Effects of inspiratory muscle training in patients with heart failure

Aim: To investigate the effects of inspiratory muscle training (IMT) on functional capacity and balance, respiratory and peripheral muscle strength, pulmonary function, dyspnea, fatigue, depression, and quality of life in heart failure patients. Methods: A prospective, randomized controlled, double-blinded study. Thirty patients with heart failure (NYHA II-III, LVEF<40%) were included. Sixteen patients received IMT at 40% of maximal inspiratory pressure (MIP), and 14 patients received sham therapy (15% of MIP) for 6 weeks. Functional capacity and balance, respiratory muscle strength, quadriceps femoris muscle strength, pulmonary function, dyspnea, fatigue, quality of life, and depression were evaluated. Results: Functional capacity and balance, respiratory and peripheral muscle strength, dyspnea, depression were significantly improved in the treatment group compared with controls; quality of life and fatigue were similarly improved within groups (p < 0.05). Functional capacity (418.59 +/- 123.32 to 478.56 +/- 131.58 m, p < 0.001), respiratory (MIP = 62.00 +/- 33.57 to 97.13 +/- 32.63 cmH(2)O, p < 0.001) and quadriceps femoris muscle strength (240.91 +/- 106.08 to 301.82 +/- 111.86 N, p < 0.001), FEV1%, FVC% and PEF%, functional balance (52.73 +/- 3.15 to 54.25 +/- 2.34, p < 0.001), functional dyspnea (2.27 +/- 0.88 to 1.07 +/- 0.79, p < 0.001), depression (11.47 +/- 7.50 to 3.20 +/- 4.09, p < 0.001), quality of life, fatigue (42.73 +/- 11.75 to 29.07 +/- 13.96, p < 0.001) were significantly improved in the treatment group. Respiratory muscle strength (MIP = 78.64 +/- 35.95 to 90.86 +/- 30.23 cmH(2)O, p = 0.001), FVC%, depression (14.36 +/- 9.04 to 9.50 +/- 10.42, p = 0.011), quality of life and fatigue (42.86 +/- 12.67 to 32.93 +/- 15.87, p = 0.008) were significantly improved in the control group. Conclusion: The IMT improves functional capacity and balance, respiratory and peripheral muscle strength; decreases depression and dyspnea perception in patients with heart failure. IMT should be included effectively in pulmonary rehabilitation programs. (C) 2011 Elsevier Ltd. All rights reserved.