Departamento de Fisioterapia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
Arq Bras Cardiol. 2012 Aug;99(2):762-71. doi: 10.1590/s0066-782x2012001100011.
Patients with chronic heart failure (CHF) may have lower inspiratory muscle strength and endurance, which may contribute to exercise intolerance. Inspiratory muscle training (IMT) can have beneficial effects on these patients. Thus, the aim of this study was to systematically review the effects of IMT compared to control groups (placebo-IMT or another intervention) in patients with CHF. A search of databases (MEDLINE, Cochrane CENTRAL and PEDro) and references of published studies, from 1960 to 2011, was conducted. Randomized trials comparing IMT to control groups in the treatment of patients with CHF were included. The GRADE approach was used to determine the quality of evidence for each outcome. Of 119 articles identified, 7 studies were included. IMT increased the distance walked in the six-minute walk test [69 m (95% CI: 7.21 to 130.79)] (very low evidence) and maximal static inspiratory pressure [23.36 cmH20 (95% CI: 11.71 to 35.02)] (low evidence) compared to control groups. However, IMT provides a significant improvement in peak oxygen consumption only in the studies that performed IMT for 12 weeks against no inspiratory load in patients with inspiratory muscle weakness [3.02 ml/kg/min-1 (95% CI: 0.43 to 5.61)]. IMT improves functional capacity and inspiratory muscle strength thereby deserving consideration as an additional intervention in patients with CHF. Larger and better-designed studies, however, are needed to clarify the potential benefit of IMT in this patient population.
患有慢性心力衰竭（CHF）的患者可能会出现吸气肌力量和耐力降低的情况，这可能导致运动耐量下降。吸气肌训练（IMT）可能对这些患者有有益的影响。因此，本研究的目的是系统地综述 IMT 与对照组（安慰剂-IMT 或其他干预）相比在 CHF 患者中的疗效。检索了从 1960 年到 2011 年发表的数据库（MEDLINE、Cochrane CENTRAL 和 PEDro）和参考文献。纳入了比较 IMT 与对照组在 CHF 患者治疗中的随机试验。使用 GRADE 方法评估每个结局的证据质量。在 119 篇文章中，有 7 项研究被纳入。与对照组相比，IMT 可增加 6 分钟步行试验中的步行距离[69 m（95% CI：7.21 至 130.79）]（极低质量证据）和最大静态吸气压力[23.36 cmH20（95% CI：11.71 至 35.02）]（低质量证据）。然而，仅在对吸气肌无力的患者进行为期 12 周的 IMT 而无吸气负荷的研究中，IMT 可显著提高峰值耗氧量[3.02 ml/kg/min-1（95% CI：0.43 至 5.61）]。IMT 可改善功能能力和吸气肌力量，因此值得考虑作为 CHF 患者的附加干预措施。然而，需要更大和设计更好的研究来阐明 IMT 在这一患者群体中的潜在益处。
