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Is there any benefit using low-intensity inspiratory and peripheral muscle training in heart failure? A randomized clinical trial

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An Erratum to this article was published on 10 July 2017

This article has been updated

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.

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Change history

  • 10 July 2017

    An erratum to this article has been published.

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Acknowledgements

We are grateful to Renato Murayama for his help with clinical assessments, to Prof. Carmen Diva Saldiva de Andre for helping us with the statistical analysis, and to Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP 2013/13598-1) for research funding.

Author information

Authors and Affiliations

  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

    Tatiana Satie Kawauchi, Lays Magalhães Braga & Naomi Kondo Nakagawa PT, PhD

  2. Dante Pazzanese Institute of Cardiology São Paulo State, Av. Dr. Dante Pazzanese, 500, São Paulo, SP, Brazil

    Iracema Ioco Kikuchi Umeda, João Manoel Rossi-Neto, Amanda Guerra de Moraes Rego Sousa & Mário Hiroyuki Hirata

  3. Heart Institute - HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 44, São Paulo, SP, Brazil

    Antonio de Pádua Mansur

  4. Department of Physical Therapy, University of Miami, Coral Gables, FL, USA

    Lawrence P. Cahalin

Authors
  1. Tatiana Satie Kawauchi
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  2. Iracema Ioco Kikuchi Umeda
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Corresponding author

Correspondence to Naomi Kondo Nakagawa PT, PhD.

Ethics declarations

Ethics approval

The University of São Paulo Medical School Ethics Committee(s) approved this study (ID 232/12). All participants gave written informed consent before data collection began.

Conflict of interest

Nothing to declare.

Additional information

An erratum to this article is available at https://doi.org/10.1007/s00392-017-1131-0.

An erratum to this article is available at https://doi.org/10.1007/s00392-017-1107-0.

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Kawauchi, T.S., Umeda, I.I.K., Braga, L.M. et al. Is there any benefit using low-intensity inspiratory and peripheral muscle training in heart failure? A randomized clinical trial. Clin Res Cardiol 106, 676–685 (2017). https://doi.org/10.1007/s00392-017-1089-y

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