| Summary: | 碩士 === 國立陽明大學 === 護理學系 === 106 === Background: Dyspnea and fatigue are hallmark symptoms of heart failure associated with impaired quality of life. Threshold inspiratory muscle training have implicated to heart failure patients in America and Europe since 1989, but limited research have been found in Taiwan.
Aim: To investigate the effects of threshold IMT on dyspnea, fatigue, and quality of life in heart failure patients.
Methods: This is a prospective, randomized controlled trail study. Twenty-night heart failure patients with inspiratory muscle weakness (MIP<70% predicted) were recruited. Fifteen patients received a 30 minutes threshold inspiratory muscle training at 30% of maximal inspiratory pressure per day for 12 weeks, and fourteen patients in control group received usual medical care. Dyspnea, fatigue, and quality of life were measured by the modified Borg scale, revised Piper fatigue scale, and Minnesota Living with Heart Failure Questionnaire at baseline, 4th weeks, 8th weeks, and 12 th weeks. The outcome data were analyzed using SPSS for Windows 20.0 version, including descriptive stastics, Pearson correlation coefficient, independent t-test, chi-square test, repeated measures analysis of variance, analysis of covariance, and generalized estimating equation (GEE).
Result: This study found that 79.3% of heart failure patients experienced mild to moderate dyspnea. 58.6% of patients experienced mild to moderate fatigue that occurred intermittent. Most patients had combined general and psychological fatigue. 86.2％ patients with fatigue can be relief by rest and sleep. The impact of heart failure on patients' quality of life was very slight to mild. This study found that pateints who took diuretics had significant poor quality of life.
The results showed that the 30 minutes threshold inspiratory muscle training at 30% of maximal inspiratory pressure per day for 12 weeks could significantly improve dyspnea (B = -1.38, p = .002), maximal inspiratory pressure (B = 7.68~63.95, p < .001), fatigue (B = -6.96, p < .001) and quality of life (B = -6.70, p = .041) at 12 th weeks.
Conclusion: We confirmed that the threshold inspiratory muscle training is an effiective, simple and safe training for heart failure patients in Taiwan. The threshold inspiratory muscle training can be implicated in clinical practice as a transition program of cardiac rehabilitation to improve the strength and endurance of inspiration muscle, and combine with the aerobic exercise to keep improve the quality of life in heart failure patients.
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