Archive | 2021
(The expiratory muscle training in patients with chronic heart failure)
Abstract
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 fraction ≤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 signifi cantly 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 signifi cant increase in chest expansion in the xiphosternal (p = 0.005) and mesosternal areas (p = 0.002). There was a signifi cant improvement in the subjective assessment of dyspnea using the modifi ed Medical Research Council (mMRC) questionnaire (p = 0.003). A decrease in PE MAX (p = 0.045) and a non-signifi cant decrease in PI MAX (p = 0.107) were observed in the control group. Chest expansion decreased insignifi cantly in both areas and mMRC in the control group. After 10 weeks of training, a statistically signifi cant difference between the given parameters was observed in both examined groups (p <0.05). Conclusion: The expiratory muscle training signifi cantly 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. Klíčová slova: