiratory muscle training group (IMT). Overall two-way ANOVA for repeated measures: p < 0.001 for group, training, and interaction effects. *Significantly different between groups (p < 0.05) by the Tukey test.