The Need for Breathing Training Techniques: The Elephant in the Heart Failure Cardiac Rehabilitation Room: A Randomized Controlled Trial

Abstract

Background: Although solid evidence has indicated that respiratory symptoms are common amongst patients with chronic heart failure (CHF), state-of-the-art cardiac rehabilitation (CR) programs do not typically include management strategies to address respiratory symptoms. This study investigated the effect of the addition of breathing exercises (BE) to the CR programs in CHF. Methods: In a two parallel-arm randomized controlled study (RCT), 40 middle-aged patients with CHF and respiratory symptoms were recruited and randomized into two equal groups (n = 20); group (A): standard CR with BE and group (B): standard CR alone. Primary outcomes were respiratory parameters and secondary outcomes included cardiovascular and cardiopulmonary outcomes. All the participants attended a program of aerobic exercise (three sessions/week, 60–75% MHR, 45–55 min) for 12 weeks, plus educational, nutritional, and psychological counseling. Group (A) patients attended the same program together with BE using inspiratory muscle training (IMT) and breathing calisthenics (BC) (six sessions/week, 15–25 min) for the same duration. Results: There was a significant improvement in the respiratory outcomes, and most of the cardiovascular and cardiopulmonary outcomes in both groups with a greater change percentage in group A (p < 0.05). Conclusions: These results indicate that the addition of BE to the CR programs in CHF is effective and is a “patient-centered” approach.

Avaliação Dos Efeitos Benéficos Do Exercício Físico Para Tratamento Da Insuficiência Cardíaca

“…Portanto, além das terapias medicamentosas, é de suma importância adicionar a terapêutica da realização de exercícios físicos para o tratamento da insuficiência cardíaca, mas de forma individualizada e com acompanhamento de profissionais para que sejam realizados testes e avaliações cardiovasculares periódicas para determinar apenas benefícios do exercício físico regular e de média potência, projetando medidas não apenas de tratamento, mas também de prevenção da insuficiência cardíaca pelo controle da pressão arterial, do fluxo sanguíneo e dos remodelamentos dos ventrículos direito e esquerdo (Farghaly et al, 2022).…”

Different Continuous Training Intensities Improve Echocardiographic Parameters, Quality of Life, and Functional Capacity in Heart Failure Patients with Reduced Ejection Fraction

“…In other words, improving the breathlessness component necessitates more training. 37 Similarly, lower intensities may yield fewer improvements in HFrEF, while higher intensities hold more promising prospects.…”