title: Is there any benefit using low-intensity inspiratory and peripheral muscle training in heart failure? A randomized clinical trial.
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.
  
  
  METHODS
  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.
authors.affiliation: 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.
authors.forename: Tatiana Satie
authors.initials: TS
authors.lastname: Kawauchi
authors.affiliation: Dante Pazzanese Institute of Cardiology São Paulo State, Av. Dr. Dante Pazzanese, 500, São Paulo, SP, Brazil.
authors.forename: Iracema Ioco Kikuchi
authors.initials: IIK
authors.lastname: Umeda
authors.affiliation: 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.
authors.forename: Lays Magalhães
authors.initials: LM
authors.lastname: Braga
authors.affiliation: Heart Institute - HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 44, São Paulo, SP, Brazil.
authors.forename: Antonio de Pádua
authors.initials: AP
authors.lastname: Mansur
authors.affiliation: Dante Pazzanese Institute of Cardiology São Paulo State, Av. Dr. Dante Pazzanese, 500, São Paulo, SP, Brazil.
authors.forename: João Manoel
authors.initials: JM
authors.lastname: Rossi-Neto
authors.affiliation: Dante Pazzanese Institute of Cardiology São Paulo State, Av. Dr. Dante Pazzanese, 500, São Paulo, SP, Brazil.
authors.forename: Amanda
authors.initials: A
authors.lastname: Guerra de Moraes Rego Sousa
authors.affiliation: Dante Pazzanese Institute of Cardiology São Paulo State, Av. Dr. Dante Pazzanese, 500, São Paulo, SP, Brazil.
authors.forename: Mário Hiroyuki
authors.initials: MH
authors.lastname: Hirata
authors.affiliation: Department of Physical Therapy, University of Miami, Coral Gables, FL, USA.
authors.forename: Lawrence P
authors.initials: LP
authors.lastname: Cahalin
authors.affiliation: 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. naomikondo@uol.com.br.
authors.forename: Naomi Kondo
authors.initials: NK
authors.lastname: Nakagawa
mesh_terms: D000328:Adult; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007320:Inspiratory Capacity / Q000502:physiology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016138:Walking / Q000502:physiology
keywords: Cardiac rehabilitation; Functional capacity; Heart failure; Resistance exercise; Respiratory muscles