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Sogard AS, Mickleborough TD. The therapeutic role of inspiratory muscle training in the management of asthma: a narrative review. Am J Physiol Regul Integr Comp Physiol 2023; 325:R645-R663. [PMID: 37720997 DOI: 10.1152/ajpregu.00325.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023]
Abstract
Asthma is a disorder of the airways characterized by chronic airway inflammation, hyperresponsiveness, and variable recurring airway obstruction. Treatment options for asthma include pharmacological strategies, whereas nonpharmacological strategies are limited. Established pharmacological approaches to treating asthma may cause unwanted side effects and do not always afford adequate protection against asthma, possibly because of an individual's variable response to medications. A potential nonpharmacological intervention that is most available and cost effective is inspiratory muscle training (IMT), which is a technique targeted at increasing the strength and endurance of the diaphragm and accessory muscles of inspiration. Studies examining the impact of IMT on asthma have reported increases in inspiratory muscle strength and a reduction in the perception of dyspnea and medication use. However, because of the limited number of studies and discordant methods between studies more evidence is required to elucidate in individuals with asthma the efficacy of IMT on inspiratory muscle endurance, exercise capacity, asthma control, symptoms, and quality of life as well as in adolescents with differing severities of asthma. Large randomized controlled trials would be a significant step forward in clarifying the effectiveness of IMT in individuals with asthma. Although IMT may have favorable effects on inspiratory muscle strength, dyspnea, and medication use, the current evidence that IMT is an effective treatment for asthma is inconclusive.
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Affiliation(s)
- Abigail S Sogard
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana, United States
| | - Timothy D Mickleborough
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana, United States
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2
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Ghannadi S, Noormohammadpour P, Mazaheri R, Sahraian MA, Mansournia MA, Pourgharib Shahi MH, Salmasi Fard AH, Abolhasani M. Effect of eight weeks respiratory muscle training on respiratory capacity, functional capacity and quality of life on subjects with mild to moderate relapsing-remitting multiple sclerosis: A single-blinded randomized controlled trial. Mult Scler Relat Disord 2022; 68:104208. [PMID: 36219925 DOI: 10.1016/j.msard.2022.104208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 09/25/2022] [Accepted: 10/01/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a chronic inflammatory disease of the nervous system leading to muscle weakness, including the respiratory muscles that cause pulmonary complications, impair functional capacity, increased fatigue, and as a result decreases the quality of life. AIM The purpose of the present study is to examine the influence of 8 weeks of respiratory muscle training (RMT) on pulmonary function and respiratory muscle strength in MS patients. METHODS The present study was a single-blind, randomized controlled trial that was conducted on 36 (27 Female, 9 Male) relapsing-remitting MS patients who were definitively diagnosed by a neurologist and randomly were divided into intervention and control groups. Both groups were educated on lifestyle modification with an emphasis on regular physical activity. In addition, the intervention group was prescribed eight weeks of respiratory muscle training with a threshold resistance device, daily, twice a day for three sets of 15 repetitions per set. Maximal expiratory pressure (PImax), maximal expiratory pressure (PEmax), spirometric indices, functional tests (six-minute walk test, timed up and go test), fatigue questionnaire, and questionnaire of quality of life were assessed before and after trials. RESULTS A total of 36 patients (75% female; mean age 38.00(8.86) years; BMI 26.56(2.64) kg/m2) were included in the study. The strength of inspiratory and expiratory muscles, respiratory function, fatigue, and quality of life were significantly improved in the intervention group (p<0.005). In addition, there was a significant improvement in the rate of fatigue and quality of life in all their dimensions (p<0.005). Only in the six-minute walk test, no significant improvement was seen in the intervention group compared to the control group (p = 0.262). CONCLUSION Findings could help therapists to provide MS patients with more effective respiratory muscle training protocols to maximize the benefits of rehabilitation.
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Affiliation(s)
- Shima Ghannadi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Pardis Noormohammadpour
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mazaheri
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sahraian
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Maryam Abolhasani
- MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
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3
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Shei RJ, Paris HL, Sogard AS, Mickleborough TD. Time to Move Beyond a "One-Size Fits All" Approach to Inspiratory Muscle Training. Front Physiol 2022; 12:766346. [PMID: 35082689 PMCID: PMC8784843 DOI: 10.3389/fphys.2021.766346] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Inspiratory muscle training (IMT) has been studied as a rehabilitation tool and ergogenic aid in clinical, athletic, and healthy populations. This technique aims to improve respiratory muscle strength and endurance, which has been seen to enhance respiratory pressure generation, respiratory muscle weakness, exercise capacity, and quality of life. However, the effects of IMT have been discrepant between populations, with some studies showing improvements with IMT and others not. This may be due to the use of standardized IMT protocols which are uniformly applied to all study participants without considering individual characteristics and training needs. As such, we suggest that research on IMT veer away from a standardized, one-size-fits-all intervention, and instead utilize specific IMT training protocols. In particular, a more personalized approach to an individual's training prescription based upon goals, needs, and desired outcomes of the patient or athlete. In order for the coach or practitioner to adjust and personalize a given IMT prescription for an individual, factors, such as frequency, duration, and modality will be influenced, thus inevitably affecting overall training load and adaptations for a projected outcome. Therefore, by integrating specific methods based on optimization, periodization, and personalization, further studies may overcome previous discrepancies within IMT research.
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Affiliation(s)
- Ren-Jay Shei
- Global Medical Department, Mallinckrodt Pharmaceuticals Company, Hampton, NJ, United States
| | - Hunter L Paris
- Department of Sports Medicine, Pepperdine University, Malibu, CA, United States
| | - Abigail S Sogard
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
| | - Timothy D Mickleborough
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, IN, United States
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4
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Dreyer S, Schneppendahl J, Moeller F, Koch A, Muth T, Schipke JD. An Updated Narrative Review on Ergometric Systems Applied to Date in Assessing Divers' Fitness. Healthcare (Basel) 2021; 9:1044. [PMID: 34442180 PMCID: PMC8394438 DOI: 10.3390/healthcare9081044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022] Open
Abstract
Many recreational divers suffer medical conditions, potentially jeopardizing their safety. To scale down risks, medical examinations are mandatory and overwhelmingly performed using bicycle ergometry, which overlooks some important aspects of diving. Searching ergometric systems that better address the underwater environment, a systematic literature search was conducted using the keywords 'diving', 'fitness', 'ergometry', and 'exertion'. All presented alternative systems found convincingly describe a greatly reduced underwater physical performance. Thus, if a diver's workload in air should already be limited, he/she will suffer early from fatigue, risking a diving incident. How to assess fitness? Performance diagnostics in sports is always specific for a modality or movement. Therefore, professional scuba divers should be tested when fin-swimming underwater. For the vast number of recreational divers, the current screening can likely not be replaced. However, to prevent accidents, divers need to understand and be able to improve factors that limit their physical performance underwater. Other systems, presented here, will continue to be important tools in underwater research.
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Affiliation(s)
- Sven Dreyer
- Hyperbaric Oxygen Therapy, University Hospital Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; (S.D.); (J.S.)
| | - Johannes Schneppendahl
- Hyperbaric Oxygen Therapy, University Hospital Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; (S.D.); (J.S.)
| | - Fabian Moeller
- Department of Exercise Physiology, Institute of Exercise Training and Sport Informatics, German Sport University Cologne, 50933 Cologne, Germany;
| | - Andreas Koch
- German Naval Medical Institute, Maritime Medicine, 24119 Kronshagen, Germany;
| | - Thomas Muth
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, 40225 Düsseldorf, Germany;
| | - Jochen D. Schipke
- Forschungsgruppe Experimentelle Chirurgie, Universitäts-Klinikum Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany
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Hess HW, Hostler D, Clemency BM, St James E, Johnson BD. Carotid body chemosensitivity is not attenuated during cold water diving. Am J Physiol Regul Integr Comp Physiol 2021; 321:R197-R207. [PMID: 34133244 DOI: 10.1152/ajpregu.00202.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Tonic carotid body (CB) activity is reduced during exposure to cold and hyperoxia. We tested the hypotheses that cold water diving lowers CB chemosensitivity and augments CO2 retention more than thermoneutral diving. Thirteen subjects [age: 26 ± 4 yr; body mass index (BMI): 26 ± 2 kg/m2) completed two 4-h head-out water immersion protocols in a hyperbaric chamber (1.6 ATA) in cold (15°C) and thermoneutral (25°C) water. CB chemosensitivity was assessed with brief hypercapnic ventilatory response ([Formula: see text]) and hypoxic ventilatory response ([Formula: see text]) tests before dive, 80 and 160 min into the dive (D80 and D160, respectively), and immediately after and 60 min after dive. Data are reported as an absolute mean (SD) change from predive. End-tidal CO2 pressure increased during both the thermoneutral water dive [D160: +2 (3) mmHg; P = 0.02] and the cold water dive [D160: +1 (2) mmHg; P = 0.03]. Ventilation increased during the cold water dive [D80: 4.13 (4.38) and D160: 7.75 (5.23) L·min-1; both P < 0.01] and was greater than the thermoneutral water dive at both time points (both P < 0.01). [Formula: see text] was unchanged during the dive (P = 0.24) and was not different between conditions (P = 0.23). [Formula: see text] decreased during the thermoneutral water dive [D80: -3.45 (3.61) and D160: -2.76 (4.04) L·min·mmHg-1; P < 0.01 and P = 0.03, respectively] but not the cold water dive. However, [Formula: see text] was not different between conditions (P = 0.17). In conclusion, CB chemosensitivity was not attenuated during the cold stress diving condition and does not appear to contribute to changes in ventilation or CO2 retention.
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Affiliation(s)
- Hayden W Hess
- Center for Research and Education in Special Environments, University at Buffalo, Buffalo, New York.,Department of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
| | - David Hostler
- Center for Research and Education in Special Environments, University at Buffalo, Buffalo, New York.,Department of Emergency Medicine, University at Buffalo, Buffalo, New York
| | - Brian M Clemency
- Center for Research and Education in Special Environments, University at Buffalo, Buffalo, New York.,Department of Emergency Medicine, University at Buffalo, Buffalo, New York
| | - Erika St James
- Center for Research and Education in Special Environments, University at Buffalo, Buffalo, New York.,Department of Emergency Medicine, University at Buffalo, Buffalo, New York
| | - Blair D Johnson
- Center for Research and Education in Special Environments, University at Buffalo, Buffalo, New York.,Department of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana
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Hinde KL, Low C, Lloyd R, Cooke CB. Inspiratory muscle training at sea level improves the strength of inspiratory muscles during load carriage in cold-hypoxia. ERGONOMICS 2020; 63:1584-1598. [PMID: 32812837 DOI: 10.1080/00140139.2020.1807613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
Inspiratory muscle training (IMT) and functional IMT (IMTF: exercise-specific IMT activities) has been unsuccessful in reducing respiratory muscle fatigue following load carriage. IMTF did not include load carriage specific exercises. Fifteen participants split into two groups (training and control) walked 6 km loaded (18.2 kg) at speeds representing ∼50%V̇O2max in cold-hypoxia. The walk was completed at baseline; post 4 weeks IMT and 4 weeks IMTF (five exercises engaging core muscles, three involved load). The training group completed IMT and IMTF at a higher maximal inspiratory pressure (Pimax) than controls. Improvements in Pimax were greater in the training group post-IMT (20.4%, p = .025) and post-IMTF (29.1%, p = .050) compared to controls. Respiratory muscle fatigue was unchanged (p = .643). No other physiological or subjective measures were improved by IMT or IMTF. Both IMT and IMTF increased the strength of respiratory muscles pre-and-post a 6 km loaded walk in cold-hypoxia. Practitioner Summary: To explore the interaction between inspiratory muscle training (IMT), load carriage and environment, this study investigated 4 weeks IMT and 4 weeks functional IMT on respiratory muscle strength and fatigue. Functional IMT improved inspiratory muscle strength pre-and-post a loaded walk in cold-hypoxia but had no more effect than IMT alone. Abbreviations: ANOVA: analysis of variance; BF: breathing frequency; CON: control group; EELV: end-expiratory lung volume; EXP: experimental group; FEV1: forced expiratory volume in one second; FiO2: fraction of inspired oxygen; FVC: forced vital capacity; HR: heart rate; IMT: inspiratory muscle training; IMTF: functional inspiratory muscle training; Pemax: maximal expiratory pressure; Pimax: maximal inspiratory pressure; RMF: respiratory muscle fatigue; RPE: rate of perceived exertion; RWU: respiratory muscle warm-up; SaO2: arterial oxygen saturation; SpO2: peripheral oxygen saturation; V̇E: minute ventilation; V̇O2: rate of oxygen uptake.
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Affiliation(s)
- K L Hinde
- Defence Science and Technology Laboratory, Salisbury, UK
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - C Low
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - R Lloyd
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
| | - C B Cooke
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
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7
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Wheelock CE, Hess HW, Johnson BD, Schlader ZJ, Clemency BM, St James E, Hostler D. Endurance and Resistance Respiratory Muscle Training and Aerobic Exercise Performance in Hypobaric Hypoxia. Aerosp Med Hum Perform 2020; 91:776-784. [PMID: 33187563 DOI: 10.3357/amhp.5624.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION: Hypoxia-induced hyperventilation is an effect of acute altitude exposure, which may lead to respiratory muscle fatigue and secondary locomotor muscle fatigue. The purpose of this study was to determine if resistive and/or endurance respiratory muscle training (RRMT and ERMT, respectively) vs. placebo respiratory muscle training (PRMT) improve cycling performance at altitude.METHODS: There were 24 subjects who were assigned to PRMT (N 8), RRMT (N 8), or ERMT (N 8). Subjects cycled to exhaustion in a hypobaric chamber decompressed to 3657 m (12,000 ft) at an intensity of 55% sea level maximal oxygen consumption (Vo2max) before and after respiratory muscle training (RMT). Additionally, subjects completed a Vo2max, pulmonary function, and respiratory endurance test (RET) before and after RMT. All RMT protocols consisted of three 30-min training sessions per week for 4 wk.RESULTS: The RRMT group increased maximum inspiratory (PImax) and expiratory (PEmax) mouth pressure after RMT (PImax: 117.7 11.6 vs. 162.6 20.0; PEmax: 164.0 33.2 vs. 216.5 44.1 cmH₂O). The ERMT group increased RET after RMT (5.2 5.2 vs.18.6 16.9 min). RMT did not improve Vo2max in any group. Both RRMT and ERMT groups increased cycling time to exhaustion (RRMT: 35.9 17.2 vs. 45.6 22.2 min and ERMT: 33.8 9.6 vs. 42.9 27.0 min).CONCLUSION: Despite different improvements in pulmonary function, 4 wk of RRMT and ERMT both improved cycle time to exhaustion at altitude.Wheelock CE, Hess HW, Johnson BD, Schlader ZJ, Clemency BM, St. James E, Hostler D. Endurance and resistance respiratory muscle training and aerobic exercise performance in hypobaric hypoxia. Aerosp Med Hum Perform. 2020; 91(10):776784.
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8
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Sackett JR, Schlader ZJ, Cruz C, Hostler D, Johnson BD. The effect of water immersion and acute hypercapnia on ventilatory sensitivity and cerebrovascular reactivity. Physiol Rep 2018; 6:e13901. [PMID: 30369098 PMCID: PMC6204237 DOI: 10.14814/phy2.13901] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/14/2018] [Accepted: 09/19/2018] [Indexed: 11/24/2022] Open
Abstract
The partial pressure of end tidal carbon dioxide (PETCO2 ), ventilatory sensitivity to CO2 , and cerebral perfusion are augmented during thermoneutral head out water immersion (HOWI). We tested the hypotheses that HOWI and acute hypercapnia augments minute ventilation, ventilatory sensitivity to CO2 , cerebral perfusion, and cerebrovascular reactivity to CO2 . Twelve subjects (age: 24 ± 3 years, BMI: 25.3 ± 2.9 kg/m2 , 6 women) participated in two experimental visits: a HOWI visit (HOWI) and a matched hypercapnia visit (Dry + CO2 ). A rebreathing test was conducted at baseline, 10, 30, 60 min, and post HOWI and Dry + CO2 . PETCO2 , minute ventilation, expired gases, blood pressure, heart rate, and middle cerebral artery blood velocity were recorded continuously. PETCO2 increased throughout HOWI (baseline: 42 ± 2 mmHg; maximum at 10 min: 44 ± 2 mmHg, P ≤ 0.013) and Dry + CO2 (baseline: 42 ± 2 mmHg; maximum at 10 min: 44 ± 2 mmHg, P ≤ 0.013) and was matched between conditions (condition main effect: P = 0.494). Minute ventilation was lower during HOWI versus Dry + CO2 (maximum difference at 60 min: 13.2 ± 1.9 vs. 16.2 ± 2.7 L/min, P < 0.001). Ventilatory sensitivity to CO2 and middle cerebral artery blood velocity were greater during HOWI versus Dry + CO2 (maximum difference at 10 min: 2.60 ± 1.09 vs. 2.20 ± 1.05 L/min/mmHg, P < 0.001, and 63 ± 18 vs. 53 ± 14 cm/sec, P < 0.001 respectively). Cerebrovascular reactivity to CO2 decreased throughout HOWI and Dry + CO2 and was not different between conditions (condition main effect: P = 0.777). These data indicate that acute hypercapnia, matched to what occurs during HOWI, augments minute ventilation but not ventilatory sensitivity to CO2 or middle cerebral artery blood velocity despite an attenuated cerebrovascular reactivity to CO2 .
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Affiliation(s)
- James R. Sackett
- Center for Research and Education in Special EnvironmentsDepartment of Exercise and Nutrition SciencesUniversity at BuffaloBuffaloNew York
| | - Zachary J. Schlader
- Center for Research and Education in Special EnvironmentsDepartment of Exercise and Nutrition SciencesUniversity at BuffaloBuffaloNew York
| | - Carol Cruz
- Center for Research and Education in Special EnvironmentsDepartment of Exercise and Nutrition SciencesUniversity at BuffaloBuffaloNew York
| | - David Hostler
- Center for Research and Education in Special EnvironmentsDepartment of Exercise and Nutrition SciencesUniversity at BuffaloBuffaloNew York
| | - Blair D. Johnson
- Center for Research and Education in Special EnvironmentsDepartment of Exercise and Nutrition SciencesUniversity at BuffaloBuffaloNew York
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9
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Yilmaz ÖF, Özdal M. Acute, chronic, and combined pulmonary responses to swimming in competitive swimmers. Respir Physiol Neurobiol 2018; 259:129-135. [PMID: 30217724 DOI: 10.1016/j.resp.2018.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 08/10/2018] [Accepted: 09/10/2018] [Indexed: 11/30/2022]
Abstract
The combined effects of swimming on the inspiratory muscles and pulmonary functions are not well known. The aim of the present study was to determine the acute, chronic, and combined effects of swimming on the pulmonary functions and respiratory muscles of competitive swimmers. Thirty males (15 in the experimental group [EG] and 15 in the control group [CG]) participated in this study. The EG subjects participated in an 8-week swim training program and performed 1 day before and after an 8-week 100-m swimming event. Pulmonary functions and respiratory muscle strength were measured immediately before and after the swimming event in the EG and before and after an 8-week period in the CG. The obtained data were analyzed using repeated measures one-way analysis of variance, least significant difference, and independent- and paired-sample t-tests. Swimming exerted negative acute effects (p < 0.05) and positive chronic effects (p < 0.05) on respiratory muscle strength and pulmonary functions. Further, the negative acute effects decreased the combined effects of the chronic and acute effects of swimming on respiratory muscle strength and pulmonary functions (p < 0.05). The results indicated that swimming exerts negative acute, positive chronic, and combined effects on respiratory muscle strength and pulmonary functions.
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Affiliation(s)
- Ömer Faruk Yilmaz
- Department of Physical Education and Sport, Institution of Gaziantep University, Lab of Gaziantep University Performance Laboratory, Turkey.
| | - Mustafa Özdal
- Department of Physical Education and Sport, Institution of Gaziantep University, Lab of Gaziantep University Performance Laboratory, Turkey.
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Sumi D, Kojima C, Goto K. Impact of Endurance Exercise in Hypoxia on Muscle Damage, Inflammatory and Performance Responses. J Strength Cond Res 2018; 32:1053-1062. [PMID: 28368957 DOI: 10.1519/jsc.0000000000001911] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sumi, D, Kojima, C, and Goto, K. Impact of endurance exercise in hypoxia on muscle damage, inflammatory and performance responses. J Strength Cond Res 32(4): 1053-1062, 2018-This study evaluated muscle damage and inflammatory and performance responses after high-intensity endurance exercise in moderate hypoxia among endurance athletes. Nine trained endurance athletes completed 2 different trials on different days: exercise under moderate hypoxia (H trial, FiO2 = 14.5%) and normoxia (N trial, FiO2 = 20.9%). They performed interval exercises (10 × 3-minute running at 95% of V[Combining Dot Above]O2max with 60-second of active rest at 60% of V[Combining Dot Above]O2max) followed by 30-minute of continuous running at 85% of V[Combining Dot Above]O2max under either hypoxic or normoxic conditions. Venous blood samples were collected 4 times: before exercise, 0, 60, and 120-minute after exercise. The time to exhaustion (TTE) during running at 90% of V[Combining Dot Above]O2max was also determined to evaluate endurance capacity 120-minute after the training session. The H trial induced a significantly greater exercise-induced elevation in the blood lactate concentration than did the N trial (p = 0.02), whereas the elevation in the exercise-induced myoglobin concentration (muscle damage marker) was significantly greater in the N trial than in the H trial (p = 0.005). There was no significant difference in plasma interleukin-6 (inflammatory marker) concentration between the H and N trials. The TTE was shorter in the N trial (613 ± 65 seconds) than in the H trial (783 ± 107 seconds, p = 0.02). In conclusion, among endurance athletes, endurance exercise under moderate hypoxic conditions did not facilitate an exercise-induced muscle damage response or cause a further reduction in the endurance capacity compared with equivalent exercise under normoxic conditions.
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Affiliation(s)
- Daichi Sumi
- Graduate School of Sports and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Chihiro Kojima
- Graduate School of Sports and Health Science, Ritsumeikan University, Kusatsu, Japan
| | - Kazushige Goto
- Graduate School of Sports and Health Science, Ritsumeikan University, Kusatsu, Japan.,Faculty of Sports and Health Science, Ritsumeikan University, Kusatsu, Japan
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11
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Sackett JR, Schlader ZJ, O'Leary MC, Chapman CL, Johnson BD. Central chemosensitivity is augmented during 2 h of thermoneutral head-out water immersion in healthy men and women. Exp Physiol 2018. [DOI: 10.1113/ep086870] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- James R. Sackett
- Center for Research and Education in Special Environments; Department of Exercise and Nutrition Sciences; University at Buffalo; Buffalo NY 14214 USA
| | - Zachary J. Schlader
- Center for Research and Education in Special Environments; Department of Exercise and Nutrition Sciences; University at Buffalo; Buffalo NY 14214 USA
| | - Morgan C. O'Leary
- Center for Research and Education in Special Environments; Department of Exercise and Nutrition Sciences; University at Buffalo; Buffalo NY 14214 USA
| | - Christopher L. Chapman
- Center for Research and Education in Special Environments; Department of Exercise and Nutrition Sciences; University at Buffalo; Buffalo NY 14214 USA
| | - Blair D. Johnson
- Center for Research and Education in Special Environments; Department of Exercise and Nutrition Sciences; University at Buffalo; Buffalo NY 14214 USA
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12
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Hostler D, Pendergast DR. Respiratory Responses during Exercise in Self-contained Breathing Apparatus among Firefighters and Nonfirefighters. Saf Health Work 2018; 9:468-472. [PMID: 30559997 PMCID: PMC6284167 DOI: 10.1016/j.shaw.2018.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 09/08/2017] [Accepted: 02/09/2018] [Indexed: 11/28/2022] Open
Abstract
Background Firefighters are required to use self-contained breathing apparatus (SCBA), which impairs ventilatory mechanics. We hypothesized that firefighters have elevated arterial CO2 when using SCBA. Methods Firefighters and controls performed a maximal exercise test on a cycle ergometer and two graded exercise tests (GXTs) at 25%, 50%, and 70% of their maximal aerobic power, once with a SCBA facemask and once with protective clothing and full SCBA. Results Respiratory rate increased more in controls than firefighters. Heart rate increased as a function of oxygen consumption (V.O2) more in controls than firefighters. End-tidal CO2 (ETCO2) during the GXTs was not affected by work rate in either group for either condition but was higher in firefighters at all work rates in both GXTs. SCBA increased ETCO2 in controls but not firefighters. Conclusions The present study showed that when compared to controls, firefighters’ hypoventilate during a maximal test and GXT. The hypoventilation resulted in increased ETCO2, and presumably increased arterial CO2, during exertion. It is proposed that firefighters have altered CO2 sensitivity due to voluntary hypoventilation during training and work. Confirmation of low CO2 sensitivity and the consequence of this on performance and long-term health remain to be determined.
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Affiliation(s)
- David Hostler
- SUNY University at Buffalo, Department of Exercise and Nutrition Sciences, Center for Research and Education in Special Environments (CRESE), USA
| | - David R Pendergast
- SUNY University at Buffalo, Department of Physiology and Biophysics, USA
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13
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Schardong J, Marcolino MAZ, Plentz RDM. Muscle Atrophy in Chronic Kidney Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1088:393-412. [PMID: 30390262 DOI: 10.1007/978-981-13-1435-3_18] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The renal damage and loss of kidney function that characterize chronic kidney disease (CKD) cause several complex systemic alterations that affect muscular homeostasis, leading to loss of muscle mass and, ultimately, to muscle atrophy. CKD-induced muscle atrophy is highly prevalent and, in association with common CKD comorbidities, is responsible for the reduction of physical capacity, functional independence, and an increase in the number of hospitalizations and mortality rates. Thus, this chapter summarizes current knowledge about the complex interactions between CKD factors and the pathophysiological mechanisms that induce muscle atrophy that, despite growing interest, are not yet fully understood. The current treatments of CKD-induced muscle atrophy are multidisciplinary, including correction of metabolic acidosis, nutritional supplementation, reducing insulin resistance, administration of androgenic steroids, resisted and aerobic exercise, neuromuscular electrical stimulation, and inspiratory muscle training. However, further studies are still needed to strengthen the comprehension of CKD-induced muscle atrophy and the better treatment strategies.
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Affiliation(s)
- Jociane Schardong
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Miriam Allein Zago Marcolino
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rodrigo Della Méa Plentz
- Graduate Program in Health Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil. .,Graduate Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil. .,Department of Physical Therapy, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.
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de Medeiros AIC, Fuzari HKB, Rattesa C, Brandão DC, de Melo Marinho PÉ. Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review. J Physiother 2017; 63:76-83. [PMID: 28433237 DOI: 10.1016/j.jphys.2017.02.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 07/07/2016] [Accepted: 02/22/2017] [Indexed: 01/26/2023] Open
Abstract
QUESTION Does inspiratory muscle training improve respiratory muscle strength, functional capacity, lung function and quality of life of patients with chronic kidney disease? Does inspiratory muscle training improve these outcomes more than breathing exercises? DESIGN Systematic review and meta-analysis of randomised trials. PARTICIPANTS People with chronic kidney disease undergoing dialysis treatment. OUTCOME MEASURES The primary outcomes were: maximal inspiratory pressure, maximal expiratory pressure, and distance covered on the 6-minute walk test. The secondary outcomes were: forced vital capacity, forced expiratory volume in the first second (FEV1), and quality of life. RESULTS The search identified four eligible studies. The sample consisted of 110 participants. The inspiratory muscle training used a Threshold® or PowerBreathe® device, with a load ranging from 30 to 60% of the maximal inspiratory pressure and lasting from 6 weeks to 6 months. The studies showed moderate to high risk of bias, and the quality of the evidence was rated low or very low, due to the studies' methodological limitations. The meta-analysis showed that inspiratory muscle training significantly improved maximal inspiratory pressure (MD 23 cmH2O, 95% CI 16 to 29) and the 6-minute walk test distance (MD 80m, 95% CI 41 to 119) when compared with controls. Significant benefits in lung function and quality of life were also identified. When compared to breathing exercises, significant benefits were identified in maximal expiratory pressure (MD 6 cmH2O, 95% CI 2 to 10) and FEV1 (MD 0.24litres 95% CI 0.14 to 0.34), but not maximal inspiratory pressure or forced vital capacity. CONCLUSION In patients with chronic renal failure on dialysis, inspiratory muscle training with a fixed load significantly improves respiratory muscle strength, functional capacity, lung function and quality of life. The evidence for these benefits may be influenced by some sources of bias. REGISTRATION PROSPERO (CRD 42015029986). [de Medeiros AIC, Fuzari HKB, Rattesa C, Brandão DC, de Melo Marinho PÉ (2017) Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review. Journal of Physiotherapy 63: 76-83].
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Affiliation(s)
| | | | - Catarina Rattesa
- Physiotherapy Department, Universidade Federal de Pernambuco, Recife, Brazil
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Vranish JR, Bailey EF. Inspiratory Muscle Training Improves Sleep and Mitigates Cardiovascular Dysfunction in Obstructive Sleep Apnea. Sleep 2016; 39:1179-85. [PMID: 27091540 DOI: 10.5665/sleep.5826] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/09/2016] [Indexed: 01/26/2023] Open
Abstract
STUDY OBJECTIVES New and effective strategies are needed to manage the autonomic and cardiovascular sequelae of obstructive sleep apnea (OSA). We assessed the effect of daily inspiratory muscle strength training (IMT) on sleep and cardiovascular function in adults unable to use continuous positive airway pressure (CPAP) therapy. METHODS This is a placebo-controlled, single-blind study conducted in twenty four adults with mild, moderate, and severe OSA. Subjects were randomly assigned to placebo or inspiratory muscle strength training. Subjects in each group performed 5 min of training each day for 6 w. All subjects underwent overnight polysomnography at intake and again at study close. RESULTS We evaluated the effects of placebo training or IMT on sleep, blood pressure, and plasma catecholamines. Relative to placebo-trained subjects with OSA, subjects with OSA who performed IMT manifested reductions in systolic and diastolic blood pressures (-12.3 ± 1.6 SBP and -5.0 ± 1.3 DBP mmHg; P < 0.01); plasma norepinephrine levels (536.3 ± 56.6 versus 380.6 ± 41.2 pg/mL; P = 0.01); and registered fewer nighttime arousals and reported improved sleep (Pittsburgh Sleep Quality Index scores: 9.1 ± 0.9 versus 5.1 ± 0.7; P = 0.001). These favorable outcomes were achieved without affecting apneahypopnea index. CONCLUSIONS The results are consistent with our previously published findings in normotensive adults but further indicate that IMT can modulate blood pressure and plasma catecholamines in subjects with ongoing nighttime apnea and hypoxemia. Accordingly, we suggest IMT offers a low cost, nonpharmacologic means of improving sleep and blood pressure in patients who are intolerant of CPAP.
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Affiliation(s)
| | - E Fiona Bailey
- The University of Arizona College of Medicine, Tucson, AZ
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Pendergast DR, Moon RE, Krasney JJ, Held HE, Zamparo P. Human Physiology in an Aquatic Environment. Compr Physiol 2015; 5:1705-50. [PMID: 26426465 DOI: 10.1002/cphy.c140018] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Water covers over 70% of the earth, has varying depths and temperatures and contains much of the earth's resources. Head-out water immersion (HOWI) or submersion at various depths (diving) in water of thermoneutral (TN) temperature elicits profound cardiorespiratory, endocrine, and renal responses. The translocation of blood into the thorax and elevation of plasma volume by autotransfusion of fluid from cells to the vascular compartment lead to increased cardiac stroke volume and output and there is a hyperperfusion of some tissues. Pulmonary artery and capillary hydrostatic pressures increase causing a decline in vital capacity with the potential for pulmonary edema. Atrial stretch and increased arterial pressure cause reflex autonomic responses which result in endocrine changes that return plasma volume and arterial pressure to preimmersion levels. Plasma volume is regulated via a reflex diuresis and natriuresis. Hydrostatic pressure also leads to elastic loading of the chest, increasing work of breathing, energy cost, and thus blood flow to respiratory muscles. Decreases in water temperature in HOWI do not affect the cardiac output compared to TN; however, they influence heart rate and the distribution of muscle and fat blood flow. The reduced muscle blood flow results in a reduced maximal oxygen consumption. The properties of water determine the mechanical load and the physiological responses during exercise in water (e.g. swimming and water based activities). Increased hydrostatic pressure caused by submersion does not affect stroke volume; however, progressive bradycardia decreases cardiac output. During submersion, compressed gas must be breathed which introduces the potential for oxygen toxicity, narcosis due to nitrogen, and tissue and vascular gas bubbles during decompression and after may cause pain in joints and the nervous system.
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Affiliation(s)
- David R Pendergast
- Center for Research and Education in Special Environments, University at Buffalo, Buffalo, New York, USA
- Department of Physiology and Biophysics, University at Buffalo, Buffalo, New York, USA
| | - Richard E Moon
- Center for Hyperbaric Medicine and Environmental Physiology, Duke University, Durham, North Carolina, USA
| | - John J Krasney
- Department of Physiology and Biophysics, University at Buffalo, Buffalo, New York, USA
| | - Heather E Held
- Biomedical Hyperbarics Research Laboratory, Molecular Pharmacology and Physiology, College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Paola Zamparo
- Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
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Vranish JR, Bailey EF. Daily respiratory training with large intrathoracic pressures, but not large lung volumes, lowers blood pressure in normotensive adults. Respir Physiol Neurobiol 2015; 216:63-9. [PMID: 26112283 DOI: 10.1016/j.resp.2015.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 05/19/2015] [Accepted: 06/04/2015] [Indexed: 01/20/2023]
Abstract
Inspiratory muscle training holds promise as a non-pharmacologic treatment that can improve respiratory muscle strength, reduce blood pressure, and improve autonomic balance in hypertensive patients. There is a gap in knowledge regarding the specific respiratory stimulus that gives rise to these favorable outcomes. We implemented five respiratory training protocols that differed in the magnitude and direction of the lung volumes and/or intrathoracic pressures generated by subjects in training. Normotensive adults were randomly assigned to each group and trained daily for 6 weeks. Pre-post and weekly measures of blood pressure showed significant declines in systolic [-8.96 mmHg (95% CI, 7.39-10.53)] and diastolic [-5.25 mmHg (95% CI, 3.67-6.83)] blood pressures for subjects who trained with large positive or negative intrathoracic pressures. Subjects who trained with modest intrathoracic pressures or large lung volumes saw no improvement in blood pressure (P > 0.3). Large intra-thoracic pressures are the specific respiratory stimulus underpinning breathing training related improvements in blood pressure.
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Affiliation(s)
- Jennifer R Vranish
- Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ 85721-0093, USA
| | - E Fiona Bailey
- Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ 85721-0093, USA.
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Held HE, Pendergast DR. The effects of respiratory muscle training on respiratory mechanics and energy cost. Respir Physiol Neurobiol 2014; 200:7-17. [PMID: 24816143 DOI: 10.1016/j.resp.2014.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 04/25/2014] [Accepted: 05/02/2014] [Indexed: 11/16/2022]
Abstract
Resistance respiratory muscle training (RRMT) increases respiratory muscle strength and can increase swimming endurance time by as much as 85%. The purpose of this study was to examine potential mechanisms by which RRMT improves exercise endurance. Eight healthy adult male scuba divers underwent experiments in a hyperbaric chamber at sea level (1 atmosphere absolute (ATA)), 2.7 ATA and 4.6 ATA, both dry and fully submersed. Subjects rested, exercised, and rested while mimicking their own exercise breathing (ISEV). Airway resistance (R(aw)), exhaled nitric oxide output (V˙(NO)), and respiratory duty cycle (T(I)/T(Tot)) were determined before and after four weeks of RRMT. RRMT decreased T(I)/T(Tot) (-10% at rest at 1 ATA), V˙(O2) (-17% at 2.7 ATA during submersed exercise), V˙(E) (-6% at 2.7 ATA during submersed exercise), and R(aw) (-34% inspiratory at 4.6 ATA submersed, -38% expiratory at 2.7 ATA dry), independent of changes in V˙(NO). Most importantly, respiratory muscle efficiency increased (+83% at 2.7 ATA submersed).
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Affiliation(s)
- Heather E Held
- Center for Research and Education in Special Environments, Department of Physiology and Biophysics, State University of New York at Buffalo, 16 Sherman Annex, Buffalo, NY 14260, United States.
| | - David R Pendergast
- Center for Research and Education in Special Environments, Department of Physiology and Biophysics, State University of New York at Buffalo, 16 Sherman Annex, Buffalo, NY 14260, United States
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Ray AD, Udhoji S, Mashtare TL, Fisher NM. A Combined Inspiratory and Expiratory Muscle Training Program Improves Respiratory Muscle Strength and Fatigue in Multiple Sclerosis. Arch Phys Med Rehabil 2013; 94:1964-70. [DOI: 10.1016/j.apmr.2013.05.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 04/12/2013] [Accepted: 05/13/2013] [Indexed: 01/22/2023]
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Illi SK, Hostettler S, Aliverti A, Spengler CM. Compartmental chest wall volume changes during volitional hyperpnoea with constant tidal volume in healthy individuals. Respir Physiol Neurobiol 2013; 185:410-5. [DOI: 10.1016/j.resp.2012.08.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 07/30/2012] [Accepted: 08/23/2012] [Indexed: 11/30/2022]
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Illi SK, Held U, Frank I, Spengler CM. Effect of Respiratory Muscle Training on Exercise Performance in Healthy Individuals. Sports Med 2012; 42:707-24. [DOI: 10.1007/bf03262290] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Powell T, Williams EM. Effect of resistive load on the inspiratory work and power of breathing during exertion. PLoS One 2012; 7:e49681. [PMID: 23209590 PMCID: PMC3507825 DOI: 10.1371/journal.pone.0049681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2012] [Accepted: 10/16/2012] [Indexed: 11/19/2022] Open
Abstract
The resistive work of breathing against an external load during inspiration (WRI) was measured at the mouth, during sub-maximal exercise in healthy participants. This measure (which excludes the elastic work component) allows the relationship between resistive work and power, ventilation and exercise modality to be explored. A total of 45 adult participants with healthy lung function took part in a series of exercise protocols, in which the relationship between WRI, power of breathing, PRI and minute ventilation, were assessed during rest, while treadmill walking or ergometer cycling, over a range of exercise intensities (up to 150 Watts) and ventilation rates (up to 48 L min−1) with applied constant resistive loads of 0.75 and 1.5 kPa.L.sec−1. Resting WRI was 0.12 JL−1 and PRI was 0.9 W. At each resistive load, independent of the breathing pattern or exercise mode, the WRI increased in a linear fashion at 20 mJ per litre of , while PRI increased exponentially. With increasing resistive load the work and power at any given increased exponentially. Calculation of the power to work ratio during loaded breathing suggests that loads above 1.5 kPa.L.sec−1 make the work of resistive breathing become inhibitive at even a moderate (>30 L sec−1). The relationship between work done and power generated while breathing against resistive loads is independent of the exercise mode (cycling or walking) and that ventilation is limited by the work required to breathe, rather than an inability to maintain or generate power.
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Affiliation(s)
| | - Edgar Mark Williams
- Faculty of Health, Sport and Science, University of Glamorgan, Pontypridd, United Kingdom
- * E-mail:
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Illi SK, Held U, Frank I, Spengler CM. Effect of Respiratory Muscle Training on Exercise Performance in Healthy Individuals. Sports Med 2012. [DOI: 10.2165/11631670-000000000-00000] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Turner LA, Tecklenburg-Lund SL, Chapman RF, Stager JM, Wilhite DP, Mickleborough TD. Inspiratory muscle training lowers the oxygen cost of voluntary hyperpnea. J Appl Physiol (1985) 2012; 112:127-34. [DOI: 10.1152/japplphysiol.00954.2011] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to determine if inspiratory muscle training (IMT) alters the oxygen cost of breathing (V̇o2RM) during voluntary hyperpnea. Sixteen male cyclists completed 6 wk of IMT using an inspiratory load of 50% (IMT) or 15% placebo (CON) of maximal inspiratory pressure (Pimax). Prior to training, a maximal incremental cycle ergometer test was performed to determine V̇o2and ventilation (V̇E) at multiple workloads. Pre- and post-training, subjects performed three separate 4-min bouts of voluntary eucapnic hyperpnea (mimic), matching V̇Ethat occurred at 50, 75, and 100% of V̇o2 max. Pimaxwas significantly increased ( P < 0.05) by 22.5 ± 8.7% from pre- to post-IMT and remained unchanged in the CON group. The V̇o2RMrequired during the mimic trial corresponded to 5.1 ± 2.5, 5.7 ± 1.4, and 11.7% ± 2.5% of the total V̇o2(V̇o2T) at ventilatory workloads equivalent to 50, 75, and 100% of V̇o2 max, respectively. Following IMT, the V̇o2RMrequirement significantly decreased ( P < 0.05) by 1.5% (4.2 ± 1.4% of V̇o2T) at 75% V̇o2 maxand 3.4% (8.1 ± 3.5% of V̇o2T) at 100% V̇o2 max. No significant changes were shown in the CON group. IMT significantly reduced the O2cost of voluntary hyperpnea, which suggests that a reduction in the O2requirement of the respiratory muscles following a period of IMT may facilitate increased O2availability to the active muscles during exercise. These data suggest that IMT may reduce the O2cost of ventilation during exercise, providing an insight into mechanism(s) underpinning the reported improvements in whole body endurance performance; however, this awaits further investigation.
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Affiliation(s)
- Louise A. Turner
- Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, Indiana
- Department of Sport and Exercise Science, Northumbria University, Newcastle upon Tyne, United Kingdom; and
| | - Sandra L. Tecklenburg-Lund
- Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, Indiana
- Health and Human Performance, Nebraska Wesleyan University, Lincoln, Nebraska
| | - Robert F. Chapman
- Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, Indiana
| | - Joel M. Stager
- Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, Indiana
| | - Daniel P. Wilhite
- Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, Indiana
| | - Timothy D. Mickleborough
- Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, Indiana
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The curious question of exercise-induced pulmonary edema. Pulm Med 2011; 2011:361931. [PMID: 21660232 PMCID: PMC3109354 DOI: 10.1155/2011/361931] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 01/21/2011] [Accepted: 01/29/2011] [Indexed: 11/23/2022] Open
Abstract
The question of whether pulmonary edema develops during exercise on land is controversial. Yet, the development of pulmonary edema during swimming and diving is well established. This paper addresses the current controversies that exist in the field of exercise-induced pulmonary edema on land and with water immersion. It also discusses the mechanisms by which pulmonary edema can develop during land exercise, swimming, and diving and the current gaps in knowledge that exist. Finally, this paper discusses how these fields can continue to advance and the areas where clinical knowledge is lacking.
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Peacher DF, Pecorella SRH, Freiberger JJ, Natoli MJ, Schinazi EA, Doar PO, Boso AE, Walker AJ, Gill M, Kernagis D, Uguccioni D, Moon RE. Effects of hyperoxia on ventilation and pulmonary hemodynamics during immersed prone exercise at 4.7 ATA: possible implications for immersion pulmonary edema. J Appl Physiol (1985) 2010; 109:68-78. [PMID: 20431020 DOI: 10.1152/japplphysiol.01431.2009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Immersion pulmonary edema (IPE) can occur in otherwise healthy swimmers and divers, likely because of stress failure of pulmonary capillaries secondary to increased pulmonary vascular pressures. Prior studies have revealed progressive increase in ventilation [minute ventilation (Ve)] during prolonged immersed exercise. We hypothesized that this increase occurs because of development of metabolic acidosis with concomitant rise in mean pulmonary artery pressure (MPAP) and that hyperoxia attenuates this increase. Ten subjects were studied at rest and during 16 min of exercise submersed at 1 atm absolute (ATA) breathing air and at 4.7 ATA in normoxia and hyperoxia [inspired P(O(2)) (Pi(O(2))) 1.75 ATA]. Ve increased from early (E, 6th minute) to late (L, 16th minute) exercise at 1 ATA (64.1 +/- 8.6 to 71.7 +/- 10.9 l/min BTPS; P < 0.001), with no change in arterial pH or Pco(2). MPAP decreased from E to L at 1 ATA (26.7 +/- 5.8 to 22.7 +/- 5.2 mmHg; P = 0.003). Ve and MPAP did not change from E to L at 4.7 ATA. Hyperoxia reduced Ve (62.6 +/- 10.5 to 53.1 +/- 6.1 l/min BTPS; P < 0.0001) and MPAP (29.7 +/- 7.4 to 25.1 +/- 5.7 mmHg, P = 0.002). Variability in MPAP among subjects was wide (range 14.1-42.1 mmHg during surface and depth exercise). Alveolar-arterial Po(2) difference increased from E to L in normoxia, consistent with increased lung water. We conclude that increased Ve at 1 ATA is not due to acidosis and is more consistent with respiratory muscle fatigue and that progressive pulmonary vascular hypertension does not occur during prolonged immersed exercise. Wide variation in MPAP among healthy subjects is consistent with variable individual susceptibility to IPE.
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Affiliation(s)
- Dionne F Peacher
- Center for Hyperbaric Medicine and Environmental Physiology, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA
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