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Nurse-Coached Muscle Training in Heart Failure

Written in 2009 by Padula, Yeaw, and Mistry, the article, A home-based nurse-coached inspiratory muscle training intervention in heart failure, looks into a homemade nurse-coached inspiratory muscle training mitigation in heart failure, and it forms the basis of this review. The article considers heart failure (HF) as the most devastating and the last passageway of all cardiac disorders. The authors posit that patients suffering from HF tend to live long, but with restricting signs, which include dyspnea that feeds on health-related quality of life (HRQOL). In addition, the research suggests that there is a high chance of dyspnea or heart failure in patients if the inspiratory muscles get weak.

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Lin, McElfresh, Hall, Bloom, and Farrell (2012) support the new initiative by explaining that it is noninvasive, affordable, safe, and a simple mediation process that could be done at home. The study’s objective was to analyze the impact of a three-month, home- based, nurse-coached (IMT) inspiratory muscle training program initiating a Threshold Device (Health scan). From this perspective, the goals of the study were two-fold. The first was to evaluate the impact of an (IMT) intervention that is mainly nurse coached in relation to inspiratory muscle dyspnea and strength. The second was to assess the effects of IMT in relation to physical/functional, self-efficiency, and psychological aspects of HRQOL.

The base of the research stemmed from the concept of self-belief theory, viz. self-efficacy. This paper offers an in-depth analysis of IMT and BE in HF patients and notes several main aspects that are in need of changing and further investigation. In addition, it looks at the expiratory muscle training role in the implementation and study of IMT targeted at several locations (late, mid, or early inspiration), and ration changes of inspiratory time to total breath time. The study implies that all these different dimensions of the study have a substantial potential to enhance many HF pathophysiological manifestation that are relevant to the study and the overall outcome of the program (Hulzebos et al., 2006).

This study is mainly a two-group research with repetitive procedures. The research participants were grouped randomly into two main categories. The first one was an experimental group and the second one was the controlled group with at least a primary-level education. The six-recorded home visits acted as the primary source of obtaining the data used during the recording of the analysis. Regular telephone follow-ups also helped in getting extra information on the monitored subjects. The modes of selection incorporated into the research included participants with no prior or current recorded pulmonary defects, community-dwelling adults, and stable heart failure patients in different classes and ejection fractions.

The various tools that were implemented within the analysis helped to bring out an in-depth measurement of the research outcome. These diverse instruments included the use of Chronic Respiratory Questionnaire Dyspnea Scale, perceived exertion scale, COPD Self-Efficacy Scale, and PI max. In addition, the CDRQ and respiratory rate analysis within the research helped in showing the principal variations within PLmax, shortness of breath experiment conducted with the statistical procedure, and post hoc analysis (Padula et al., 2009).

In conclusion, the gathered in-depth IMT study from across clinical conditions gradually affirms IMT as an efficient and safe intervention for improving IMS. In addition, this study in particular extended IMT to a theoretically based effective and nurse-managed intervention. In heart failure studies, the IMT clinical application can stand as an independent mitigation procedure together with regiments and medical rehabilitation. Most clinical nursing practice applications still do not consider the IMT as a viable and tested option. The main aim behind this omission is that the device threshold gadget is a medical instrument, and its usage often is associated with specialists and qualified employees. Lastly, irrespective of the extensive and well-planned explanation and research, the study leaves room for implications for further practices and investigations.


Hulzebos, H., Helders, J., Favié, J., De Bie, A., de la Riviere, B., & Van Meeteren, N. (2006). Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: a randomized clinical trial. JAMA, 296(15), 1851-1857.

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Lin, S., McElfresh, J., Hall, B., Bloom, R., & Farrell, K. (2012). Inspiratory muscle training in patients with heart failure: a systematic review. Cardiopulmonary Physical Therapy Journal, 23(3), 29-36.

Padula, A., Yeaw, E., & Mistry, S. (2009). A home-based nurse-coached inspiratory muscle training intervention in heart failure. Applied Nursing Research, 22(1), 18-25.

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