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A cycle ergometer exercise program improves exercise capacity and inspiratory muscle function in hospitalized patients awaiting heart transplantation: a pilot study
Forestieri P, Guizilini S, Peres M, Bublitz C, Bolzan DW, Rocco IS, Santos VB, Moreira RSL, Breda JR, de Almeida DR, Carvalho ACC, Arena R, Gomes WJ
Revista Brasileira de Cirurgia Cardiovascular [Brazilian Journal of Cardiovascular Surgery] 2016 Sep-Oct;31(5):389-395
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The purpose of this study was to evaluate the effect of a cycle ergometer exercise program on exercise capacity and inspiratory muscle function in hospitalized patients with heart failure awaiting heart transplantation with intravenous inotropic support. METHODS: Patients awaiting heart transplantation were randomized and allocated prospectively into two groups: (1) control group (n = 11) -- conventional protocol; and (2) intervention group (n = 7) -- stationary cycle ergometer exercise training. Functional capacity was measured by the six-minute walk test and inspiratory muscle strength assessed by manovacuometry before and after the exercise protocols. RESULTS: Both groups demonstrated an increase in six-minute walk test distance after the experimental procedure compared to baseline; however, only the intervention group had a significant increase (p = 0.08 and p = 0.001 for the control and intervention groups, respectively). Intergroup comparison revealed a greater increase in the intervention group compared to the control (p < 0.001). Regarding the inspiratory muscle strength evaluation, the intragroup analysis demonstrated increased strength after the protocols compared to baseline for both groups; statistical significance was only demonstrated for the intervention group, though (p = 0.22 and p < 0.01, respectively). Intergroup comparison showed a significant increase in the intervention group compared to the control (p < 0.01). CONCLUSION: Stationary cycle ergometer exercise training shows positive results on exercise capacity and inspiratory muscle strength in patients with heart failure awaiting cardiac transplantation while on intravenous inotropic support.

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