Aerobic exercise and inspiratory muscle training increase functional capacity in patients with univentricular physiology after Fontan operation: A randomized controlled trial.

Autor: Turquetto ALR; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil. Electronic address: aida.turquetto@hc.fm.usp.br., Dos Santos MR; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., Agostinho DR; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., Sayegh ALC; The University of Auckland, New Zealand., de Souza FR; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., Amato LP; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., Barnabe MSR; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., de Oliveira PA; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., Liberato G; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., Binotto MA; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., Negrão CE; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil; School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil., Canêo LF; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., Trindade E; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., Jatene FB; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil., Jatene MB; Heart Institute, University of São Paulo Medical School, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2021 May 01; Vol. 330, pp. 50-58. Date of Electronic Publication: 2021 Feb 09.
DOI: 10.1016/j.ijcard.2021.01.058
Abstrakt: Background: The effect of exercise training and its mechanisms on the functional capacity improvement in Fontan patients (FP) are virtually unknown. This trial evaluated four-month aerobic exercise training and inspiratory muscle training on functional capacity, pulmonary function, and autonomic control in patients after Fontan operation.
Methods: A randomized controlled clinical trial with 42 FP aged 12 to 30 years and, at least, five years of Fontan completion. Twenty-seven were referred to a four-months supervised and personalized aerobic exercise training (AET) or an inspiratory muscle training (IMT). A group of non-exercise (NET) was used as control. The effects of the exercise training in peak VO 2 ; pulmonary volumes and capacities, maximal inspiratory pressure (MIP); muscle sympathetic nerve activity (MSNA); forearm blood flow (FBF); handgrip strength and cross-sectional area of the thigh were analyzed.
Results: The AET decreased MSNA (p = 0.042), increased FBF (p = 0.012) and handgrip strength (p = 0.017). No significant changes in autonomic control were found in IMT and NET groups. Both AET and IMT increased peak VO2, but the increase was higher in the AET group compared to IMT (23% vs. 9%). No difference was found in the NET group. IMT group showed a 58% increase in MIP (p = 0.008) in forced vital capacity (p = 0.011) and forced expiratory volume in the first second (p = 0.011). No difference in pulmonary function was found in the AET group.
Conclusions: Both aerobic exercise and inspiratory muscle training improved functional capacity. The AET group developed autonomic control, and handgrip strength, and the IMT increased inspiratory muscle strength and spirometry.
Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02283255.
(Copyright © 2021 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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