PURPOSE: We assessed the feasibility of a 6-week combined program of autonomous walking plus high intensity inspiratory muscle training (IMT) in individuals with heart failure (HF) during the transitional care period. METHODS: Individuals with HF being discharged within the past 3 months were enrolled. This was a preliminary, 2-armed randomized controlled trial with participants blinded: (1) the autonomous walking-only program with a weekly step goal; and (2) the combined program with IMT added at 60% maximal inspiratory pressure. Feasibility was assessed by frequency of participation. Average 7-day step count and PImax were determined weekly. Additional outcomes included 6-minute walk test and the Minnesota living with heart failure questionnaire (MLHFQ). RESULTS: Sixteen participants were randomized (age 56 +/- 12 years), but only 8 completed the study. Seven participants had good adherence of 80% to 100% in activity and breathing exercise logs. Four participants in the combined program showed a 21% to 58% improvement based on the MLHFQ. A small sample size and the high dropout rate were addressed. CONCLUSIONS: The combined program of autonomous walking and high-intensity IMT appeared to be feasible and beneficial after the transitional care period. Novel strategies to enhance subject recruitment and adherence are needed for future studies.

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