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"Exercise tolerance"

Review Article

Cardiopulmonary rehabilitation

Effectiveness of Inspiratory Muscle Training on Respiratory Muscle Strength in Patients Undergoing Cardiac Surgeries: A Systematic Review With Meta-Analysis
Fiona Verdine Dsouza, Sampath Kumar Amaravadi, Stephen Rajan Samuel, Harish Raghavan, Nagaraja Ravishankar
Ann Rehabil Med 2021;45(4):264-273.   Published online August 30, 2021
DOI: https://doi.org/10.5535/arm.21027
To determine the effect of inspiratory muscle training (IMT) on pulmonary function, respiratory muscle strength (RMS), and functional capacity in patients undergoing cardiac surgery. The PubMed, PEDro, CINAHL, Web of Science, CENTRAL, and EMBASE databases were searched from inception to June 2020. Randomized controlled trials (RCTs) that evaluated patients who underwent cardiac surgery were included in this review. Meta-analysis performed using a random-effects model showed that the mean difference in forced vital capacity, forced expiratory volume in 1 second, 6-minute walk distance, and RMS was 3.47% (95% confidence interval [CI], 0.57 to 6.36), 5.80% (95% CI, 2.03 to 9.56), 78.05 m (95% CI, 60.92 to 95.18), and 4.8 cmH2O (95% CI, -4.00 to 13.4), respectively. There is strong evidence that IMT improves inspiratory muscle strength, pulmonary function, and functional capacity, and reduces the length of hospital stay in patients undergoing cardiac surgery.

Citations

Citations to this article as recorded by  
  • The Effects of Pursed Lip Breathing Exercises on Patients' Post‐Bronchoscopy Recovery Parameters: A Nurse‐Led Quasi‐Experimental Study
    Rasha Abdulhalim Alqadi, Azza Ibrahim Abdelkader Habiba, Hanaa Hamad Mohamed El Sayed Akl, Engy AbdelRhman Khamis, Daniel Joseph E. Berdida
    Nursing & Health Sciences.2025;[Epub]     CrossRef
  • Can resistance prehabilitation training bring additional benefits in valvular cardiac surgery? protocol for a randomized controlled trial
    Jorge Montero-Cámara, Francisco José Ferrer-Sargues, María José Segrera Rovira, Adrián Sarria Cabello, David Cuesta Peredo, Juan Antonio Margarit Calabuig, Noemí Valtueña-Gimeno, María Luz Sánchez-Sánchez, Robert Jeenchen Chen
    PLOS ONE.2024; 19(5): e0303163.     CrossRef
  • Effectiveness of improving coordination abilities after cardiac surgery: a review
    Natalya V. Arkhipova, Svetlana A. Pomeshkina, Evgeniy V. Bykov
    Bulletin of Rehabilitation Medicine.2024; 23(3): 52.     CrossRef
  • Inspiratory Muscle Training in Phase 1 and 2 Postoperative Cardiac Rehabilitation Following Coronary Artery Bypass Graft Surgery: Systematic Review With Meta-Analysis
    Clênia Oliveira Araújo, Carla Cristina Araújo Alves, Francisco R A dos Santos, Lawrence P Cahalin, Graziella França Bernardelli Cipriano, Gerson Cipriano
    Physical Therapy.2024;[Epub]     CrossRef
  • Effect of Inspiratory Muscle Training on Outcomes After Cardiac Surgery
    Linqi Fang, Anqi Cheng, Zhaohua Zhu, Mengming Shao, Guoai Wang
    Journal of Cardiopulmonary Rehabilitation and Prevention.2024; 44(5): 324.     CrossRef
  • Effects of preoperative respiratory muscle training for improvement of postoperative health related quality of life in mitral valve replacement patients
    Umama Umar, Ahad Hussain, Komal Tariq
    Physiotherapy Research International.2024;[Epub]     CrossRef
  • Benefits from Implementing Low- to High-Intensity Inspiratory Muscle Training in Patients Undergoing Cardiac Surgery: A Systematic Review
    Aphrodite Evangelodimou, Irini Patsaki, Alexandros Andrikopoulos, Foteini Chatzivasiloglou, Stavros Dimopoulos
    Journal of Cardiovascular Development and Disease.2024; 11(12): 380.     CrossRef
  • The impact of threshold-loaded inspiratory muscle training and respiratory biofeedback on preserving inspiratory muscle strength and vital capacity after CABG: a randomized clinical trial
    Bahareh Mehregan-Far
    American Journal of Cardiovascular Disease.2024; 14(6): 375.     CrossRef
  • Distinguishing science from pseudoscience in commercial respiratory interventions: an evidence-based guide for health and exercise professionals
    Camilla R. Illidi, Lee M. Romer, Michael A. Johnson, Neil C. Williams, Harry B. Rossiter, Richard Casaburi, Nicholas B. Tiller
    European Journal of Applied Physiology.2023; 123(8): 1599.     CrossRef
  • Inspiratory Muscle and Functional Performance of Patients Entering Cardiac Rehabilitation after Cardiac Valve Replacement
    Sabine Gempel, Meryl Cohen, Eryn Milian, Melany Vidret, Andrew Smith, Ian Jones, Yessenia Orozco, Neva Kirk-Sanchez, Lawrence P. Cahalin
    Journal of Cardiovascular Development and Disease.2023; 10(4): 142.     CrossRef
  • Comparison of Effects of Liuzijue Exercise and Conventional Respiratory Training on Patients after Cardiac Surgery: A Randomized Controlled Trial
    Qiao-li Zhang, Min Ge, Cheng Chen, Fu-dong Fan, Yan Jin, Ning Zhang, Lei Wang
    Chinese Journal of Integrative Medicine.2023; 29(7): 579.     CrossRef
  • Inspiratory muscle training to reduce risk of pulmonary complications after coronary artery bypass grafting: a systematic review and meta-analysis
    Yuping Xiang, Qin Zhao, Tinahui Luo, Ling Zeng
    Frontiers in Cardiovascular Medicine.2023;[Epub]     CrossRef
  • Impact of cardiac rehabilitation on pre- and post-operative transcatheter aortic valve replacement prognoses
    Jieru Zou, Jie Yuan, Jingjin Liu, Qingshan Geng
    Frontiers in Cardiovascular Medicine.2023;[Epub]     CrossRef
  • The Effects of Inspiratory Muscle Training (IMT) on Patients Undergoing Coronary Artery Bypass Graft (CABG) Surgery: A Systematic Review and Meta-Analysis
    Sisi Zhang, Bo Li, Xiaoping Meng, Houjuan Zuo, Dayi Hu
    Reviews in Cardiovascular Medicine.2023;[Epub]     CrossRef
  • Resistance exercise for cardiac rehabilitation
    Danielle L. Kirkman, Duck-chul Lee, Salvatore Carbone
    Progress in Cardiovascular Diseases.2022; 70: 66.     CrossRef
  • Respiratory Muscle Strength in Patients with Coronary Heart Disease and Different Musculoskeletal Disorders
    E. D. Bazdyrev, N. A. Terentyeva, N. A. Galimova, K. E. Krivoshapova, O. L. Barbarash
    Rational Pharmacotherapy in Cardiology.2022; 18(4): 393.     CrossRef
  • 7,886 View
  • 238 Download
  • 15 Web of Science
  • 16 Crossref
Original Articles
Changes in Aerobic Capacity Over Time in Elderly Patients With Acute Myocardial Infarction During Cardiac Rehabilitation
Ki-Hong Kim, Yun-Chol Jang, Min-Keun Song, Hyeng-Kyu Park, In-Sung Choi, Jae-Young Han
Ann Rehabil Med 2020;44(1):77-84.   Published online February 29, 2020
DOI: https://doi.org/10.5535/arm.2020.44.1.77
Objective
To test the hypothesis that a longer duration of phase II cardiac rehabilitation is required to recover the exercise capacity of elderly patients compared to younger patients.
Methods
We retrospectively reviewed and analyzed the medical records of patients who were referred to our cardiac rehabilitation (CR) center and underwent percutaneous coronary intervention for acute myocardial infarction (AMI). A total of 70 patients were enrolled who underwent an exercise tolerance test (ETT) 3 weeks after the occurrence of an AMI (T0), 6 weeks after the first ETT (T1), and 12 weeks after the first ETT (T2). Patients older than 65 years were assigned to the elderly group (n=24) and those aged 65 years and younger to the younger group (n=46). Both groups performed center-based or home-based CR for 12 weeks (3 times per week and 1 session per day). Exercise intensity for each individual was based on the target heart rate calculated by the Karvonen formula. The change in maximal metabolic equivalents (METmax) of the two groups was measured at each assessment point (T0, T1, and T2) to investigate the recovery of exercise capacity.
Results
The younger group showed improvement in METmax between T0 and T1. However, METmax of the elderly group showed no significant improvement between T0 and T1. The exercise capacity, measured with METmax, of all groups showed improvement between T0 and T2.
Conclusion
Elderly patients with AMI need a longer duration of CR (>6 weeks) than younger patients with AMI.

Citations

Citations to this article as recorded by  
  • Advancements, challenges, and innovative strategies in cardiac rehabilitation for patients with acute myocardial infarction: A systematic review
    Sisheng Zhang, Yuhui Lin
    Current Problems in Cardiology.2025; 50(2): 102934.     CrossRef
  • L’unité de gériatrie aiguë à orientation cardio-gériatrique : une innovation pour la prise en charge des patients âgés
    Amaury Broussier, Nina Liu, Nathalie Marie-Nelly, Émilie Thomas, Livia Labon, Gita Motamed
    Soins.2025;[Epub]     CrossRef
  • Effect of Combined Exercise Training on Physical and Cognitive Function in Women With Type 2 Diabetes
    Nafiseh Ghodrati, Amir Hossein Haghighi, Seyed Alireza Hosseini Kakhak, Sadegh Abbasian, Gary S. Goldfield
    Canadian Journal of Diabetes.2023; 47(2): 162.     CrossRef
  • The effects of rate pressure product at admission on cardiopulmonary function during hospitalization in patients with acute myocardial infarction
    Chun-Mei Zeng, Yan-Mei Zhao, Yi-Yi Li, Rong-Rong Gan, Zheng Ling, Ping Li
    Postgraduate Medicine.2023; 135(8): 803.     CrossRef
  • Relationship Between Number of Cardiac Rehabilitation Exercise Training Sessions, Muscle Mass, and Cardiorespiratory Fitness in Rural Elderly Patients with Coronary Artery Disease
    Seong Bok Choi, Ji Hee Kim
    Journal of Multidisciplinary Healthcare.2023; Volume 16: 3309.     CrossRef
  • Cardiac Rehabilitation and Complementary Physical Training in Elderly Patients after Acute Coronary Syndrome: A Pilot Study
    Aurelija Beigienė, Daiva Petruševičienė, Vitalija Barasaitė, Raimondas Kubilius, Jūratė Macijauskienė
    Medicina.2021; 57(6): 529.     CrossRef
  • Shorter Wait Times to Cardiac Rehabilitation Associated With Greater Exercise Capacity Improvements
    Dion Candelaria, Robert Zecchin, Cate Ferry, Laila Ladak, Sue Randall, Robyn Gallagher
    Journal of Cardiopulmonary Rehabilitation and Prevention.2021; 41(4): 243.     CrossRef
  • Predictors for one-year outcomes of cardiorespiratory fitness and cardiovascular risk factor control after cardiac rehabilitation in elderly patients: The EU-CaRE study
    Prisca Eser, Thimo Marcin, Eva Prescott, Leonie F. Prins, Evelien Kolkman, Wendy Bruins, Astrid E. van der Velde, Carlos Peña Gil, Marie-Christine Iliou, Diego Ardissino, Uwe Zeymer, Esther P. Meindersma, Arnoud W. J. Van’tHof, Ed P. de Kluiver, Matthias
    PLOS ONE.2021; 16(8): e0255472.     CrossRef
  • Community-Based Cardiac Rehabilitation Conducted in a Public Health Center in South Korea: A Preliminary Study
    Sora Baek, Yuncheol Ha, Jaemin Mok, Hee-won Park, Hyo-Rim Son, Mi-Suk Jin
    Annals of Rehabilitation Medicine.2020; 44(6): 481.     CrossRef
  • 6,257 View
  • 189 Download
  • 8 Web of Science
  • 9 Crossref
Comparison of Obesity Related Index and Exercise Capacity Between Center-Based and Home-Based Cardiac Rehabilitation Programs
Hyeng-Kyu Park, Ki-Hong Kim, Ji-Hyun Kim, Min-Keun Song, In-Sung Choi, Jae-Young Han
Ann Rehabil Med 2019;43(3):297-304.   Published online June 28, 2019
DOI: https://doi.org/10.5535/arm.2019.43.3.297
Objective
To compare a center-based cardiac rehabilitation (CR) program with a home-based CR program in terms of improving obesity related index and cardiopulmonary exercise capacity after the completing a phase II CR program.
Methods
In this study, there were seventy-four patients with acute myocardial infarction after percutaneous coronary intervention who were analyzed. Patients with mild to moderate risk (ejection fraction >40%) were included in the group. The patients underwent an exercise tolerance test by measurement of the modified Bruce protocol at three assessment points. Those in the center-based CR group participated in a 4-week training program with electrocardiography monitoring of the patient’s progress and results, while those patients who were in the home-based CR group underwent self-exercise training. We measured the obesity related indices such as body mass index, fat free mass index (FFMI), and cardiopulmonary exercise capacity including peak oxygen consumption (VO2max), metabolic equivalents (METs), heart rate, resting systolic blood pressure and the diastolic blood pressure of the participants and noted the results.
Results
Of the 74 patients, 25 and 49 participated in the center-based and home-based CR programs, respectively. Both groups showed significant improvement in VO2max and METs at 1-month and 6-month follow-up. However, FFMI was significantly improved only in the center-based CR group after 1 month of the phase II CR.
Conclusion
Both groups identified in the study showed significant improvement of VO2max and METs at 1-month and 6-month follow-up. However, there was no significant difference in the intergroup analysis. A significant improvement of FFMI was seen only in the center-based CR group after phase II CR.

Citations

Citations to this article as recorded by  
  • A scale for measuring home-based cardiac rehabilitation exercise adherence: a development and validation study
    Zhen Yang, Yuanhui Sun, Huan Wang, Chunqi Zhang, Aiping Wang
    BMC Nursing.2023;[Epub]     CrossRef
  • Center-Based vs Home-Based Geriatric Rehabilitation on Sarcopenia Components: A Systematic Review and Meta-analysis
    Qiaowei Li, Fang Wang, Xiaoqun Liu, Huijuan Zhong, Feng Huang, Pengli Zhu
    Archives of Physical Medicine and Rehabilitation.2022; 103(8): 1663.     CrossRef
  • Do Patients Maintain Proper Long-Term Cardiopulmonary Fitness Levels After Cardiac Rehabilitation? A Retrospective Study Using Medical Records
    Chul Kim, Hee Eun Choi, Jin Hyuk Jang, Jun Hyeong Song, Byung-Ok Kim
    Annals of Rehabilitation Medicine.2021; 45(2): 150.     CrossRef
  • An observational study substantiating the statistical significance of cardiopulmonary exercise with laboratory tests during the acute and subacute phases of center and home-based cardiac rehabilitation
    Jeong Jae Lee, Jun Young Ko, Seungbok Lee
    Medicine.2021; 100(31): e26861.     CrossRef
  • Rehabilitación cardíaca fase 2 post infarto agudo al miocardio.
    Kirby Gutiérrez Arce, Jessy Estefanía Funez Estrada, Cristian Yovany Rojas Aboyte, Perla Lizeth Hernández Cortés Hernández Cortés, María Cristina Enríquez Reyna
    Revista de Ciencias del Ejercicio FOD.2021;[Epub]     CrossRef
  • 6,340 View
  • 167 Download
  • 4 Web of Science
  • 5 Crossref
Relationship Between Post-exercise Heart Rate Recovery and Changing Ratio of Cardiopulmonary Exercise Capacity
Ji-Hyun Kim, Yu-Ri Choe, Min-Keun Song, In-Sung Choi, Jae-Young Han
Ann Rehabil Med 2017;41(6):1039-1046.   Published online December 28, 2017
DOI: https://doi.org/10.5535/arm.2017.41.6.1039
Objective

To determine whether heart rate recovery (HRR) following an exercise tolerance test (ETT) is correlated with a changing ratio of peak oxygen consumption (VO2) and maximal metabolic equivalents (METmax).

Methods

A total of 60 acute myocardial infarction (AMI) patients who underwent ETT at both assessment points - 3 weeks (T0) after the AMI attack and 3 months after T0 (T1) were included. After achieving a peak workload, the treadmill was stopped with a 5-minute cooldown period, and the patients recovered in a comfortable and relaxed seated position. HRR was defined as the difference between the maximal heart rate (HRmax) and the HR measured at specific time intervals - immediately after the cool down period (HRR-0) and 3 minutes after the completion of the ETT (HRR-3).

Results

HRR-0 and HRR-3 increased over time, whereas VO2max and METmax did not show significant changes. There was a positive correlation between HRR at T0 and the exercise capacity at T0. HRR at T0 also showed a positive correlation with the exercise capacity at T1. There was no significant correlation between HRR measured at T0 and the change in the ratio of VO2max and METmax, as calculated by subtracting VO2max and METmax obtained at T0 from those obtained at T1, divided by VO2max at T0 and multiplied by 100.

Conclusion

Post-exercise HRR measured at 3 weeks after the AMI onset can reflect the exercise capacity 3 months after the first ETT. However, it may be difficult to correlate post-exercise HRR at T0 with the degree of increase in cardiopulmonary exercise capacity in patients with AMI.

Citations

Citations to this article as recorded by  
  • Influence of physical fitness of coronary disease patients on vagal reentry and heart rate recovery after exercise with and without fluid replacement
    Júlio César d. Á. Soares, Maria Júlia L. Laurino, Anne K. F. d. Silva, Lorena A. Santos, Luiz Carlos M. Vanderlei
    Clinical Physiology and Functional Imaging.2023; 43(5): 327.     CrossRef
  • Effects of rope skipping exercise on physical, cardiovascular fitness and exercise tolerance in adolescent students with moderate intellectual disability
    Y.‐Y. Lin, C.‐T. Su, Y.‐H. Liao, Y.‐C. Liu
    Journal of Intellectual Disability Research.2023; 67(11): 1136.     CrossRef
  • Links between Exercise Capacity, Exercise Training, and Metabolism
    Alena Spagnolo, Sebastian Klug, Christina Schenkl, Michael Schwarzer
    Comprehensive Physiology.2023; 13(4): 5115.     CrossRef
  • Perturbations of Adjuvant Chemotherapy on Cardiovascular Responses and Exercise Tolerance in Patients with Early-Stage Breast Cancer
    Hsin-Fu Lin, Ching-Ying Tseng, Toby Mündel, Yi-Yuan Lin, Chung-Chi Lin, Chiao-Nan Chen, Yi-Hung Liao
    Biology.2021; 10(9): 910.     CrossRef
  • 6,336 View
  • 101 Download
  • 5 Web of Science
  • 4 Crossref
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