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European Journal of Physical and Rehabilitation Medicine 2015 December;51(6):773-9

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Acute hemodynamic and electrocardiographic responses to a session of inspiratory muscle training in cardiopulmonary rehabilitation

Ramos P. S. 1, 2, Da Costa Da Silva B. 1, Gomes Da Silva L. O. 1, Araújo C. G. 1, 3

1 Exercise Medicine Clinic – Clinimex, Rio de Janeiro, Brazil; 2 Faculty of Medical and Health Science, Maternity Hospital Therezinha de Jesus, SUPREMA, Juiz de Fora, Brazil; 3 Heart Institute Edson Saad, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil



BACKGROUND: Inspiratory muscle training (IMT) has been shown to generate significant benefits in different clinical conditions; however, there is scarce information regarding acute clinical and hemodynamic effects.
AIM: The aim of this study was to evaluate clinical, hemodynamic and electrocardiographic responses during a single short IMT session in patients enrolled in cardiopulmonary rehabilitation program (CRP).
DESIGN: Cross-sectional study.
SETTING: Patients referred and regularly attending a non-hospital based medically-supervised exercise program.
POPULATION: One hundred and sixty patients patients who regularly performed inspiratory muscle training
METHODS: A convenience sample of 21 elderly patients (16 men; 60-87 years of age) had an ECG continuously recorded and heart rate (HR) and blood pressure (BP) measured before, during and one-minute after a single IMT session - two sets of 15 cycles with one-minute interval.
RESULTS: Comparing values obtained before, during second set and one-minute after IMT, no differences were found to HR (bpm) - 68±2 vs. 70±2 vs. 66±3 (P=0.05) and in systolic and diastolic BP (mm Hg) values, respectively, - 105±3 vs. 111±4 vs. 108±3 (P=0.06) and - 68±2 vs. 72±3 vs. 68±2 (P=0.14); (before, during second set and one-minute after TMI). During IMT, seven (33%) of patients presented minor cardiac arrhythmias, most of them isolated premature ventricular contractions. Additionally, no abnormal signs or symptoms were found.
CONCLUSION: Apart of minor and clinically irrelevant ECG abnormalities seen in 1/3 of the patients, a short IMT session did not induce significant hemodynamic responses or relevant clinical abnormalities. Based on these results, for elderly patients involved in CPR, IMT seems to be clinically safe and continuous ECG monitoring did not seem to add significant or relevant information.
CLINICAL REHABILITATION IMPACT: For elderly patients participating in CPR, short IMT sessions do not induce major hemodynamic responses and seem to be clinically safe. This is potentially useful information if IMT is to be prescribed in home-based programs.

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