scholarly journals Selection of the optimal respiratory muscle training mode in patients with class II-III chronic heart failure

Kardiologiia ◽  
2021 ◽  
Vol 61 (2) ◽  
pp. 69-75
Author(s):  
A. G. Arutyunov ◽  
E. A. Kolesnikova ◽  
K. V. Ilyina ◽  
A. K. Rylova ◽  
G. P. Arutyunov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Muscle Mass ◽  
Respiratory Muscle ◽  
Training Group ◽  
Dynamic Loads ◽  
Diaphragm Muscle ◽  
Respiratory Muscle Training ◽  
Muscle Training ◽  
Combined Training

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.

Benefit of Selective Respiratory Muscle Training on Exercise Capacity in Patients With Chronic Congestive Heart Failure

Circulation ◽  
1995 ◽  
Vol 91 (2) ◽  
pp. 320-329 ◽  
Author(s):  
Donna M. Mancini ◽  
David Henson ◽  
John La Manca ◽  
Lisa Donchez ◽  
Sanford Levine
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Exercise Capacity ◽  
Respiratory Muscle ◽  
Respiratory Muscle Training ◽  
Chronic Congestive Heart Failure ◽  
Muscle Training

scholarly journals Integrative respiratory and skeletal musculature training in patients with functional class II–IV chronic heart failure and low or intermediate left ventricular ejection fraction: Design and rationale

2020 ◽  
Vol 35 (2) ◽  
pp. 123-130
Author(s):  
J. L. Begrambekova ◽  
N. A. Karanadze ◽  
V. Yu. Mareev ◽  
E. A. Kolesnikova ◽  
Ya. A. Orlova
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Respiratory Muscle ◽  
Aerobic Training ◽  
Respiratory Muscles ◽  
Treadmill Walking ◽  
Respiratory Muscle Training ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Muscle Training

Respiratory system remodeling plays an important role in the progression of congestive heart failure (CHF). Decreased oxygenation of the respiratory muscles during intense physical exertion in patients with CHF may aggravate respiratory failure and provoke hyperactivation of the inspiratory metaborefl ex, thereby aggravating exercise intolerance due to a decrease in muscular system perfusion. Respiratory muscle training can minimize the eff ects of inspiration metaborefl ex activation and prolong the duration of exercise.Trial design. This is a prospective randomized trial with a sham control. The trial will include 40 adult patients of both genders with NYHA II-III CHF and with ejection fraction (EF) ≤ 49%. Patients will be randomized in a 1:1 ratio to either Active or Control group. Active group will receive four-week guided respiratory muscles training followed by 12-week guided aerobic training (treadmill walking). Control group will receive four-week sham respiratory muscles training (THRESHOLD® IMT breathing trainer with level slightly above 0), followed by 12 weeks guided aerobic training (treadmill walking). The primary aim is to compare the eff ect of diff erent training modalities on functional capacity (peak VO2 ). Secondary outcome measures include changes in respiratory muscle strength, serum biomarkers (NT-proBNP and ST2) and Angiotensin II. Health-related quality of life (MLwHFQ.23) and psycho-emotional state of patients also will be assessed.The study also planned an additional analysis with a suitable group of patients who were screened but refused to participate in the study.Conclusion. Heart failure patients often give up exercise due to symptoms of shortness of breath and muscle weakness. We suggest that the training technique based on the inclusion of respiratory muscle training as the fi rst stage of cardiac rehabilitation will positively aff ect the eff ectiveness of subsequent aerobic training in patients with heart failure, by reducing the activity of RAAS and SAS and increasing respiratory effi ciency. 

scholarly journals Effects of Resistance Training of Peripheral Muscles Versus Respiratory Muscles in Older Adults With Sarcopenia Who are Institutionalized: A Randomized Controlled Trial

2018 ◽  
Vol 26 (4) ◽  
pp. 637-646 ◽  
Author(s):  
Maria À. Cebrià i Iranzo ◽  
Mercè Balasch-Bernat ◽  
María Á. Tortosa-Chuliá ◽  
Sebastià Balasch-Parisi
Keyword(s):  
Skeletal Muscle ◽  
Resistance Training ◽  
Muscle Mass ◽  
Gait Speed ◽  
Training Group ◽  
Knee Extension ◽  
Respiratory Muscle Training ◽  
Control Group ◽  
Muscle Training ◽  
Peripheral Muscle

This study compares the effects of two resistance training programs in peripheral and respiratory musculature on muscle mass and strength and physical performance and identifies the appropriate muscle mass parameter for assessing the intervention effects. Thirty-seven institutionalized older Spanish adults with sarcopenia were analyzed: control group (n = 17), respiratory muscle training group (n = 9), and peripheral muscle training group (n = 11). Measured outcomes were appendicular skeletal muscle mass (ASM/height2, ASM/weight, and ASM/BMI), isometric knee extension, arm flexion and handgrip strength, maximal inspiratory and expiratory pressures, and gait speed pre- and postintervention. Trained groups participated in a 12-week program and improved in maximum static inspiratory pressure, maximum static expiratory pressure, knee extension, and arm flexion (p < .05), whereas nonsignificant changes were found in gait speed and ASM indexes pre- and postintervention in the three groups. In conclusion, resistance training improved skeletal muscle strength in the studied population, and any ASM index was found to be appropriate for detecting changes after physical interventions.

scholarly journals Impact of Heart Transplantation on the Recovery of Peripheral and Respiratory Muscle Mass and Strength in Patients With Chronic Heart Failure

2018 ◽  
Vol 4 (11) ◽  
pp. e395 ◽  
Author(s):  
Lenise C. B. C. Fernandes ◽  
Italo M. de Oliveira ◽  
Paula Frassinetti C. B. C. Fernandes ◽  
João David de Souza Neto ◽  
Maria do Socorro Q. Farias ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Heart Transplantation ◽  
Muscle Mass ◽  
Respiratory Muscle

scholarly journals Current approaches to rehabilitation of patients with chronic heart failure

2010 ◽  
Vol 1 (1) ◽  
pp. 20-24 ◽  
Author(s):  
G. P Arutyunov ◽  
E. A Kolesnikova ◽  
A. K Rylova
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Treatment Adherence ◽  
Treatment Process ◽  
Functional Class ◽  
Respiratory Muscle Training ◽  
Class Iii ◽  
Muscle Training ◽  
Russian Study ◽  
Positive Results

The paper provides a critical review of the specific features of treatment in patients with Functional Class III-IV chronic heart failure (CHF). In addition, the authors give the positive results of their own studies dealing with respiratory muscle training in CHF. Greater treatment adherence by a patient is promoted by the attraction of his/her relatives to the treatment process. For wider involvement of physicians in the problem, the authors arranged a Russian study to increase the adherence of patients with CHF to treatment and rehabilitation, by attracting patients’ relatives to this process.

Respiratory muscle training decreases diaphragm DNA damage in rats with heart failure

2018 ◽  
Vol 96 (3) ◽  
pp. 221-226 ◽  
Author(s):  
Rodrigo B. Jaenisch ◽  
Giuseppe P. Stefani ◽  
Camila Durante ◽  
Chalyne Chechi ◽  
Vítor S. Hentschke ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dna Damage ◽  
Respiratory Muscle ◽  
Diastolic Pressure ◽  
Morphological Changes ◽  
Left Ventricular ◽  
Respiratory Muscle Training ◽  
Tail Moment ◽  
Muscle Training ◽  
Hemodynamic Variables

Respiratory muscle training (RMT) promotes beneficial effects on respiratory mechanics, heart and lung morphological changes, and hemodynamic variables in rats with heart failure (HF). However, the relation between RMT effects and diaphragm oxidative stress remains unclear. Therefore, the aim of this study was to evaluate the RMT effects on diaphragm DNA damage in HF rats. Wistar rats were allocated into 4 groups: sedentary sham (Sed-Sham, n = 8), trained sham (RMT-Sham, n = 8), sedentary HF (Sed-HF, n = 8), and trained HF (RMT-HF, n = 8). The animals underwent a RMT protocol (30 min/day, 5 days/week for 6 weeks), whereas sedentary animals did not exercise. Groups were compared by a two-way ANOVA and Tukey’s post hoc tests. In rats with HF, RMT promoted reduction in pulmonary congestion (p < 0.0001) and left ventricular end diastolic pressure (p < 0.0001). Moreover, RMT produced a decrease in the diaphragm DNA damage in HF rats. This was demonstrated through the reduction in the percentage of tail DNA (p < 0.0001), tail moment (p < 0.01), and Olive tail moment (p < 0.001). These findings showed that a 6-week RMT protocol in rats with HF promoted an improvement in hemodynamic function and reduces diaphragm DNA damage.

scholarly journals Respiratory muscle training improves hemodynamics, autonomic function, baroreceptor sensitivity, and respiratory mechanics in rats with heart failure

2011 ◽  
Vol 111 (6) ◽  
pp. 1664-1670 ◽  
Author(s):  
Rodrigo B. Jaenisch ◽  
Vítor S. Hentschke ◽  
Edson Quagliotto ◽  
Paulo R. Cavinato ◽  
Letiane A. Schmeing ◽  
...  
Keyword(s):  
Heart Failure ◽  
Respiratory System ◽  
Respiratory Muscle ◽  
Autonomic Function ◽  
Respiratory Mechanics ◽  
Diastolic Pressure ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Respiratory Muscle Training ◽  
Muscle Training

Respiratory muscle training (RMT) improves functional capacity in chronic heart-failure (HF) patients, but the basis for this improvement remains unclear. We evaluate the effects of RMT on the hemodynamic and autonomic function, arterial baroreflex sensitivity (BRS), and respiratory mechanics in rats with HF. Rats were assigned to one of four groups: sedentary sham ( n = 8), trained sham ( n = 8), sedentary HF ( n = 8), or trained HF ( n = 8). Trained animals underwent a RMT protocol (30 min/day, 5 day/wk, 6 wk of breathing through a resistor), whereas sedentary animals did not. In HF rats, RMT had significant effects on several parameters. It reduced left ventricular (LV) end-diastolic pressure ( P < 0.01), increased LV systolic pressure ( P < 0.01), and reduced right ventricular hypertrophy ( P < 0.01) and pulmonary ( P < 0.001) and hepatic ( P < 0.001) congestion. It also decreased resting heart rate (HR; P < 0.05), indicating a decrease in the sympathetic and an increase in the vagal modulation of HR. There was also an increase in baroreflex gain ( P < 0.05). The respiratory system resistance was reduced ( P < 0.001), which was associated with the reduction in tissue resistance after RMT ( P < 0.01). The respiratory system and tissue elastance (Est) were also reduced by RMT ( P < 0.01 and P < 0.05, respectively). Additionally, the quasistatic Est was reduced after RMT ( P < 0.01). These findings show that a 6-wk RMT protocol in HF rats promotes an improvement in hemodynamic function, sympathetic and vagal heart modulation, arterial BRS, and respiratory mechanics, all of which are benefits associated with improvements in cardiopulmonary interaction.

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