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High-intensity vs. Low-intensity Inspiratory Muscle Training in Patients With Heart Failure

F

Federal University of Bahia

Status

Unknown

Conditions

Heart Failure

Treatments

Other: High-intensity IMT + Aerobic/resistance exercise
Other: Low-intensity IMT + Aerobic/resistance exercise
Other: Sham IMT + Aerobic/resistance exercise

Study type

Interventional

Funder types

Other

Identifiers

NCT03247361
FUBahia HIIT IMT

Details and patient eligibility

About

It is well-known that muscle weakness and deconditioning play an important role in low exercise capacity of patients with HF. Interestingly, not only peripheral muscles are impaired, but also respiratory muscles. Studies have shown that patients with HF may have, in addition to decreasing maximal inspiratory muscle strength and endurance, metabolic and structural impairments in diaphragm fibers. Moreover, exercise capacity and weakness of inspiratory muscles have been associated with low quality of life and poor prognosis, which make the addition of inspiratory muscle training (IMT) reasonable in cardiovascular rehabilitation.The specifications of the loads to be imposed during IMT is the main factor determining the outcome. Studies of IMT have highlighted the need for a fixed inspiratory workload during exercise. Thus, purpose of this report was to perform a randomized clinical trial of the effects of addition of high-intensity vs. low-intensity IMT to combined aerobic and resistance Exercise in patients with heart failure.

Enrollment

90 estimated patients

Sex

All

Ages

18 to 65 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • The target population consists of adults patients aged ≥ 18 years with heart failure and New York Heart Association (NYHA) class I-III.

Exclusion criteria

  • Unstable angina;
  • coronary revascularization;
  • Decompensated heart failure functional class IV (NYHA);
  • Recent transplant or hospitalization (6 months <);
  • Chronic Obstructive Pulmonary Disease;
  • Neuromuscular, Orthopedic, Neurologic and Neoplastic Diseases;
  • Recent myocardial infarction or cardiac surgery (less than 6 months);
  • Atrial Fibrillation.

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Triple Blind

90 participants in 3 patient groups

High-intensity IMT
Experimental group
Description:
High-intensity IMT + Aerobic/resistance exercise IMT: Training loads will be adjusted weekly to the maximal inspiratory pressure (MIP). In the first 2 weeks as adaptation, the protocol will be of 2 minutes warm-up with intensity 20% of MIP. The training will have 7 peaks of intensity with 70% of MIP for 30 sec, with 30-sec of passive rest between the peaks, finishing the training with 20% of MIP for 2 min, totaling 10 min and 30 sec. From the third week the protocol will be of 2 min warm-up with intensity 30% of MIP. The training will have 7 peaks of intensity with 70% of MIP for 60 sec, with 60-second of passive rest between the peaks, finishing the training with 20% of MIP for 2 min, totaling 17 min. Exercise: see group Combined aerobic/resistance exercise
Treatment:
Other: High-intensity IMT + Aerobic/resistance exercise
Low-intensity IMT
Active Comparator group
Description:
Low-intensity IMT + Aerobic/resistance exercise IMT:Training loads will be also adjusted weekly to the maximal inspiratory pressure (MIP). In the first two weeks as adaptation, the protocol will be of 2 minutes warm-up with intensity 20% of MIP. The training will be held with 3 sets of 15 repetitions, with 40% of MIP, finishing the training with 20% of MIP for 2 minutes. From the third week the protocol will be of 2 minutes warm-up with intensity 30% of MIP. The training will be held with 3 sets of 15 repetitions, with 60% of MIP, finishing the training with 30% of MIP for 2 minutes. Exercise: see group Combined aerobic/resistance exercise
Treatment:
Other: Low-intensity IMT + Aerobic/resistance exercise
Aerobic/resistance exercise
Sham Comparator group
Description:
Sham IMT + Aerobic/resistance exercise Aerobic session will consist of a 4-min of warm-up, 20 minutes of exercise, and 4 min of cool-down. Intensity will set by the formula: Training HR = (maximum HR - resting HR) × intensity % + resting HR. Patients will exercise using 30 seconds, high-intensity work phases 0.7% followed by 1-minute recovery bouts 0.5%. Resistance exercise will consist of dynamic lower and upper limb exercise. Upper limb exercises will include 3 sets of exercises for each muscle group performed with 10 repetitions each. Lower limb exercises will include 3 sets of exercises for each muscle group performed with 12 repetitions each. Resistance exercises will be performed at 12-MR.
Treatment:
Other: Sham IMT + Aerobic/resistance exercise

Trial contacts and locations

1

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Central trial contact

Mansueto Gomes-Neto, PhD

Data sourced from clinicaltrials.gov

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