Trénink expiračního svalstva u pacientů s chronickým srdečním selháním - průběžné výsledky pilotní studie

• Title in English: The pulmonary effects of exspiratory muscle training in patients with heart failure
• Authors: DOSBABA Filip; ŽURKOVÁ Petra; BAŤALÍK Ladislav; VYSOKÝ Robert; LUDKA Ondřej; ŠPINAR Jindřich
• Year of publication: 2016
• Type: Conference abstract
• MU Faculty or unit: Faculty of Medicine
• Description: Aim: to objectify the effect of at-home-performed expiratory muscle training (EMT) with a Threshold PEP® trainer on functional lung capacity, mouth occlusion pressures, chest expansion, dyspnea and fatigue in patients with systolic heart failure. Methods: prospective consecutive evaluation of 23 patients with systolic heart failure (NYHA II-III, ejection fraction< 45 %). Patients were divided as follows: 13 patients were included in the intervention group, performing EMT with a 5-20 % of maximum expiration occlusion pressure. 10 patients were included in the control group, without intervention. In all patients spirometric and bodypletismographic parameters, chest expansion and level of dyspnea were evaluated. Results: a significant improvement of selected parameters was observed in the group with EMT compared to the control group (p 0.05). Expiratory muscle strength PEmax = 7.59 (4.83 – 10.99) to 9.49 (8.02 – 12.65); PImax = 4.80 (3.90 – 7.59) to 7.20 (5.39 – 8.90) kPa, p < 0.001); parameters FEV1 and PEF, p 0.05; chest expansion in xiphosternal line, p = 0.007; in mesosternal line, p = 0.001; dyspnoe evaluation mMRC (2 (1 – 2) to 1 (0 – 2), p = 0.002). In the control group respiratory muscle strength decreased (PEmax = 7.95 (7.20 – 14.60) to 7.76 (4.25 – 11.23), p = 0.055), PImax = 7.05 (4.20 – 9.10) to 6.10 (5.00 – 8.20)kPa, p = 0.0117); chest expansion decreased, p < 0.5; subjective perception of dyspnea mMRC stagnated (2 (1 – 3), p = 0.625). Significant differences an all selected parameters were observed between the two groups with p* 0.05. Conclusion: EMT significantly improves functional capacity, increases respiratory muscle strength characterized by mouth occlusion pressures, improves chest expansion; decreases subjective perception of stress dyspnoe and fatigue in patients with chronic heart failure. Supported by the project (Ministry of Health. Czech Republic) for conceptual development of research organization 65269705 (University Hospital Brno, Brno, Czech Republic).