Inspiratory Muscle Training on Exercise Capacity, Dyspnoea and Health Status in Pulmonary Hypertension: A Randomised Controlled Trial.

IF 6.3 2区医学 Q1 RESPIRATORY SYSTEM

Respirology Pub Date : 2025-08-01 Epub Date: 2025-05-26 DOI:10.1111/resp.70054

Fabrício Farias da Fontoura, Gabriela Roncato, Gisela Martina Bohns Meyer, Cássia da Luz Goulart, Fernanda Brum Spilimbergo, Gerson Cipriano Junior, Marilia Gabriela Bernadeli, Katya Rigatto, Danilo Cortozi Berton

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Abstract

Background and objective: To evaluate the effects of a high-intensity inspiratory muscle training on respiratory muscle strength, exercise capacity, dyspnoea, and health-related quality of life (HRQL) in patients with pulmonary hypertension (PH).

Methods: Single-blinded, randomised controlled trial 35 women with clinically stable PH (subgroups 1 and 4), functional class II and III, were randomly assigned to a high-intensity inspiratory muscle training (IMT) or sham training. Daily 8-week IMT protocol with 50% (IMT-50%) of maximal inspiratory muscle pressure (PImax) or sham training with a fixed load of 3 cmH₂O (IMT-S). Daily training time consisted of 2 cycles of 30 dynamic inspiratory efforts twice daily, 7 days/week, for 8 weeks using an inspiratory threshold-loading device.

Results: There were significantly greater improvements in the intervention group (17 patients) compared to sham (14 patients) on PImax [Δpost-pre = 56.4 cmH₂O (95% CI 63.5 to 49.3) versus IMT-S 25.2 cmH₂O (95% CI 33.1 to 17.4), p < 0.001]. The intervention group improved their 6MWT [Δpost-pre, IMT 50% = 33.5 m (95% CI 15.9 to 51.2) vs. IMT-S -1.1 m (95% CI -26.7 to 24.4), p < 0.001]. Dyspnoea perception at the end of the 6-min walk test (6MWT) and mMRC significantly improved in the IMT-50% group: Dyspnoea [Δpost-pre = -1.1 (95% CI -1.5 to -0.7) vs. IMT-S -0.2 (95% CI -1.3 to 0.9), p < 0.001] and mMRC [Δpost-pre = -0.6 (95% CI -0.8 to 0.3) vs. IMT-S 0 (95% CI -0.2 to 0.2), p < 0.001].

Conclusions: A high-intensity protocol of IMT improves respiratory muscle strength, exercise capacity, and dyspnoea in symptomatic patients with PH.

Trial registration: The trial was recorded on the Trials registry RBR-33gm3k (https://ensaiosclinicos.gov.br/rg/RBR-33gm3k).

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吸气肌训练对肺动脉高压患者运动能力、呼吸困难和健康状况的影响：一项随机对照试验。

背景与目的：评价高强度吸气肌训练对肺动脉高压（PH）患者呼吸肌力量、运动能力、呼吸困难和健康相关生活质量（HRQL）的影响。方法：单盲、随机对照试验，35名临床PH稳定的女性（亚组1和4），功能等级II和III，随机分配到高强度吸气肌训练（IMT）或假训练。每日8周的IMT方案，最大吸气肌压力（PImax）为50% （IMT-50%）或假训练，固定负荷为3 cmH2O （IMT- s）。每日训练时间包括2个周期，每次30次动态吸气，每天两次，每周7天，连续8周使用吸气阈值加载装置。结果：干预组（17例）比假手术组（14例）有更大的改善[Δpost-pre = 56.4 cmH2O （95% CI 63.5至49.3）相比IMT- s 25.2 cmH2O (95% CI 33.1至17.4),p]。结论：高强度IMT方案改善有症状的ph患者的呼吸肌力量，运动能力和呼吸困难。试验记录在试验注册中心RBR-33gm3k （https://ensaiosclinicos.gov.br/rg/RBR-33gm3k）上。

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来源期刊

Respirology 医学-呼吸系统

CiteScore

10.60

自引率

5.80%

发文量

225

审稿时长

1 months

期刊介绍： Respirology is a journal of international standing, publishing peer-reviewed articles of scientific excellence in clinical and clinically-relevant experimental respiratory biology and disease. Fields of research include immunology, intensive and critical care, epidemiology, cell and molecular biology, pathology, pharmacology, physiology, paediatric respiratory medicine, clinical trials, interventional pulmonology and thoracic surgery. The Journal aims to encourage the international exchange of results and publishes papers in the following categories: Original Articles, Editorials, Reviews, and Correspondences. Respirology is the preferred journal of the Thoracic Society of Australia and New Zealand, has been adopted as the preferred English journal of the Japanese Respiratory Society and the Taiwan Society of Pulmonary and Critical Care Medicine and is an official journal of the World Association for Bronchology and Interventional Pulmonology.