Effects of peripheral and different inspiratory muscle training methods in coronary artery disease patients with metabolic syndrome: A randomized-controlled trial

Kıymet Muammer; Fatma Mutluay; Rengin Demir; Alev Arat Özkan

doi:10.1016/j.rmed.2020.106119

Effects of peripheral and different inspiratory muscle training methods in coronary artery disease patients with metabolic syndrome: A randomized-controlled trial

Respir Med. 2020 Oct:172:106119. doi: 10.1016/j.rmed.2020.106119. Epub 2020 Aug 22.

Authors

Kıymet Muammer¹, Fatma Mutluay², Rengin Demir¹, Alev Arat Özkan¹

Affiliations

¹ Department of Cardiology, Cardiology Institute, Istanbul University-Cerrahpasa, Istanbul, Turkey.
² Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Medipol University, Istanbul, Turkey. Electronic address: fmutluay@medipol.edu.tr.

PMID: 32877886
DOI: 10.1016/j.rmed.2020.106119

Abstract

Background OBJECTIVE: To investigate the effects of peripheral muscle training (PMT) and different inspiratory muscle training (IMT) methods on respiratory functions, exercise capacity, and biochemistry parameters in coronary artery disease patients with metabolic syndrome.

Methods: This prospective, single-blind, randomized-controlled study included 60 patients of stable coronary artery disease with metabolic syndrome (New York Heart Association [NYHA] Class I-II, left ventricular ejection fraction >40%). Patients were randomly divided into three groups: neuromuscular electrical stimulation (NMES) plus PMT group (NMES + PMT group, n = 20), IMT plus PMT group (IMT + PMT group, n = 20) and PMT group (PMT group, n = 20). Treatment continued for six weeks for all groups. The NMES was applied to rectus abdominis, IMT was applied with 30% of maximal inspiratory pressures, and PMT was applied at home. Spirometry, maximal inspiratory and expiratory pressure, dyspnea scores, exercise stress test, and biochemistry parameters were measured before and after training.

Results: There were significant improvements in spirometric tests, respiratory muscle strength, dyspnea scores, exercise capacity, fasting blood glucose, and antistreptolysin O after treatment in all groups (p < 0.05). Significant improvements in C-reactive protein and erythrocyte sedimentation rate were observed in NMES + PMT and IMT + PMT groups (p < 0.05). Among the groups, there was a significant difference in maximal inspiratory pressure (p = 0.02) and erythrocyte sedimentation rate (p = 0.037) in favor of NMES + PMT group (p < 0.05).

Conclusion: Our study results showed significant improvements in respiratory functions, exercise capacity, and biochemistry markers in all groups. Different IMT methods can be used in cardiopulmonary rehabilitation to improve exercise intolerance in coronary artery disease patients with metabolic syndrome.

Clinical trial registration number: NCT03523026.

Keywords: Coronary artery disease; Inspiratory muscle training; Metabolic syndrome; Neuromuscular electrical stimulation; Peripheral muscle training.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Aged
Antistreptolysin / metabolism
Blood Glucose / metabolism
Blood Sedimentation
Breathing Exercises / methods*
C-Reactive Protein / metabolism
Coronary Artery Disease / etiology
Coronary Artery Disease / metabolism
Coronary Artery Disease / physiopathology*
Coronary Artery Disease / rehabilitation*
Electric Stimulation Therapy
Exercise Tolerance*
Fasting
Female
Humans
Male
Metabolic Syndrome / complications
Metabolic Syndrome / metabolism
Metabolic Syndrome / physiopathology*
Metabolic Syndrome / rehabilitation*
Middle Aged
Muscle Strength
Prospective Studies
Respiratory Muscles / physiology*
Spirometry
Treatment Outcome

Substances

Blood Glucose
Antistreptolysin
C-Reactive Protein

Associated data

ClinicalTrials.gov/NCT03523026