Hossein Pour Amir Hossein, Gholami Mohammad, Saki Mandana, Birjandi Mehdi
Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran.
School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran.
Jpn J Nurs Sci. 2020 Apr;17(2):e12290. doi: 10.1111/jjns.12290. Epub 2019 Aug 19.
Fatigue and dyspnea are debilitating symptoms in patients with heart failure (HF). The purpose of this study was to evaluate the effects of inspiratory muscle training (IMT) on dyspnea, fatigue and the New York Heart Association (NYHA) functional classification in patients with HF.
In this prospective, randomized, controlled trial, 84 patients with HF (NYHA classes II-III/IV) with a mean age of 56.62 ± 9.56 years were randomly assigned to a 6-week IMT (n = 42) or a sham IMT (n = 42) program. The IMT was performed at 40% of the maximal inspiratory pressure (MIP) in the IMT group and at 10% in the sham group. The main outcomes were assessed at baseline and after the intervention and included dyspnea severity scale (Modified Medical Research Council [MMRC], Fatigue Severity Scale [FSS] and the NYHA functional classification (based on the presenting symptoms).
The between-group analysis showed significant improvements in dyspnea, fatigue and the NYHA functional classification in the IMT group compared to the sham group (P < .05). The within-group analysis showed significant improvements in dyspnea (from 2.63 ± 0.79 to 1.38 ± 0.66, P < .001), fatigue (from 43.36 ± 8.5 to 28.95 ± 9.11, P < .001) and the NYHA functional classification (from 2.73 ± 0.5 to 2.1 ± 0.6, P = .001) in the IMT group, while fatigue and dyspnea increased significantly in the sham group.
The 6-week home-based IMT was found to be an effective and safe tool for reducing dyspnea and fatigue and improving the NYHA functional classification.
疲劳和呼吸困难是心力衰竭（HF）患者的衰弱症状。本研究的目的是评估吸气肌训练（IMT）对HF患者呼吸困难、疲劳及纽约心脏协会（NYHA）功能分级的影响。
在这项前瞻性、随机、对照试验中，84例平均年龄为56.62±9.56岁的HF患者（NYHA II-III/IV级）被随机分配到为期6周的IMT组（n = 42）或假IMT组（n = 42）。IMT组以最大吸气压（MIP）的40%进行训练，假IMT组以10%进行训练。在基线和干预后评估主要结局，包括呼吸困难严重程度量表（改良医学研究委员会[MMRC]）、疲劳严重程度量表（FSS）和NYHA功能分级（基于出现的症状）。
组间分析显示，与假IMT组相比，IMT组在呼吸困难、疲劳及NYHA功能分级方面有显著改善（P < 0.05）。组内分析显示，IMT组在呼吸困难（从2.63±0.79降至1.38±0.66，P < 0.001）、疲劳（从43.36±8.5降至28.95±9.11，P < 0.001）及NYHA功能分级（从2.73±0.5降至2.1±0.6，P = 0.001）方面有显著改善，而假IMT组的疲劳和呼吸困难显著增加。
为期6周的家庭式IMT被发现是减轻呼吸困难和疲劳及改善NYHA功能分级的有效且安全的方法。
