Inspiratory Muscle and Peripheral Muscle Training in Chronic Heart Failure

Study Overview
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Brief Summary
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Heart failure is a clinical syndrome that is the common end of several cardiac diseases with symptoms such as muscle fatigue, dyspnea and reduction of quality of life. To improve respiratory and general functional capacity of these patients, there are strategies that can be used such as inspiratory muscle training and peripheral muscle training (dynamic resistance training).

Detailed Description
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After agreement with the written informed consent, 35 subjects with severe heart failure were included in this study. They were randomized in three groups: controls, low-intensity and moderate-intensity group. All volunteers were assessed at Baseline and 8-weeks intervention. Cardiac events were registered following two years from baseline. The present study aimed to assess the effects of a combined program of inspiratory and peripheral muscle training on respiratory and general functional capacity and quality of life in patients with chronic heart failure.

Official Title
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Inspiratory Muscle and Peripheral Muscle Combined Training Effects on the Respiratory and Functional Capacity and Quality of Life in Chronic Heart Failure

Conditions
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Chronic Heart Failure

Intervention / Treatment
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* Other: control
* Other: moderate-intensity group
* Other: low-intensity group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: chronic heart failure (functional class from NYHA II and III), left ventricle ejection fraction bellow or equal 40%. Exclusion Criteria: uncontrolled arrhythmia pulmonary edema or pulmonary congestion in the last 30 days peripheral oxygen saturation bellow 92% in resting condition respiratory infection in the previous 30 days to the enrollment into the study cognitive, neurological or orthopedic limitations

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Control group<br>patients awaiting for evaluation to cardiac rehabilitation or transplantation | Other: control<br>* No intervention during the 8-weeks period of the study because of awaiting evaluation for cardiac rehabilitation or transplantation<br>|
| Experimental: moderate-intensity group<br>Patients will be submitted to a 8-weeks training program, with inspiratory muscle trained at 30% of the maximal inspiratory pressure (30 minutes/session/7 days/week) and peripheral muscle trained with upper and lower exercises (50% of the 1-maximum repetition test). | Other: moderate-intensity group<br>* Patients will be submitted to a 8-weeks training program with inspiratory muscle trained at 30% of the maximal inspiratory pressure (30 minutes/session/7 days/week) + peripheral muscle trained with exercises of upper limbs and lower limbs (50% 1 RM, increased every 2-weeks).<br>|
| Active Comparator: low-intensity group<br>Patients will be submited to a 8 weeks training program, with inspiratory muscle trained at 15% of the maximal inspiratory pressure (30 minutes/session/7 days/week) and peripheral muscle trained with exercises of upper limbs and lower limbs (0,5 Kg each). | Other: low-intensity group<br>* Patients will be submited to a 8 weeks training program, with inspiratory muscle trained at 15% of the maximal inspiratory pressure (30 minutes/session/7 days/week) + peripheral muscle trained with exercises of upper limbs and lower limbs (0,5 kg each)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in respiratory muscle strength (in centimeters of water) | Inspiratory and expiratory muscle strength was assessed by using a pressure transducer (MVD-300 Microhard System, GlobalMed, Porto Alegre, Brazil). | Before and after 8-weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| walking distance | To assess functional capacity using walking distance (6-min walk test accordingly to ATS and ERS guidelines) | Before and after 8-weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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muscle training, walking test, chronic heart failure, functional capacity