Jessiane Bianca Pinheiro da Silva, Maria Carolina Rosário Santana, Bruno Prata Martinez, Helder Brito Duarte
{"title":"无创通气支持作为提高心力衰竭患者运动耐受性的工具：荟萃分析的系统回顾","authors":"Jessiane Bianca Pinheiro da Silva, Maria Carolina Rosário Santana, Bruno Prata Martinez, Helder Brito Duarte","doi":"10.1002/pri.70037","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong>Heart failure (HF) is a complex syndrome that impacts persons' daily activities and adherence to exercise programs. Non-Invasive ventilation (NIV) reduces respiratory load and improves cardiac function, potentially serving as an important adjunct in its treatment. These effects can be enhanced with a cardiac rehabilitation program, improving dyspnea and functionality. This study aimed to evaluate the effects of NIV during exercise on functional performance outcomes, dyspnea, QL, hemodynamics, and respiratory function.</p><p><strong>Methods: </strong>A systematic review followed by meta-analysis was conducted. Searches were performed in PubMed, CENTRAL, Embase, LILACS, SciELO, and CINAHL.</p><p><strong>Eligibility criteria: </strong>Randomized clinical trials of patients over 18 years of age with HF, compared to a control group, were included with the objective of improving exercise tolerance. The studies were categorized as short-term effects of NIV and those implementing an exercise program.</p><p><strong>Results: </strong>Seven studies were included in the qualitative review and five in the meta-analysis. Only two studies presented a low risk of bias. The analyzed outcomes were the 6-min walk test (6MWT), dyspnea, SpO2, heart rate (HR), systolic, and diastolic arterial pressure (SAP and DAP, respectively), maximal inspiratory and expiratory muscle strength (MIP and MEP, respectively), forced expiratory volume in one second (FEV1), and quality of life (QL).</p><p><strong>Discussion: </strong>There was a significant difference in favor of the NIV group compared to the control group in both modalities in relation to the 6MWT, with a mean difference (MD) 41.72 (CI 95% 2.15, 81.29) meters in the exercise program and MD 68.61 (CI 95% 5.69, 131.54) meters in short-term effect studies. There were also favorable results in the outcomes of dyspnea and FEV1 in the NIV group (p < 0.01). There were no statistically significant differences in the outcomes peripheral oxygen saturation (p = 0.11), systolic (p = 0.76) and diastolic blood pressure (p = 0.93), heart rate (p = 0.19), MIP (p = 0.49), MEP (p = 0.22) and QL (p = 0.13).</p><p><strong>Trail registration: </strong>PROSPERO CRD42022367746.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 2","pages":"e70037"},"PeriodicalIF":1.8000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Non-Invasive Ventilatory Support as a Tool to Improve Exercise Tolerance in Patients With Heart Failure: A Systematic Review With Meta-Analysis.\",\"authors\":\"Jessiane Bianca Pinheiro da Silva, Maria Carolina Rosário Santana, Bruno Prata Martinez, Helder Brito Duarte\",\"doi\":\"10.1002/pri.70037\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and purpose: </strong>Heart failure (HF) is a complex syndrome that impacts persons' daily activities and adherence to exercise programs. Non-Invasive ventilation (NIV) reduces respiratory load and improves cardiac function, potentially serving as an important adjunct in its treatment. These effects can be enhanced with a cardiac rehabilitation program, improving dyspnea and functionality. This study aimed to evaluate the effects of NIV during exercise on functional performance outcomes, dyspnea, QL, hemodynamics, and respiratory function.</p><p><strong>Methods: </strong>A systematic review followed by meta-analysis was conducted. Searches were performed in PubMed, CENTRAL, Embase, LILACS, SciELO, and CINAHL.</p><p><strong>Eligibility criteria: </strong>Randomized clinical trials of patients over 18 years of age with HF, compared to a control group, were included with the objective of improving exercise tolerance. The studies were categorized as short-term effects of NIV and those implementing an exercise program.</p><p><strong>Results: </strong>Seven studies were included in the qualitative review and five in the meta-analysis. Only two studies presented a low risk of bias. The analyzed outcomes were the 6-min walk test (6MWT), dyspnea, SpO2, heart rate (HR), systolic, and diastolic arterial pressure (SAP and DAP, respectively), maximal inspiratory and expiratory muscle strength (MIP and MEP, respectively), forced expiratory volume in one second (FEV1), and quality of life (QL).</p><p><strong>Discussion: </strong>There was a significant difference in favor of the NIV group compared to the control group in both modalities in relation to the 6MWT, with a mean difference (MD) 41.72 (CI 95% 2.15, 81.29) meters in the exercise program and MD 68.61 (CI 95% 5.69, 131.54) meters in short-term effect studies. 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Non-Invasive Ventilatory Support as a Tool to Improve Exercise Tolerance in Patients With Heart Failure: A Systematic Review With Meta-Analysis.
Background and purpose: Heart failure (HF) is a complex syndrome that impacts persons' daily activities and adherence to exercise programs. Non-Invasive ventilation (NIV) reduces respiratory load and improves cardiac function, potentially serving as an important adjunct in its treatment. These effects can be enhanced with a cardiac rehabilitation program, improving dyspnea and functionality. This study aimed to evaluate the effects of NIV during exercise on functional performance outcomes, dyspnea, QL, hemodynamics, and respiratory function.
Methods: A systematic review followed by meta-analysis was conducted. Searches were performed in PubMed, CENTRAL, Embase, LILACS, SciELO, and CINAHL.
Eligibility criteria: Randomized clinical trials of patients over 18 years of age with HF, compared to a control group, were included with the objective of improving exercise tolerance. The studies were categorized as short-term effects of NIV and those implementing an exercise program.
Results: Seven studies were included in the qualitative review and five in the meta-analysis. Only two studies presented a low risk of bias. The analyzed outcomes were the 6-min walk test (6MWT), dyspnea, SpO2, heart rate (HR), systolic, and diastolic arterial pressure (SAP and DAP, respectively), maximal inspiratory and expiratory muscle strength (MIP and MEP, respectively), forced expiratory volume in one second (FEV1), and quality of life (QL).
Discussion: There was a significant difference in favor of the NIV group compared to the control group in both modalities in relation to the 6MWT, with a mean difference (MD) 41.72 (CI 95% 2.15, 81.29) meters in the exercise program and MD 68.61 (CI 95% 5.69, 131.54) meters in short-term effect studies. There were also favorable results in the outcomes of dyspnea and FEV1 in the NIV group (p < 0.01). There were no statistically significant differences in the outcomes peripheral oxygen saturation (p = 0.11), systolic (p = 0.76) and diastolic blood pressure (p = 0.93), heart rate (p = 0.19), MIP (p = 0.49), MEP (p = 0.22) and QL (p = 0.13).
期刊介绍：
Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.
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