title: Effects of inspiratory muscle training in patients with heart failure.
abstract: OBJECTIVE
  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), FEV(1)%, 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, 06500 Ankara, Turkey. bosnakmeral@hotmail.com
authors.forename: Meral
authors.initials: M
authors.lastname: Bosnak-Guclu
authors.forename: Hulya
authors.initials: H
authors.lastname: Arikan
authors.forename: Sema
authors.initials: S
authors.lastname: Savci
authors.forename: Deniz
authors.initials: D
authors.lastname: Inal-Ince
authors.forename: Erol
authors.initials: E
authors.lastname: Tulumen
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Lale
authors.initials: L
authors.lastname: Tokgözoglu
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003866:Depressive Disorder / Q000523:psychology / Q000534:rehabilitation; D004311:Double-Blind Method; D004417:Dyspnea / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation; D017079:Exercise Tolerance; D005221:Fatigue / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D005541:Forced Expiratory Volume; D006333:Heart Failure / Q000503:physiopathology; D006801:Humans; D007320:Inspiratory Capacity; D008297:Male; D053580:Muscle Strength; D011446:Prospective Studies; D011788:Quality of Life; D012132:Respiratory Muscles / Q000503:physiopathology*; D012138:Respiratory Therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome