Cor Vasa 2021, 63(1):41-47 | DOI: 10.33678/cor.2020.095

(The expiratory muscle training in patients with chronic heart failure)

Filip Dosbaba

Rehabilitační oddělení, Fakultní nemocnice Brno, Brno

Introduction: Chronic heart failure (CHF) is accompanied by dyspnea of various etiologies, one of which is respiratory muscle myopathy.

Aim: To objectify the effect of home expiratory muscle training with the expiratory trainer on occlusive oral pressures, chest expansion, dyspnea and fatigue in patients with CHF.

Materials and methods: 26 consecutive patients with stable CHF (NYHA II-III, left ventricular ejection frac- tion ≤45%) were prospectively included in the study. Patients were divided into an intervention group - 13 patients who performed expiratory muscle training with 5-20% of maximum expiratory occlusive pressure, 13 patients represented a control group without intervention. Occlusive oral pressures, chest expansion, and dyspnea were assessed in all patients.

Results: After 10 weeks of expiratory muscle training the maximum expiratory occlusion pressure (PE_MAX) increased significantly from 7.48 (4.73-10.35) kPa to 9.09 (8.12-11.99) kPa (p = 0.007), the maximum inspiratory occlusion pressure (PI_MAX) also increased from 4.95 (3.89-7.86) kPa to 7.35 (5.25-8.72) kPa (p <0.001). There was a statistically significant increase in chest expansion in the xiphosternal (p = 0.005) and meso- sternal areas (p = 0.002). There was a significant improvement in the subjective assessment of dyspnea using the modified Medical Research Council (mMRC) questionnaire (p = 0.003). A decrease in PE_MAX (p = 0.045) and a non-significant decrease in PI_MAX (p = 0.107) were observed in the control group. Chest expansion de- creased insignificantly in both areas and mMRC in the control group. After 10 weeks of training, a statistically significant difference between the given parameters was observed in both examined groups (p <0.05).

Conclusion: The expiratory muscle training significantly increases the strength of respiratory muscles characterized by occlusive oral pressures, improves chest expansion, reduces subjectively perceived stress dyspnea and fatigue in patients with stabilized CHF.

Keywords: Expiratory muscle, Heart failure, Occlusive mouth pressure, Quality of life, Respiratory training

Received: September 25, 2020; Revised: October 20, 2020; Accepted: October 24, 2020; Published: February 25, 2021  Show citation