Montemezzo Dayane, Fregonezi Guilherme Augusto, Pereira Danielle Aparecida, Britto Raquel Rodrigues, Reid W Darlene
Rehabilitation Sciences Graduation Program, Laboratory of Assessment and Research in Cardiorespiratory Performance, Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Laboratory of Physical Therapy PneumoCardioVascular, Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
Arch Phys Med Rehabil. 2014 Jul;95(7):1398-407. doi: 10.1016/j.apmr.2014.02.022. Epub 2014 Mar 13.
To determine whether the impact of inspiratory muscle weakness on inspiratory muscle training (IMT) affects inspiratory function and exercise capacity in chronic heart failure (CHF) patients.
Electronic searches were performed using the Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Cochrane Systematic Review, Embase, MEDLINE, and Physiotherapy Evidence Database (PEDro) databases up to August 2013.
Articles were included if participants had CHF and were >18 years old; the design was a randomized controlled trial; intervention was IMT; measurements were of inspiratory muscle function or exercise capacity; and the articles were published in English, Portuguese, or Spanish. Of the 1455 articles identified in the database searches, 9 studies met the inclusion criteria.
Two independent reviewers selected and extracted information from articles and assessed the quality of the studies using the PEDro scale. The 2 reviewers discussed disagreements until consensus was achieved.
Meta-analyses compared IMT with controls/sham for maximal inspiratory pressure, sustained maximal inspiratory pressure, 6-minute walk distance, peak oxygen consumption, and minute ventilation after IMT. Subgroup analyses compared those with and without muscle weakness. CHF with inspiratory muscle weakness showed greater gains in the 6-minute walk distance and peak oxygen consumption compared with those with normative maximal inspiratory pressure. The mean quality analysis score was 7.1, and scores ranged from 6 to 10.
The results emphasize the importance of evaluating the inspiratory muscles to identify patients with CHF and inspiratory muscle weakness; subgroup that showed better results after IMT.
确定吸气肌无力对吸气肌训练（IMT）的影响是否会影响慢性心力衰竭（CHF）患者的吸气功能和运动能力。
截至2013年8月，使用护理学与健康相关文献累积索引、Cochrane对照试验中心注册库、Cochrane系统评价、Embase、MEDLINE和物理治疗证据数据库（PEDro）数据库进行电子检索。
纳入的文章要求参与者患有CHF且年龄大于18岁；设计为随机对照试验；干预措施为IMT；测量指标为吸气肌功能或运动能力；文章以英文、葡萄牙文或西班牙文发表。在数据库检索中识别出的1455篇文章中，有9项研究符合纳入标准。
两名独立的评审员从文章中选择并提取信息，并使用PEDro量表评估研究质量。两位评审员讨论分歧，直至达成共识。
荟萃分析比较了IMT与对照组/假干预组在最大吸气压、持续最大吸气压、6分钟步行距离、峰值耗氧量和IMT后每分通气量方面的差异。亚组分析比较了有和没有肌无力的患者。与最大吸气压正常的患者相比，伴有吸气肌无力的CHF患者在6分钟步行距离和峰值耗氧量方面有更大的改善。平均质量分析得分为7.1，分数范围为6至10分。
结果强调了评估吸气肌以识别CHF和吸气肌无力患者的重要性；该亚组在IMT后显示出更好的结果。
