High-intensity vs. Low-intensity Inspiratory Muscle Training in Patients With Heart Failure
Heart Failure
About this trial
This is an interventional treatment trial for Heart Failure focused on measuring Heart Failure; Rehabilitation
Eligibility Criteria
Inclusion Criteria:
- The target population consists of adults patients aged ≥ 18 years with heart failure and New York Heart Association (NYHA) class I-III.
Exclusion Criteria:
- Unstable angina;
- coronary revascularization;
- Decompensated heart failure functional class IV (NYHA);
- Recent transplant or hospitalization (6 months <);
- Chronic Obstructive Pulmonary Disease;
- Neuromuscular, Orthopedic, Neurologic and Neoplastic Diseases;
- Recent myocardial infarction or cardiac surgery (less than 6 months);
- Atrial Fibrillation.
Sites / Locations
- Mansueto Gomes NetoRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Active Comparator
Sham Comparator
High-intensity IMT
Low-intensity IMT
Aerobic/resistance exercise
High-intensity IMT + Aerobic/resistance exercise IMT: Training loads will be adjusted weekly to the maximal inspiratory pressure (MIP). In the first 2 weeks as adaptation, the protocol will be of 2 minutes warm-up with intensity 20% of MIP. The training will have 7 peaks of intensity with 70% of MIP for 30 sec, with 30-sec of passive rest between the peaks, finishing the training with 20% of MIP for 2 min, totaling 10 min and 30 sec. From the third week the protocol will be of 2 min warm-up with intensity 30% of MIP. The training will have 7 peaks of intensity with 70% of MIP for 60 sec, with 60-second of passive rest between the peaks, finishing the training with 20% of MIP for 2 min, totaling 17 min. Exercise: see group Combined aerobic/resistance exercise
Low-intensity IMT + Aerobic/resistance exercise IMT:Training loads will be also adjusted weekly to the maximal inspiratory pressure (MIP). In the first two weeks as adaptation, the protocol will be of 2 minutes warm-up with intensity 20% of MIP. The training will be held with 3 sets of 15 repetitions, with 40% of MIP, finishing the training with 20% of MIP for 2 minutes. From the third week the protocol will be of 2 minutes warm-up with intensity 30% of MIP. The training will be held with 3 sets of 15 repetitions, with 60% of MIP, finishing the training with 30% of MIP for 2 minutes. Exercise: see group Combined aerobic/resistance exercise
Sham IMT + Aerobic/resistance exercise Aerobic session will consist of a 4-min of warm-up, 20 minutes of exercise, and 4 min of cool-down. Intensity will set by the formula: Training HR = (maximum HR - resting HR) × intensity % + resting HR. Patients will exercise using 30 seconds, high-intensity work phases 0.7% followed by 1-minute recovery bouts 0.5%. Resistance exercise will consist of dynamic lower and upper limb exercise. Upper limb exercises will include 3 sets of exercises for each muscle group performed with 10 repetitions each. Lower limb exercises will include 3 sets of exercises for each muscle group performed with 12 repetitions each. Resistance exercises will be performed at 12-MR.