Evidence-based Effects of RMT on Heart Failure

As we have seen over the course of a number of blog posts, respiratory muscle training (RMT) can have an incredible effect upon individuals suffering from heart failure. Individuals suffering from chronic heart failure (CHF) can suffer from any (or all) of the following:
  • Respiratory muscle weakness
  • Peripheral muscle weakness
  • Impaired inspiratory metaboreflex
  • Impaired autonomic cardiac control
  • Constrictive blood vessel activity
  • The above issues can contribute to a number of problems for CHF patients, including dyspnea, exercise intolerance, and fatigue. Any one of these can markedly lower the patient’s quality of life, and experiencing multiple problems at once can serve to complicate diagnosis and treatment. Luckily, RMT offers a way to help CHF patients improve and better their outlook as well as their quality of life. Let’s take a look at some of the different ways that RMT can help CHF patients.

    Respiratory muscle training (RMT)

    • Increases respiratory muscle strength and endurance
    • Improves exercise capacity and endurance
    • Improves ventilation during exercise
    • Reduces dyspnea
    • Improves blood flow to the limbs during rest and exercise
    • Delays respiratory fatigue
    • Improves diaphragmatic function and velocity
    • Improves autonomic cardiac control
    • Improves sympathetic nerve activity
    • Improves the effects of aerobic exercise

    Patient Impact

    The evidence shows that RMT alleviates the symptoms of CHF while also effectively improving its underlying causes. Please take a look at the included references for more detailed information.


    1. Bosnak-Guclu M, et al. Effects of inspiratory muscle training in patients with heart failure. Resp Med. 2011;105(11):1671-1681
    2. Cahalin LP, et al. Inspiratory muscle training in patients with chronic heart failure awaiting cardiac transplantation: results of a pilot clinical trial. PhysTher .1997;77(8):830–838.
    3. Chiappa GR, et al.Inspiratory Muscle Training Improves Blood Flow to Resting and Exercising Limbs in Patients With Chronic Heart Failure. J Am Coll Cardiol. 2008;51(17):1663-71.
    4. Dall’Ago P., et al. Inspiratory muscle training in patients with congestive heart failure and inspiratory muscle weakness: a randomized trial. J Am Coll Cardiol. 2006;47(4):757-63.
    5. Darnley GM, et al. Effects of resistive breathing on exercise capacity and diaphragm function in patients with ischaemic heart disease.Eur J Heart Fail. 1999;1(3):297-300.
    6. Laoutaris I, et al. Inspiratory muscle training using an incremental endurance test alleviates dyspnea and improves functional status in patients with chronic heart failure. Eur J Cardiovasc. Prev. Rehabil. 2004;11(6):489–496.
    7. Mancini DM, et al. Benefit of Selective Respiratory Muscle Training on Exercise Capacity in Patients With Chronic Congestive Heart Failure. Circulation.1995; 91: 320-329.
    8. Mello PR, et al. Inspiratory muscle training reduces sympathetic nervous activity and improves inspiratory muscle weakness and quality of life in patients with chronic heart failure: a clinical trial. J Cardiopulm Rehabil Prev. 2012;32(5):255-61.
    9. Stein R, et al. Inspiratory muscle training improves oxygen uptake efficiency slope in patients with chronic heart failure. J Cardiopulm Rehabil Prev. 2009;29(6):392–395.
    10. Weiner P, et al. The effect of specific inspiratory muscle training on the sensation of dyspnea and exercise tolerance in patients with congestive heart failure.Clin Cardiol. 1999,22(11),:727–732.
    11. Winkelmann ER, et al Addition of inspiratory muscle training to aerobic training improves cardiorespiratory responses to exercise in patients with heart failure and inspiratory muscle weakness. Am Heart J. 2009;158(5):768.e1–768.e7.


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