OBJECTIVE: To determine whether the impact of inspiratory muscle weakness on inspiratory muscle training (IMT) affects inspiratory function and exercise capacity in chronic heart failure (CHF) patients. DATA SOURCES: Electronic searches were performed using the CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Systematic Review, Embase, Medline and PEDro databases up to August 2013. STUDY SELECTION: Articles were included if participants had CHF and were older than 18 years; the design was a randomized control trial; intervention was IMT; measurements were of inspiratory muscle function or exercise capacity; and the articles were published in English, Portuguese or Spanish. Of the 1,455 articles identified in the database searches, nine studies met the inclusion criteria. DATA EXTRACTION: Two independent reviewers selected and extracted information from articles and assessed the quality of the studies using PEDro scale. The two reviewers discussed disagreements until consensus was achieved. DATA SYNTHESIS: Meta-analyses compared IMT to control/sham for maximal inspiratory pressure, sustained maximal inspiratory pressure, six-minute walk distance, peak oxygen consumption and minute ventilation after inspiratory muscle training. Subgroup analyses compared those with and without muscle weakness. CHF with inspiratory muscle weakness showed greater gains in six-minute walk distance and peak oxygen consumption compared to those with normal maximal inspiratory pressure. The mean quality analysis score was 7.1, and scores ranged from 6 to 10. CONCLUSION: The results emphasize the importance of evaluating the inspiratory muscles to identify CHF patients with inspiratory muscle weakness; groups showing better results after inspiratory muscle training following this treatment.

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