https://doi.org/10.1177/0269215517704269 Clinical Rehabilitation 1–8 © The Author(s) 2017 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0269215517704269 journals.sagepub.com/home/cre CLINICAL REHABILITATION Addition of non-invasive ventilatory support to combined aerobic and resistance training improves dyspnea and quality of life in heart failure patients: a randomized controlled trial Hugo Souza Bittencourt 1 , Cristiano Gonçalves Cruz 1 , Bruno Costa David 2 , Erenaldo Rodrigues-Jr 2 , Camille Magalhães Abade 2 , Roque Aras Junior 2 , Vitor Oliveira Carvalho 3 , Francisco Borges Faria dos Reis 1 and Mansueto Gomes Neto 2 Abstract Objective: To test the hypothesis that combined aerobic and resistance training and non-invasive ventilatory support result in additional benefits compared with combined aerobic and resistance training alone in heart failure patients. Design: A randomized, single-blind, controlled study. Setting: Cardiac rehabilitation center. Participants: A total of 46 patients with New York Heart Association class II/III heart failure were randomly assigned to a 10-week program of combined aerobic and resistance training, plus non-invasive ventilatory support (n = 23) or combined aerobic and resistance training alone (n = 23). Methods: Before and after intervention, results for the following were obtained: 6-minute walk test, forced vital capacity, forced expiratory volume at one second, maximal inspiratory muscle pressure, and maximal expiratory muscle pressure, with evaluation of dyspnea by the London Chest Activity of Daily Living scale, and quality of life with the Minnesota Living With Heart Failure questionnaire. Results: Of the 46 included patients, 40 completed the protocol. The combined aerobic and resistance training plus non-invasive ventilatory support, as compared with combined aerobic and resistance training alone, resulted in significantly greater benefit for dyspnea (mean change: 4.8 vs. 1.3, p = 0.004), and quality of life (mean change: 19.3 vs. 6.8, p = 0.017). In both groups, the 6-minute walk test improved significantly (mean change: 45.7 vs. 44.1, p = 0.924), but without a statistically significant difference. 1 Hospital Ana Nery, Salvador, Brazil 2 Programa de Pós-Graduação em Medicina e Saúde. Universidade Federal da Bahia, Salvador, Brazil 3 Universidade Federal de Sergipe, Aracaju, Brazil These authors contributed equally to this work. Corresponding author: Mansueto Gomes Neto, Physical Therapy Department, Health Science Institute, Universidade Federal da Bahia, Salvador, BA, CEP 40.110-100, Brazil. Email: mansueto.neto@ufba.br 704269CRE 0 0 10.1177/0269215517704269Clinical RehabilitationBittencourt et al. research-article 2017 Original Article