Objective:To systematically evaluate the therapeutic effects of inspiratory muscle training(IMT)on cardiopulmonary functions in patients with heart failure.Methods:PubMed,EMbase,the Cochrane Library,Web of Science,CBM...Objective:To systematically evaluate the therapeutic effects of inspiratory muscle training(IMT)on cardiopulmonary functions in patients with heart failure.Methods:PubMed,EMbase,the Cochrane Library,Web of Science,CBM,WanFang Data,VIP,and CNKI databases were searched to collect randomized controlled trials about the effects of IMT on cardiopulmonary function in patients with heart failure.Meta-analysis was performed using RevMan 5.3 software after two researchers independently screened the literatures,extracted the data,and evaluated the risk of bias.Results:A total of 20 articles with 1,415 patients were included.Meta-analysis showed that IMT was able to increase the 6-minute walking distance(mean difference(MD)=59.41,95%confidence interval(CI)(51.02–67.80),P<0.001)and maximum inspiratory pressure(MD=15.59,95%CI(12.96–18.21),P<0.001)in patients with heart failure compared with the control group.But there was no statistical difference in peak oxygen uptake(MD=1.37,95%CI(?0.57–3.30),P=0.17),first second forced expiratory volume(MD=?5.79,95%CI(?12.23–0.65),P=0.08)and forced vital capacity(MD=?0.45,95%CI(?6.39–5.49),P=0.88)between the control and the experimental group.Conclusion:Available evidence suggested that IMT seemed to be a useful strategy for improving exercise capacity and inspiratory muscle strength in heart failure patients.Limited by the quantity and quality of the included studies,the above conclusions need to be verified by more high-quality studies.展开更多
While life expectancy is greatly improved after a heart transplant, survival is still limited, and compared to the general population, the exercise capacity and healthrelated quality of life of heart transplant recipi...While life expectancy is greatly improved after a heart transplant, survival is still limited, and compared to the general population, the exercise capacity and healthrelated quality of life of heart transplant recipients are reduced. Increased exercise capacity is associated with a better prognosis. However, although several studies have documented positive effects of exercise after heart transplantation(HTx), little is known about the type, frequency and intensity of exercise that provides the greatest health benefits. Moreover, the long-term effects of exercise on co-morbidities and survival are also unclear. Exercise restrictions apply to patients with a denervated heart, and for decades, it was believed that the transplanted heart remained denervated. This has since been largely disproved, but despite the new knowledge, the exercise restrictions have largely remained, and up-to-date guidelines on exercise prescription after HTx do not exist. High-intensity, interval based aerobic exercise has repeatedly been documented to have superior positive effects and health benefits compared to moderate exercise. This applies to both healthy subjects as well as in several patient groups, such as patients with metabolic syndrome, coronary artery disease or heart failure. However, whether the effects of this type of exercise are also applicable to heart transplant populations has not yet been full yestablished. The purpose of this article is to give an overview of the current knowledge about the exercise capacity and effect of exercise among heart transplant recipients and to discuss future exercise strategies.展开更多
文摘Objective:To systematically evaluate the therapeutic effects of inspiratory muscle training(IMT)on cardiopulmonary functions in patients with heart failure.Methods:PubMed,EMbase,the Cochrane Library,Web of Science,CBM,WanFang Data,VIP,and CNKI databases were searched to collect randomized controlled trials about the effects of IMT on cardiopulmonary function in patients with heart failure.Meta-analysis was performed using RevMan 5.3 software after two researchers independently screened the literatures,extracted the data,and evaluated the risk of bias.Results:A total of 20 articles with 1,415 patients were included.Meta-analysis showed that IMT was able to increase the 6-minute walking distance(mean difference(MD)=59.41,95%confidence interval(CI)(51.02–67.80),P<0.001)and maximum inspiratory pressure(MD=15.59,95%CI(12.96–18.21),P<0.001)in patients with heart failure compared with the control group.But there was no statistical difference in peak oxygen uptake(MD=1.37,95%CI(?0.57–3.30),P=0.17),first second forced expiratory volume(MD=?5.79,95%CI(?12.23–0.65),P=0.08)and forced vital capacity(MD=?0.45,95%CI(?6.39–5.49),P=0.88)between the control and the experimental group.Conclusion:Available evidence suggested that IMT seemed to be a useful strategy for improving exercise capacity and inspiratory muscle strength in heart failure patients.Limited by the quantity and quality of the included studies,the above conclusions need to be verified by more high-quality studies.
文摘While life expectancy is greatly improved after a heart transplant, survival is still limited, and compared to the general population, the exercise capacity and healthrelated quality of life of heart transplant recipients are reduced. Increased exercise capacity is associated with a better prognosis. However, although several studies have documented positive effects of exercise after heart transplantation(HTx), little is known about the type, frequency and intensity of exercise that provides the greatest health benefits. Moreover, the long-term effects of exercise on co-morbidities and survival are also unclear. Exercise restrictions apply to patients with a denervated heart, and for decades, it was believed that the transplanted heart remained denervated. This has since been largely disproved, but despite the new knowledge, the exercise restrictions have largely remained, and up-to-date guidelines on exercise prescription after HTx do not exist. High-intensity, interval based aerobic exercise has repeatedly been documented to have superior positive effects and health benefits compared to moderate exercise. This applies to both healthy subjects as well as in several patient groups, such as patients with metabolic syndrome, coronary artery disease or heart failure. However, whether the effects of this type of exercise are also applicable to heart transplant populations has not yet been full yestablished. The purpose of this article is to give an overview of the current knowledge about the exercise capacity and effect of exercise among heart transplant recipients and to discuss future exercise strategies.
