Effects of inspiratory muscle training on pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation: a randomized controlled trial

Zeren, Melih; Demir, Rengin; Yiğit, Zerrin; Gürses, Hülya Nilgün

doi:10.1177/0269215515628038

Cited by 32 publications

(35 citation statements)

References 34 publications

(45 reference statements)

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“…The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram (figure 1) describes the selection process. Nine studies (nine publications) were included in this analysis2 10 25–31 (see table 1).…”

Section: Resultsmentioning

confidence: 99%

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Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials

et al. 2018

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ObjectiveThe aim of this study was to undertake a contemporary review of the impact of exercise-based cardiac rehabilitation (CR) targeted at patients with atrial fibrillation (AF).MethodsWe conducted searches of PubMED, EMBASE and the Cochrane Library of Controlled Trials (up until 30 November 2017) using key terms related to exercise-based CR and AF. Randomised and non-randomised controlled trials were included if they compared the effects of an exercise-based CR intervention to a no exercise or usual care control group. Meta-analyses of outcomes were conducted where appropriate.ResultsThe nine randomised trials included 959 (483 exercise-based CR vs 476 controls) patients with various types of AF. Compared with control, pooled analysis showed no difference in all-cause mortality (risk ratio (RR) 1.08, 95% CI 0.77 to 1.53, p=0.64) following exercise-based CR. However, there were improvements in health-related quality of life (mean SF-36 mental component score (MCS): 4.00, 95% CI 0.26 to 7.74; p=0.04 and mean SF-36 physical component score: 1.82, 95% CI 0.06 to 3.59; p=0.04) and exercise capacity (mean peak VO2: 1.59 ml/kg/min, 95% CI 0.11 to 3.08; p=0.04; mean 6 min walk test: 46.9 m, 95% CI 26.4 to 67.4; p<0.001) with exercise-based CR. Improvements were also seen in AF symptom burden and markers of cardiac function.ConclusionsExercise capacity, cardiac function, symptom burden and health-related quality of life were improved with exercise-based CR in the short term (up to 6 months) targeted at patients with AF. However, high-quality multicentre randomised trials are needed to clarify the impact of exercise-based CR on key patient and health system outcomes (including health-related quality of life, mortality, hospitalisation and costs) and how these effects may vary across AF subtypes.

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Section: Resultsmentioning

confidence: 99%

“…Evidence from pooled analysis of eight studies2 25–31 showed 52 deaths in 445 (11.7%) exercising participants and 47 deaths in 438 (10.7%) control participants. There was no significant difference in pooled RR between exercise-based CR and control groups (RR 1.08, 95% CI 0.77 to 1.53, p=0.64, I 2 =0%) (figure 2).…”

Section: Resultsmentioning

confidence: 99%

Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials

et al. 2018

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“… 9 , 10 Additionally, one study showed respiratory muscle weakness in patients with AF. 8 However, the pulmonary function of these patients and its contribution to the disease burden has not been extensively investigated.…”

Section: Introductionmentioning

confidence: 99%

Relationship of respiratory muscle strength, pulmonary function, and functional capacity with quality of life in patients with atrial fibrillation

et al. 2017

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ObjectiveTo examine the relationship of pulmonary parameters and functional capacity with quality of life (QoL) in patients with atrial fibrillation (AF).MethodsThirty-six patients with chronic AF were included in this cross-sectional study. QoL was assessed with the Medical Outcomes Survey 36-item Short Form (SF-36) and Minnesota Living with Heart Failure Questionnaire (MLHFQ). Respiratory muscle strength and pulmonary function were also measured. Functional capacity was assessed with the 6-min walk test (6MWT). The Borg CR10 Scale was used to determine the resting dyspnea and fatigue levels.ResultsThe SF-36 physical component summary score was correlated with the maximum inspiratory pressure (r = 0.517), maximum expiratory pressure (r = 0.391), 6MWT distance (r = 0.542), resting Borg dyspnea score (r = −0.692), and resting Borg fatigue score (r = −0.727). The MLHFQ total score was correlated with the maximum inspiratory pressure (r = −0.542), maximum expiratory pressure (r = −0.384), 6MWT distance (r = −0.535), resting Borg dyspnea score (r = 0.641), and resting Borg fatigue score (r = 0.703). The resting Borg fatigue score was the significant independent predictor of the SF-36 physical component score and the MLHFQ total score.ConclusionRespiratory muscle strength, functional capacity measured with the 6MWT, and resting symptoms including dyspnea and fatigue may have an impact on QoL in patients with AF.

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“…We observed that most selected studies [12][13][14] have applied IMT protocols at 30% of the MIP for 30 minutes daily, for eight weeks. Many other works have shown that this training protocol promotes not only improvements in the respiratory muscle resistance and strength, but also in the functional capacity and quality of life of chronic disease patients 9,22 . These protocols, with more repetitions and less intensity, seem to elicit less exacerbated hemodynamic responses during the inspiratory muscle exercise, offering more safety for cardiovascular patients.…”

Section: Discussionmentioning

confidence: 94%

“…On the other hand, Kaminski et al 14 have verified that IMT improved the ANS action on patients with the same disease, but with no diagnosis of respiratory muscle weakness. Unlike the interaction between inspiratory muscle weakness and IMT for the maximal inspiratory pressure (MIP) outcome, which indicates that the lower the pre-intervention MIP is, the higher the improvement observed after the training 21,22 , possibly, for these patients with bigger respiratory muscle force damage, the intensity and time of IMT application may have been insufficient to create the positive autonomic adaptations observed in other populations.…”

Section: Discussionmentioning

confidence: 99%

Efeitos do treinamento muscular inspiratório no controle autonômico: revisão sistemática

et al. 2018

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| The autonomic nervous system dysfunction has an important role on the physiopathology of some diseases. A possible option to improve the autonomic control is the inspiratory muscle training (IMT). The aim of this study was to systematically review the available literature about the effects of this training modality on autonomic control. A search was performed for controlled and randomized clinical trials on database MEDLINE, PEDro, SciELO and LILACS by two independent reviewers, who also evaluated the methodologic quality (PEDro scale). 181 articles were found and, after elegibility criteria analysis, four studies were included. The included studies showed good methodological quality and assessed the effect of IMT on the autonomic control of participants with risk factors for cardiovascular disease. The autonomic control was evaluated by heart rate variability (HRV) analysis and by noradrenaline plasma levels. The IMT improved autonomic control in 3 studies,reducing the sympathetic nervous system (noradrenaline plasma levels; LF nu -HRV) and increasing the vagal nervous system (HF un -HRV). It is concluded that IMT may be a therapeutic alternative to improve the autonomic control.

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Effects of inspiratory muscle training on pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation: a randomized controlled trial

Abstract: Inspiratory muscle training can improve pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation.

Cited by 32 publications

References 34 publications

Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials

Exercise-based cardiac rehabilitation improves exercise capacity and health-related quality of life in people with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials

Relationship of respiratory muscle strength, pulmonary function, and functional capacity with quality of life in patients with atrial fibrillation

Efeitos do treinamento muscular inspiratório no controle autonômico: revisão sistemática

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