Older patients with acute heart failure
Conditions
Interventions
High intensity nspiratory muscle training Duration: From study enrollment to discharge Load: PI-max 60%. Times: 15 times per session, 3 sets per day Frequency: at least 5 days per week
Low intensi
Sponsors
Other
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1)Patients over 65 years old admitted to the National Hospital Organization Sendai Medical Center with a diagnosis of acute heart failure and prescribed cardiac rehabilitation by a physician. 2)Patients who have been informed about the study and obtained written consent from the individual. 3)Patients who have inspiratory muscle weakness on examination at the start of cardiac rehabilitation 4)Patients who are implementable the 2-minute walk test on the examination at the start of cardiac rehabilitation.
Exclusion criteria
Exclusion criteria: 1)Acute myocardial infarction 2)Requiring care in an intensive care unit 3)Severe dementia 4)Impairment from stroke, injury, impaired consciousness, psychiatric disorder or other medical disorder that precludes participation in the intervention 5)Advanced chronic kidney disease (eGFR < 20 mL/min/1.73 m2) or dialysis 6)Prior cardiac transplantation or planned within the next 6 months 7)Expected use of continuous intravenous inotropic therapy after discharge 8)VAD, IMPELLA, or IABP is required or anticipated within the next 6 months 9)Expected use of continuous intravenous inotropic therapy after discharge 10)Uncontrolled diabetes (HbA1c > 8.4%) 11)Peripheral arterial disease (Fontain III or IV) 12)Severe anemia (hemoglobin < 8.0g/dl) 13)Patients who needed assistance for walking a month before hospitalization 14)Patients with mechanical ventilation and non-invasive positive pressure ventilation 15)Diseases and clinical conditions that are absolute contraindications to aggressive exercise training -Unstable angina or low-threshold myocardial ischemia induced by slow walking (2 METs) on a flat surface -Uncontrolled arrhythmias causing hemodynamic abnormalities (ventricular fibrillation, sustained ventricular tachycardia) -Severe valvular disease indicated for surgery, especially symptomatic aortic stenosis -Severe left ventricular outflow tract stenosis due to obstructive hypertrophic cardiomyopathy, etc. -Acute pulmonary embolism, pulmonary infarction and deep vein thrombosis -Active myocarditis, pericarditis, endocarditis -Acute systemic disease -Acute aortic dissection -Moderate or severe aortic aneurysm -Severe hypertension -Thrombophlebitis -Embolism within 2 weeks -Serious organ diseases -Mental or physical impairment that interferes with safe implementation of exercise training 16)Diseases affecting respiratory muscle strength -Neuromuscular diseases -Respiratory diseases 17)Orthopedic diseases affecting gait
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 2-minute walk distance (measured at baseline and at discharge) | — |
Secondary
| Measure | Time frame |
|---|---|
| Change in dyspnea and lower-limb fatigue before and after 2-minute walk distance, EuroQol 5-dimensional 5-level, physical activity, inspiratory and expiratory muscle strength, diaphragm thickness, tongue pressure, and respiratory sarcopenia (measured at baseline and at discharge) Number and type of adverse events and changes in vital signs with inspiratory muscle training | — |
Countries
Japan
Contacts
Public ContactRen Takahashi
Hirosaki University Graduate School of Health Sciences Division of Comprehensive Rehabilitation Sciences
Outcome results
None listed