Heart Failure & Disease

Any condition that prevents normal physical activity can lead to inspiratory muscle weakness, such as heart conditions.

In patients with chronic heart failure, inspiratory muscle training, such as with the POWERbreathe Medic, has been shown to:

• Improve exercise tolerance by 19%^2,3
• Improve quality of life by 16%^2,3

Patients with chronic heart failure (CHF) have a restrictive pattern of lung function due to the presence of pulmonary hypertension. This lung 'stiffness' increases the load on the inspiratory muscles and makes a significant contribution to their dyspnoea. In addition, there is evidence of inspiratory muscle weakness that emerges as an independent predictor of prognosis in this group of patients¹. Two randomised controlled trials of IMT both reported significant improvements in dyspnoea, exercise tolerance (see figure 1), quality of life^2,3.

Because the cardiovascular strain of POWERbreathe training is very low, it is suitable for even the most physically compromised patients, and is particularly helpful in patients who are too ill for rehabilitation.

Research

Links to research papers, published in peer-reviewed, high quality scientific journals. As well as original studies, we have also included some articles that review IMT; these have been written by experts in this field of research.

Evidence that the condition of the inspiratory muscles is impaired

• Inspiratory muscle strength is a determinant of maximum oxygen consumption in chronic heart failure.
• The oxygen cost of breathing in patients with cardiorespiratory disease.
• Muscle strength, symptom intensity, and exercise capacity in patients with cardiorespiratory disorders.
• Inspiratory muscle relaxation rate slows during exhaustive treadmill walking in patients with chronic heart failure.
• Respiratory muscle function and exercise intolerance in heart failure.

• ¹ Respiratory muscle dysfunction in congestive heart failure: clinical correlation and prognostic significance.

Studies showing that IMT is helpful

• Addition of inspiratory muscle training to aerobic training improves cardiorespiratory responses to exercise in patients with heart failure and inspiratory muscle weakness
• Effects of Inspiratory Muscle Training on Autonomic Activity, Endothelial Vasodilator Function, and N-Terminal Pro-brain Natriuretic Peptide Levels in Chronic Heart Failure.
• Inspiratory muscle training improves blood flow to resting and exercising limbs in patients with chronic heart failure.
• Inspiratory muscle training in patients with chronic heart failure awaiting cardiac transplantation: results of a pilot clinical trial.
• ² Inspiratory muscle training using an incremental endurance test alleviates dyspnea and improves functional status in patients with chronic heart failure.
• ³ Inspiratory muscle training in patients with heart failure and inspiratory muscle weakness: a randomized trial.
• Effects of resistive breathing on exercise capacity and diaphragm function in patients with ischaemic heart disease.
• Selective training of respiratory muscles in patients with chronic heart failure.
• Effect of specific inspiratory muscle training on dyspnea and exercise tolerance in congestive heart failure.
• Benefit of selective respiratory muscle training on exercise capacity in patients with chronic congestive heart failure.
• A home-based nurse-coached inspiratory muscle training intervention in heart failure.
• Inspiratory muscle training improves blood flow to resting and exercising limbs in patients with chronic heart failure.
• Immune response to inspiratory muscle training in patients with chronic heart failure.
• Effects of inspiratory muscle training on autonomic activity, endothelial vasodilator function, and N-terminal pro-brain natriuretic peptide levels in chronic heart failure.