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Ladriñán-Maestro A, Sánchez-Infante J, Martín-Vera D, Sánchez-Sierra A. Influence of an inspiratory muscle fatigue protocol on healthy youths on respiratory muscle strength, vertical jump performance and muscle oxygen saturation: a randomized controlled trial. J Transl Med 2024; 22:732. [PMID: 39103816 DOI: 10.1186/s12967-024-05555-3] [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: 05/29/2024] [Accepted: 07/29/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Inspiratory muscle fatigue has been shown to have effects on limbs blood flow and physical performance. This study aimed to evaluate the influence of an inspiratory muscle fatigue protocol on respiratory muscle strength, vertical jump performance and muscle oxygen saturation in healthy youths. METHODS A randomized and double-blinded controlled clinical trial, was conducted. Twenty-four participants aged 18-45 years, non-smokers and engaged in sports activity at least three times a week for a minimum of one year were enrolled in this investigation. Participants were randomly assigned to three groups: Inspiratory Muscle Fatigue (IMFG), Activation, and Control. Measurements of vertical jump, diaphragmatic ultrasound, muscle oxygen saturation, and maximum inspiratory pressure were taken at two stages: before the intervention (T1) and immediately after treatment (T2). RESULTS The IMFG showed lower scores in muscle oxygen saturation and cardiorespiratory variables after undergoing the diaphragmatic fatigue intervention compared to the activation and control groups (p < 0.05). For the vertical jump variables, intragroup differences were found (p < 0.01), but no differences were shown between the three groups (p > 0.05). CONCLUSIONS Inspiratory muscle fatigue appears to negatively impact vertical jump performance, muscle oxygen saturation and inspiratory muscle strength in healthy youths. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT06271876. Date of registration 02/21/2024. https://clinicaltrials.gov/study/NCT06271876 .
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Affiliation(s)
- Arturo Ladriñán-Maestro
- School for Doctoral Studies and Research, Universidad Europea de Madrid, Madrid, Spain
- Research Group on Exercise Therapy and Functional Rehabilitation, Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
| | - Jorge Sánchez-Infante
- Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain
- Department of Sport Sciences, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Spain
- Physiotherapy Research Group of Toledo (GIFTO), Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Madrid, Spain
| | - Daniel Martín-Vera
- Research Group on Exercise Therapy and Functional Rehabilitation, Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, 28670, Spain
| | - Alberto Sánchez-Sierra
- Research Group on Exercise Therapy and Functional Rehabilitation, Faculty of Sports Sciences, Universidad Europea de Madrid, Madrid, Spain.
- Faculty of Physiotherapy and Nursing of Toledo, Universidad de Castilla-La Mancha, Toledo, Spain.
- Physiotherapy Research Group of Toledo (GIFTO), Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha, Toledo, Spain.
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, 28670, Spain.
- Clínica Sierra Varona SL, Av Boladiez, 34, 45007, Toledo, Spain.
- Department of Physical Therapy, Camilo José Cela University, Madrid, Spain.
- Department of Physical Therapy , Universidad Alfonso X El Sabio, Villanueva de la Cañada, Spain.
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Kipp S, Arn SR, Leahy MG, Guenette JA, Sheel AW. The metabolic cost of breathing for exercise ventilations: effects of age and sex. J Appl Physiol (1985) 2024; 137:329-342. [PMID: 38841757 DOI: 10.1152/japplphysiol.00282.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/03/2024] [Accepted: 06/03/2024] [Indexed: 06/07/2024] Open
Abstract
Given that there are both sex-based structural differences in the respiratory system and age-associated declines in pulmonary function, the purpose of this study was to assess the effects of age and sex on the metabolic cost of breathing (V̇o2RM) for exercise ventilations in healthy younger and older males and females. Forty healthy participants (10 young males 24 ± 3 yr; 10 young females 24 ± 3 yr; 10 older males 63 ± 3 yr, 10 older females 63 ± 6 yr) mimicked their exercise breathing patterns (voluntary hyperpnea) in the absence of exercise across a range of exercise intensities. At peak exercise, V̇o2RM represented a significantly greater fraction of peak oxygen consumption (V̇o2peak) in young females, 12.7 ± 4.0%, compared with young males, 10.7 ± 3.0% (P = 0.027), whereas V̇o2RM represented 13.5 ± 2.3% of V̇o2peak in older females and 13.2 ± 3.3% in older males. At relative ventilations, there was a main effect of age, with older males consuming a significantly greater fraction of V̇o2RM (6.6 ± 1.9%) than the younger males (4.4 ± 1.3%; P = 0.012), and older females consuming a significantly greater fraction of V̇o2RM (6.9 ± 2.5%) than the younger females (5.1 ± 1.4%; P = 0.004) at 65% V̇emax. Furthermore, both younger and older males had significantly better respiratory muscle efficiency than their female counterparts at peak exercise (P = 0.011; P = 0.015). Similarly, younger participants were significantly more efficient than older participants (6.5 ± 1.5% vs. 5.5 ± 2.0%; P = 0.001). Normal age-related changes in respiratory function, in addition to sex-based differences in airway anatomy, appear to influence the ventilatory responses and the cost incurred to breathe during exercise.NEW & NOTEWORTHY Here we show that at moderate and high-intensity exercise, older individuals incur a higher cost to breathe than their younger counterparts. However, as individuals age, the sex difference in the cost of breathing narrows. Collectively, our findings suggest that the normative age-related changes in respiratory structure and function, and sex differences in airway anatomy, appear to influence the ventilatory responses to exercise and the oxygen cost to breathe.
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Affiliation(s)
- Shalaya Kipp
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sierra R Arn
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael G Leahy
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jordan A Guenette
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Heart Lung Innovation, Providence Research, The University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - A William Sheel
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Heart Lung Innovation, Providence Research, The University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada
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Leahy MG, Busch SA, Thrall SF, Hillen SJ, Sheel AW, Foster GE. Reflex sympathetic activation to inspiratory muscle loading is attenuated in females relative to males. Am J Physiol Heart Circ Physiol 2024; 327:H28-H37. [PMID: 38700472 DOI: 10.1152/ajpheart.00133.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/02/2024] [Accepted: 05/02/2024] [Indexed: 05/05/2024]
Abstract
Intense inspiratory muscle work can evoke a metabolite-stimulated pressor reflex, commonly referred to as the respiratory muscle metaboreflex. When completing similar relative and absolute levels of inspiratory work, females have an attenuated blood pressure response. We sought to test the hypothesis that the lower blood pressure response to the respiratory muscle metaboreflex in females is associated with a reduced sympathetic response. Healthy young (26 ± 4 yr) males (n = 9) and females (n = 7) completed two experimental days. On day 1, participants completed pulmonary function testing and became familiarized with an inspiratory pressure-threshold loading (PTL) task. On the second day, balloon-tipped catheters were placed in the esophagus and stomach to measure pleural and gastric pressures, and transdiaphragmatic pressure was calculated. A microelectrode was inserted into the fibular nerve to quantify muscle sympathetic nerve activity (MSNA), and participants then completed isocapnic PTL to task failure. There was a significant sex-by-time interaction in the mean arterial pressure (MAP, P = 0.015) and burst frequency (P = 0.039) response to PTL. Males had a greater rise in MAP (Δ21 ± 9 mmHg) than females (Δ13 ± 5 mmHg, P = 0.026). Males also demonstrated a greater rise in MSNA burst frequency (Δ18 ± 7 bursts/min) than females (Δ10 ± 5 bursts/min, P = 0.015). The effect of sex was observed despite females and males completing the same magnitude of diaphragm work throughout the task (P = 0.755). Our findings provide novel evidence that the lower blood pressure response to similar relative and absolute inspiratory muscle work in females is associated with lower sympathetic activation.NEW & NOTEWORTHY The blood pressure response to high levels of inspiratory muscle work is lower in females and occurs alongside a reduced sympathetic response. The reduced blood pressure and sympathetic response occur despite males and females performing similar levels of absolute inspiratory work. Our findings provide evidence that sex differences in the respiratory muscle metaboreflex are, in part, sympathetically mediated.
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Affiliation(s)
- Michael G Leahy
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephen A Busch
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott F Thrall
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Okanagan, British Columbia, Canada
| | - Sam J Hillen
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - A William Sheel
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Glen E Foster
- Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Okanagan, British Columbia, Canada
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Kipp S, Leahy MG, Sheel AW. Sports Bra Restriction on Respiratory Mechanics during Exercise. Med Sci Sports Exerc 2024; 56:1168-1176. [PMID: 38350462 DOI: 10.1249/mss.0000000000003403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
PURPOSE We set out to understand how underband tightness or pressure of a sports bra relates to respiratory function and the mechanical work of breathing ( during exercise. Our secondary purpose was to quantify the effects of underband pressure on O 2 during submaximal running. METHODS Nine highly trained female runners with normal pulmonary function completed maximal and submaximal running in three levels of underband restriction: loose, self-selected, and tight. RESULTS During maximal exercise, we observed a significantly greater during the tight condition (350 ± 78 J·min -1 ) compared with the loose condition (301 ± 78 J·min -1 ; P < 0.05), and a 5% increase in minute ventilation ( ) during the tight condition compared with the loose condition ( P < 0.05). The pattern of breathing also differed between the two conditions; the greater maximal during the tight condition was achieved by a higher breathing frequency (57 ± 6 vs. 52 ± 7 breaths·min -1 ; P < 0.05), despite tidal volume being significantly lower in the tight condition compared with the loose condition (1.97 ± 0.20 vs. 2.05 ± 0.23 L; P < 0.05). During steady-state submaximal running, O 2 increased 1.3 ± 1.1% (range: -0.3 to 3.2%, P < 0.05) in the tight condition compared with the loose condition. CONCLUSIONS Respiratory function may become compromised by the pressure exerted by the underband of a sports bra when women self-select their bra size. In the current study, loosening the underband pressure resulted in a decreased work of breathing, changed the ventilatory breathing pattern to deeper, less frequent breaths, and decreased submaximal oxygen uptake (improved running economy). Our findings suggest sports bra underbands can impair breathing mechanics during exercise and influence whole-body metabolic rate.
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Affiliation(s)
- Shalaya Kipp
- School of Kinesiology, University of British Columbia, Vancouver, BC, CANADA
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Koizumi J, Ohya T. Effects of High-Intensity Inspiratory Muscle Warm-Up on High-Intensity Exercise Performance and Muscle Oxygenation. Int J Sports Physiol Perform 2024; 19:347-355. [PMID: 38215734 DOI: 10.1123/ijspp.2023-0163] [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: 05/05/2023] [Revised: 10/14/2023] [Accepted: 11/30/2023] [Indexed: 01/14/2024]
Abstract
PURPOSE An inspiratory muscle warm-up (IMW) improves inspiratory muscle function, but the effects of high-intensity exercise are inconsistent. We aimed to determine the effects of high-intensity IMW on high-intensity exercise performance and muscle oxygenation. METHODS Ten healthy men (maximal oxygen uptake [V˙O2max] 52.2 [5.0] mL·kg-1·min-1) performed constant-load exercise to exhaustion on a cycle ergometer at V˙O2max under 2 IMW conditions: a placebo condition (PLA) and a high-intensity IMW condition (HIGH). The inspiratory loads were set at 15% and 80% of maximal inspiratory pressure, respectively. Maximal inspiratory pressure was measured before and after IMW. Oxyhemoglobin was measured in the vastus lateralis by near-infrared spectroscopy during exercise. Rating of perceived exertion (RPE) for a leg was measured after 1 and 2 minutes of exercise. RESULTS Exercise tolerance was significantly higher under HIGH than PLA (228 [49] s vs 218 [49] s, P = .003). Maximal inspiratory pressure was significantly increased by IMW under HIGH (from 125 [20] to 136 [25] cm H2O, P = .031). Oxyhemoglobin was significantly higher under HIGH than PLA at 80% of the total duration of exercise (P = .048). RPE for the leg was significantly lower under HIGH than PLA after 2 minutes of exercise (P = .019). CONCLUSIONS Given that oxyhemoglobin is an index of local oxygen supply, the results of this study suggest that high-intensity IMW increases the oxygen supply to active limbs. It may also reflect a reduction in RPE in the leg. In addition, high-intensity IMW may improve exercise performance.
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Affiliation(s)
- Jun Koizumi
- Graduate School of Health and Sport Science, Chukyo University, Aichi, Japan
| | - Toshiyuki Ohya
- Graduate School of Health and Sport Science, Chukyo University, Aichi, Japan
- School of Health and Sport Science, Chukyo University, Aichi, Japan
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Haddad T, Mons V, Meste O, Dempsey JA, Abbiss CR, Brisswalter J, Blain GM. Breathing a low-density gas reduces respiratory muscle force development and marginally improves exercise performance in master athletes. Eur J Appl Physiol 2024; 124:651-665. [PMID: 37973652 DOI: 10.1007/s00421-023-05346-6] [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: 08/06/2023] [Accepted: 10/16/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION We tested the hypothesis that breathing heliox, to attenuate the mechanical constraints accompanying the decline in pulmonary function with aging, improves exercise performance. METHODS Fourteen endurance-trained older men (67.9 ± 5.9 year, [Formula: see text]O2max: 50.8 ± 5.8 ml/kg/min; 151% predicted) completed two cycling 5-km time trials while breathing room air (i.e., 21% O2-79% N2) or heliox (i.e., 21% O2-79% He). Maximal flow-volume curves (MFVC) were determined pre-exercise to characterize expiratory flow limitation (EFL, % tidal volume intersecting the MFVC). Respiratory muscle force development was indirectly determined as the product of the time integral of inspiratory and expiratory mouth pressure (∫Pmouth) and breathing frequency. Maximal inspiratory and expiratory pressure maneuvers were performed pre-exercise and post-exercise to estimate respiratory muscle fatigue. RESULTS Exercise performance time improved (527.6 ± 38 vs. 531.3 ± 36.9 s; P = 0.017), and respiratory muscle force development decreased during inspiration (- 22.8 ± 11.6%, P < 0.001) and expiration (- 10.8 ± 11.4%, P = 0.003) with heliox compared with room air. EFL tended to be lower with heliox (22 ± 23 vs. 30 ± 23% tidal volume; P = 0.054). Minute ventilation normalized to CO2 production ([Formula: see text]E/[Formula: see text]CO2) increased with heliox (28.6 ± 2.7 vs. 25.1 ± 1.8; P < 0.001). A reduction in MIP and MEP was observed post-exercise vs. pre-exercise but was not different between conditions. CONCLUSIONS Breathing heliox has a limited effect on performance during a 5-km time trial in master athletes despite a reduction in respiratory muscle force development.
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Affiliation(s)
- Toni Haddad
- LAMHESS, Sciences et Techniques des Activités Physiques et Sportives, Université Côte d'Azur, 261 Bd du Mercantour, 06200, Nice, France.
- Centre VADER, Université Côte d'Azur, Nice, France.
- Centre for Exercise and Sport Science Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
| | - Valentin Mons
- LAMHESS, Sciences et Techniques des Activités Physiques et Sportives, Université Côte d'Azur, 261 Bd du Mercantour, 06200, Nice, France
- Centre VADER, Université Côte d'Azur, Nice, France
- LJAD, Université Côte d'Azur, CNRS, Nice, France
| | - Olivier Meste
- Lab I3S, Université Côte d'Azur, CNRS, Sophia Antipolis, Nice, France
| | - Jerome A Dempsey
- John Rankin Laboratory of Pulmonary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Chris R Abbiss
- Centre for Exercise and Sport Science Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Jeanick Brisswalter
- LAMHESS, Sciences et Techniques des Activités Physiques et Sportives, Université Côte d'Azur, 261 Bd du Mercantour, 06200, Nice, France
- Centre VADER, Université Côte d'Azur, Nice, France
| | - Gregory M Blain
- LAMHESS, Sciences et Techniques des Activités Physiques et Sportives, Université Côte d'Azur, 261 Bd du Mercantour, 06200, Nice, France
- Centre VADER, Université Côte d'Azur, Nice, France
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Peters CM, Dempsey JA, Hopkins SR, Sheel AW. Is the Lung Built for Exercise? Advances and Unresolved Questions. Med Sci Sports Exerc 2023; 55:2143-2159. [PMID: 37443459 PMCID: PMC11186580 DOI: 10.1249/mss.0000000000003255] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
ABSTRACT Nearly 40 yr ago, Professor Dempsey delivered the 1985 ACSM Joseph B. Wolffe Memorial Lecture titled: "Is the lung built for exercise?" Since then, much experimental work has been directed at enhancing our understanding of the functional capacity of the respiratory system by applying complex methodologies to the study of exercise. This review summarizes a symposium entitled: "Revisiting 'Is the lung built for exercise?'" presented at the 2022 American College of Sports Medicine annual meeting, highlighting the progress made in the last three-plus decades and acknowledging new research questions that have arisen. We have chosen to subdivide our topic into four areas of active study: (i) the adaptability of lung structure to exercise training, (ii) the utilization of airway imaging to better understand how airway anatomy relates to exercising lung mechanics, (iii) measurement techniques of pulmonary gas exchange and their importance, and (iv) the interactions of the respiratory and cardiovascular system during exercise. Each of the four sections highlights gaps in our knowledge of the exercising lung. Addressing these areas that would benefit from further study will help us comprehend the intricacies of the lung that allow it to meet and adapt to the acute and chronic demands of exercise in health, aging, and disease.
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Affiliation(s)
| | - Jerome A Dempsey
- Population Health Science, John Rankin Laboratory of Pulmonary Medicine, University of Wisconsin-Madison, Madison, WI
| | - Susan R Hopkins
- Department of Radiology, University of California San Diego, La Jolla, CA
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Contreras-Briceño F, Espinosa-Ramírez M, Rivera-Greene A, Guerra-Venegas C, Lungenstrass-Poulsen A, Villagra-Reyes V, Caulier-Cisterna R, Araneda OF, Viscor G. Monitoring Changes in Oxygen Muscle during Exercise with High-Flow Nasal Cannula Using Wearable NIRS Biosensors. BIOSENSORS 2023; 13:985. [PMID: 37998160 PMCID: PMC10669262 DOI: 10.3390/bios13110985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/04/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023]
Abstract
Exercise increases the cost of breathing (COB) due to increased lung ventilation (V˙E), inducing respiratory muscles deoxygenation (∇SmO2), while the increase in workload implies ∇SmO2 in locomotor muscles. This phenomenon has been proposed as a leading cause of exercise intolerance, especially in clinical contexts. The use of high-flow nasal cannula (HFNC) during exercise routines in rehabilitation programs has gained significant interest because it is proposed as a therapeutic intervention for reducing symptoms associated with exercise intolerance, such as fatigue and dyspnea, assuming that HFNC could reduce exercise-induced ∇SmO2. SmO2 can be detected using optical wearable devices provided by near-infrared spectroscopy (NIRS) technology, which measures the changes in the amount of oxygen bound to chromophores (e.g., hemoglobin, myoglobin, cytochrome oxidase) at the target tissue level. We tested in a study with a cross-over design whether the muscular desaturation of m.vastus lateralis and m.intercostales during a high-intensity constant-load exercise can be reduced when it was supported with HFNC in non-physically active adults. Eighteen participants (nine women; age: 22 ± 2 years, weight: 65.1 ± 11.2 kg, height: 173.0 ± 5.8 cm, BMI: 21.6 ± 2.8 kg·m-2) were evaluated in a cycle ergometer (15 min, 70% maximum watts achieved in ergospirometry (V˙O2-peak)) breathing spontaneously (control, CTRL) or with HFNC support (HFNC; 50 L·min-1, fiO2: 21%, 30 °C), separated by seven days in randomized order. Two-way ANOVA tests analyzed the ∇SmO2 (m.intercostales and m.vastus lateralis), and changes in V˙E and ∇SmO2·V˙E-1. Dyspnea, leg fatigue, and effort level (RPE) were compared between trials by the Wilcoxon matched-paired signed rank test. We found that the interaction of factors (trial × exercise-time) was significant in ∇SmO2-m.intercostales, V˙E, and (∇SmO2-m.intercostales)/V˙E (p < 0.05, all) but not in ∇SmO2-m.vastus lateralis. ∇SmO2-m.intercostales was more pronounced in CTRL during exercise since 5' (p < 0.05). Hyperventilation was higher in CTRL since 10' (p < 0.05). The ∇SmO2·V˙E-1 decreased during exercise, being lowest in CTRL since 5'. Lower dyspnea was reported in HFNC, with no differences in leg fatigue and RPE. We concluded that wearable optical biosensors documented the beneficial effect of HFNC in COB due to lower respiratory ∇SmO2 induced by exercise. We suggest incorporating NIRS devices in rehabilitation programs to monitor physiological changes that can support the clinical impact of the therapeutic intervention implemented.
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Affiliation(s)
- Felipe Contreras-Briceño
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile; (M.E.-R.); (A.R.-G.); (C.G.-V.); (A.L.-P.); (V.V.-R.)
- Millennium Institute for Intelligent Healthcare Engineering (iHEALTH), Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Maximiliano Espinosa-Ramírez
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile; (M.E.-R.); (A.R.-G.); (C.G.-V.); (A.L.-P.); (V.V.-R.)
| | - Augusta Rivera-Greene
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile; (M.E.-R.); (A.R.-G.); (C.G.-V.); (A.L.-P.); (V.V.-R.)
| | - Camila Guerra-Venegas
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile; (M.E.-R.); (A.R.-G.); (C.G.-V.); (A.L.-P.); (V.V.-R.)
| | - Antonia Lungenstrass-Poulsen
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile; (M.E.-R.); (A.R.-G.); (C.G.-V.); (A.L.-P.); (V.V.-R.)
| | - Victoria Villagra-Reyes
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile; (M.E.-R.); (A.R.-G.); (C.G.-V.); (A.L.-P.); (V.V.-R.)
| | - Raúl Caulier-Cisterna
- Department of Informatics and Computing, Faculty of Engineering, Universidad Tecnológica Metropolitana, Av. José Pedro Alessandri #1242, Santiago 7800002, Chile;
| | - Oscar F. Araneda
- Laboratory of Integrative Physiology of Biomechanics and Physiology of Effort, Kinesiology School, Faculty of Medicine, Universidad de los Andes, Av. Monseñor Álvaro del Portillo 12455, Santiago 7620001, Chile;
| | - Ginés Viscor
- Secció de Fisiologia, Departament de Biologia Cel·lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, Av. Diagonal #643, 08028 Barcelona, Spain;
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Angus SA, Taylor JL, Mann LM, Williams AM, Stöhr EJ, Au JS, Sheel AW, Dominelli PB. Attenuating intrathoracic pressure swings decreases cardiac output at different intensities of exercise. J Physiol 2023; 601:4807-4821. [PMID: 37772933 DOI: 10.1113/jp285101] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/05/2023] [Indexed: 09/30/2023] Open
Abstract
Intrathoracic pressure (ITP) swings that permit spontaneous ventilation have physiological implications for the heart. We sought to determine the effect of respiration on cardiac output (Q ̇ $\dot Q$ ) during semi-supine cycle exercise using a proportional assist ventilator to minimize ITP changes and lower the work of breathing (Wb ). Twenty-four participants (12 females) completed three exercise trials at 30%, 60% and 80% peak power (Wmax ) with unloaded (using a proportional assist ventilator, PAV) and spontaneous breathing. Intrathoracic and intraabdominal pressures were measured with balloon catheters placed in the oesophagus and stomach. Left ventricular (LV) volumes andQ ̇ $\dot Q$ were determined via echocardiography. Heart rate (HR) was measured with electrocardiogram and a customized metabolic cart measured oxygen uptake (V ̇ O 2 ${\dot V_{{{\mathrm{O}}_{\mathrm{2}}}}}$ ). Oesophageal pressure swings decreased from spontaneous to PAV breathing by -2.8 ± 3.1, -4.9 ± 5.7 and -8.1 ± 7.7 cmH2 O at 30%, 60% and 80% Wmax , respectively (P = 0.01). However, the decreases in Wb were similar across exercise intensities (27 ± 42 vs. 35 ± 24 vs. 41 ± 22%, respectively, P = 0.156). During PAV breathing compared to spontaneous breathing,Q ̇ $\dot Q$ decreased by -1.0 ± 1.3 vs. -1.4 ± 1.4 vs. -1.5 ± 1.9 l min-1 (all P < 0.05) and stroke volume decreased during PAV breathing by -11 ± 12 vs. -9 ± 10 vs. -7 ± 11 ml from spontaneous breathing at 30%, 60% and 80% Wmax , respectively (all P < 0.05). HR was lower during PAV breathing by -5 ± 4 beats min-1 at 80% Wmax (P < 0.0001). Oxygen uptake decreased by 100 ml min-1 during PAV breathing compared to spontaneous breathing at 80% Wmax (P < 0.0001). Overall, attenuating ITPs mitigated LV preload and ejection, thereby suggesting that the ITPs associated with spontaneous respiration impact cardiac function during exercise. KEY POINTS: Pulmonary ventilation is accomplished by alterations in intrathoracic pressure (ITP), which have physiological implications on the heart and dynamically influence the loading parameters of the heart. Proportional assist ventilation was used to attenuate ITP changes and decrease the work of breathing during exercise to examine its effects on left ventricular (LV) function. Proportional assist ventilation with progressive exercise intensities (30%, 60% and 80% Wmax ) led to reductions in cardiac output at all intensities, primarily through reductions in stroke volume. Decreases in LV end-diastolic volume (30% and 60% Wmax ) and increases in LV end-systolic volume (80% Wmax ) were responsible for the reduction in stroke volume. The relationship between cardiac output and oxygen uptake is disrupted during respiratory muscle unloading.
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Affiliation(s)
- Sarah A Angus
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Joshua L Taylor
- School of Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Leah M Mann
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Alexandra M Williams
- International Collaboration on Repair Discoveries (ICORD), The University of British Columbia, Vancouver, British Columbia, Canada
- Department of Cellular and Physiological Science, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Eric J Stöhr
- Institute of Sports Science, COR-HELIX, Leibniz University Hannover, Hannover, Germany
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Jason S Au
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Andrew William Sheel
- School of Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Paolo B Dominelli
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
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10
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Dempsey JA, Welch JF. Control of Breathing. Semin Respir Crit Care Med 2023; 44:627-649. [PMID: 37494141 DOI: 10.1055/s-0043-1770342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Substantial advances have been made recently into the discovery of fundamental mechanisms underlying the neural control of breathing and even some inroads into translating these findings to treating breathing disorders. Here, we review several of these advances, starting with an appreciation of the importance of V̇A:V̇CO2:PaCO2 relationships, then summarizing our current understanding of the mechanisms and neural pathways for central rhythm generation, chemoreception, exercise hyperpnea, plasticity, and sleep-state effects on ventilatory control. We apply these fundamental principles to consider the pathophysiology of ventilatory control attending hypersensitized chemoreception in select cardiorespiratory diseases, the pathogenesis of sleep-disordered breathing, and the exertional hyperventilation and dyspnea associated with aging and chronic diseases. These examples underscore the critical importance that many ventilatory control issues play in disease pathogenesis, diagnosis, and treatment.
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Affiliation(s)
- Jerome A Dempsey
- John Rankin Laboratory of Pulmonary Medicine, Department of Population Health Sciences, University of Wisconsin, Madison, Wisconsin
| | - Joseph F Welch
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
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11
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McCarthy DG, Bostad W, Bone J, Powley FJ, Richards DL, Gibala MJ. Effect of Acute Ketone Monoester Ingestion on Cardiorespiratory Responses to Exercise and the Influence of Blood Acidosis. Med Sci Sports Exerc 2023; 55:1286-1295. [PMID: 36849121 DOI: 10.1249/mss.0000000000003141] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
PURPOSE This study aimed to examine the effect of KE ingestion on exercise cardiac output ( Q˙ ) and the influence of blood acidosis. We hypothesized that KE versus placebo ingestion would increase Q ˙, and coingestion of the pH buffer bicarbonate would mitigate this effect. METHODS In a randomized, double-blind, crossover manner, 15 endurance-trained adults (peak oxygen uptake (V̇O 2peak ), 60 ± 9 mL·kg -1 ·min -1 ) ingested either 0.2 g·kg -1 sodium bicarbonate or a salt placebo 60 min before exercise, and 0.6 g·kg -1 KE or a ketone-free placebo 30 min before exercise. Supplementation yielded three experimental conditions: basal ketone bodies and neutral pH (CON), hyperketonemia and blood acidosis (KE), and hyperketonemia and neutral pH (KE + BIC). Exercise involved 30 min of cycling at ventilatory threshold intensity, followed by determinations of V̇O 2peak and peak Q ˙. RESULTS Blood [β-hydroxybutyrate], a ketone body, was higher in KE (3.5 ± 0.1 mM) and KE + BIC (4.4 ± 0.2) versus CON (0.1 ± 0.0, P < 0.0001). Blood pH was lower in KE versus CON (7.30 ± 0.01 vs 7.34 ± 0.01, P < 0.001) and KE + BIC (7.35 ± 0.01, P < 0.001). Q ˙ during submaximal exercise was not different between conditions (CON: 18.2 ± 3.6, KE: 17.7 ± 3.7, KE + BIC: 18.1 ± 3.5 L·min -1 ; P = 0.4). HR was higher in KE (153 ± 9 bpm) and KE + BIC (154 ± 9) versus CON (150 ± 9, P < 0.02). V̇O 2peak ( P = 0.2) and peak Q ˙ ( P = 0.3) were not different between conditions, but peak workload was lower in KE (359 ± 61 W) and KE + BIC (363 ± 63) versus CON (375 ± 64, P < 0.02). CONCLUSIONS KE ingestion did not increase Q ˙ during submaximal exercise despite a modest elevation of HR. This response occurred independent of blood acidosis and was associated with a lower workload at V̇O 2peak .
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Affiliation(s)
- Devin G McCarthy
- Department of Kinesiology, McMaster University, Hamilton, ON, CANADA
| | - William Bostad
- Department of Kinesiology, McMaster University, Hamilton, ON, CANADA
| | - Jack Bone
- Department of Kinesiology, McMaster University, Hamilton, ON, CANADA
| | - Fiona J Powley
- Department of Kinesiology, McMaster University, Hamilton, ON, CANADA
| | | | - Martin J Gibala
- Department of Kinesiology, McMaster University, Hamilton, ON, CANADA
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12
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Koizumi J, Ohya T. Effects of high-intensity inspiratory muscle warm-up on inspiratory muscle strength and accessory inspiratory muscle activity. Respir Physiol Neurobiol 2023; 313:104069. [PMID: 37141931 DOI: 10.1016/j.resp.2023.104069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/21/2023] [Accepted: 04/30/2023] [Indexed: 05/06/2023]
Abstract
This study aimed to determine the effects of work-matched moderate-intensity and high-intensity inspiratory muscle warm-up (IMW) on inspiratory muscle strength and accessory inspiratory muscle activity. Eleven healthy men performed three IMWs at different intensities, namely, placebo, moderate-intensity, and high-intensity, set, respectively, at 15%, 40%, and 80% of maximal inspiratory mouth pressure (MIP). MIP was measured before and after IMW. Electromyography (EMG) was recorded for the sternocleidomastoid muscle (SCM) and intercostal muscles (IC) during IMW. MIP increased significantly in the moderate-intensity condition (104.2 ± 5.1%, p<0.05) and high-intensity condition (106.5 ± 6.2%, p<0.01) after IMW. The EMG amplitudes of the SCM and IC during IMW were significantly higher in the order of high-intensity, moderate-intensity, and placebo conditions. There was a significant correlation between changes in MIP and EMG amplitude of the SCM (r=0.60, p<0.01) and IC (r=0.47, p<0.01) during IMW. These findings suggest that high-intensity IMW increases neuromuscular activity in the accessory inspiratory muscles, which may improve inspiratory muscle strength.
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Affiliation(s)
- Jun Koizumi
- Graduate School of Health and Sport Science, Chukyo University, Aichi, Japan.
| | - Toshiyuki Ohya
- Graduate School of Health and Sport Science, Chukyo University, Aichi, Japan; School of Health and Sport Science, Chukyo University, Aichi, Japan
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13
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Arcidiacono DM, Lavoie EM, Potter AW, Vangala SV, Holden LD, Soucy HY, Karis AJ, Friedl KE, Santee WR, Looney DP. Peak performance and cardiometabolic responses of modern US army soldiers during heavy, fatiguing vest-borne load carriage. APPLIED ERGONOMICS 2023; 109:103985. [PMID: 36764233 DOI: 10.1016/j.apergo.2023.103985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/06/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Physiological limits imposed by vest-borne loads must be defined for optimal performance monitoring of the modern dismounted warfighter. PURPOSE To evaluate how weighted vests affect locomotion economy and relative cardiometabolic strain during military load carriage while identifying key physiological predictors of exhaustion limits. METHODS Fifteen US Army soldiers (4 women, 11 men; age, 26 ± 8 years; height, 173 ± 10 cm; body mass (BM), 79 ± 16 kg) performed four incremental walking tests with different vest loads (0, 22, 44, or 66% BM). We examined the effects of vest-borne loading on peak walking speed, the physiological costs of transport, and relative work intensity. We then sought to determine which of the cardiometabolic indicators (oxygen uptake, heart rate, respiration rate) was most predictive of task failure. RESULTS Peak walking speed significantly decreased with successively heavier vest loads (p < 0.01). Physiological costs per kilometer walked were significantly higher with added vest loads for each measure (p < 0.05). Relative oxygen uptake and heart rate were significantly higher during the loaded trials than the 0% BM trial (p < 0.01) yet not different from one another (p > 0.07). Conversely, respiration rate was significantly higher with the heavier load in every comparison (p < 0.01). Probability modeling revealed heart rate as the best predictor of task failure (marginal R2, 0.587, conditional R2, 0.791). CONCLUSION Heavy vest-borne loads cause exceptional losses in performance capabilities and increased physiological strain during walking. Heart rate provides a useful non-invasive indicator of relative intensity and task failure during military load carriage.
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Affiliation(s)
- Danielle M Arcidiacono
- United States Army Research Institute of Environmental Medicine (USARIEM), 10 General Greene Avenue, Natick, MA, 01760, USA; Oak Ridge Institute for Science and Education (ORISE), 1299 Bethel Valley Rd, Oak Ridge, TN, 37830, USA
| | - Elizabeth M Lavoie
- United States Army Research Institute of Environmental Medicine (USARIEM), 10 General Greene Avenue, Natick, MA, 01760, USA; Oak Ridge Institute for Science and Education (ORISE), 1299 Bethel Valley Rd, Oak Ridge, TN, 37830, USA; University at Buffalo, SUNY, 211 Kimball Tower, Buffalo, NY, 14214, USA
| | - Adam W Potter
- United States Army Research Institute of Environmental Medicine (USARIEM), 10 General Greene Avenue, Natick, MA, 01760, USA
| | - Sai V Vangala
- United States Army Research Institute of Environmental Medicine (USARIEM), 10 General Greene Avenue, Natick, MA, 01760, USA
| | - Lucas D Holden
- United States Army Research Institute of Environmental Medicine (USARIEM), 10 General Greene Avenue, Natick, MA, 01760, USA; Oak Ridge Institute for Science and Education (ORISE), 1299 Bethel Valley Rd, Oak Ridge, TN, 37830, USA
| | - Hope Y Soucy
- United States Army Research Institute of Environmental Medicine (USARIEM), 10 General Greene Avenue, Natick, MA, 01760, USA; Oak Ridge Institute for Science and Education (ORISE), 1299 Bethel Valley Rd, Oak Ridge, TN, 37830, USA
| | - Anthony J Karis
- United States Army Research Institute of Environmental Medicine (USARIEM), 10 General Greene Avenue, Natick, MA, 01760, USA
| | - Karl E Friedl
- United States Army Research Institute of Environmental Medicine (USARIEM), 10 General Greene Avenue, Natick, MA, 01760, USA
| | - William R Santee
- United States Army Research Institute of Environmental Medicine (USARIEM), 10 General Greene Avenue, Natick, MA, 01760, USA
| | - David P Looney
- United States Army Research Institute of Environmental Medicine (USARIEM), 10 General Greene Avenue, Natick, MA, 01760, USA.
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14
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Theodorou AA, Chatzinikolaou PN, Margaritelis NV, Christodoulou F, Tsatalas T, Paschalis V. Short-Term L-Citrulline Supplementation Does Not Affect Inspiratory Muscle Oxygenation and Respiratory Performance in Older Adults. Nutrients 2023; 15:nu15081951. [PMID: 37111169 PMCID: PMC10145540 DOI: 10.3390/nu15081951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/06/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
In sports nutrition, nitric oxide (NO•) precursors such as L-citrulline are widely used to enhance NO• bioavailability, which is considered an ergogenic aid. Our study aimed to examine the effect of short-term L-citrulline supplementation on respiratory muscles' performance, fatigue, and oxygenation in older adults. Fourteen healthy older males took 6 g of L-citrulline or a placebo for seven days in a double-blind crossover design. Pulmonary function via spirometry (i.e., forced expired volume in 1 s (FEV1), forced vital capacity (FVC), and their ratio)), fractional exhaled nitric oxide (NO•), maximal inspiratory pressure (MIP), rate of perceived exertion, and sternocleidomastoid muscle oxygenation (i.e., oxyhemoglobin (Δ[O2Hb]) and de-oxyhemoglobin (Δ[HHb]), total hemoglobin concentration (Δ[tHb]), and tissue saturation index (TSI%)) were evaluated at baseline, after seven days of L-citrulline supplementation, and after incremental resistive breathing to task failure of the respiratory muscles. The exhaled NO• value was only significantly increased after the supplementation (26% p < 0.001) in the L-citrulline condition. Pulmonary function, MIP, rate of perceived exertion, and sternocleidomastoid muscle oxygenation were not affected by the L-citrulline supplementation. In the present study, although short-term L-citrulline supplementation increased exhaled NO•, no ergogenic aids were found on the examined parameters at rest and after resistive breathing to task failure in older adults.
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Affiliation(s)
- Anastasios A Theodorou
- Department of Life Sciences, School of Sciences, European University Cyprus, 1516 Nicosia, Cyprus
| | - Panagiotis N Chatzinikolaou
- Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, 61122 Thessaloniki, Greece
| | - Nikos V Margaritelis
- Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, 61122 Thessaloniki, Greece
| | - Filippos Christodoulou
- Department of Life Sciences, School of Sciences, European University Cyprus, 1516 Nicosia, Cyprus
| | - Themistoklis Tsatalas
- Department of Life Sciences, School of Sciences, European University Cyprus, 1516 Nicosia, Cyprus
- Department of Physical Education & Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Vassilis Paschalis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece
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15
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Chan JS, Mann LM, Doherty CJ, Angus SA, Thompson BP, Devries MC, Hughson RL, Dominelli PB. The effect of inspiratory muscle training and detraining on the respiratory metaboreflex. Exp Physiol 2023; 108:636-649. [PMID: 36754374 PMCID: PMC10103864 DOI: 10.1113/ep090779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/13/2022] [Indexed: 02/10/2023]
Abstract
NEW FINDINGS What is the central question of this study? Is the attenuation of the respiratory muscle metaboreflex preserved after detraining? What is the main finding and its importance? Inspiratory muscle training increased respiratory muscle strength and attenuated the respiratory muscle metaboreflex as evident by lower heart rate and blood pressure. After 5 weeks of no inspiratory muscle training (detraining), respiratory muscle strength was still elevated and the metaboreflex was still attenuated. The benefits of inspiratory muscle training persist after cessation of training, and attenuation of the respiratory metaboreflex follows changes in respiratory muscle strength. ABSTRACT Respiratory muscle training (RMT) improves respiratory muscle (RM) strength and attenuates the RM metaboreflex. However, the time course of muscle function loss after the absence of training or 'detraining' is less known and some evidence suggest the respiratory muscles atrophy faster than other muscles. We sought to determine the RM metaboreflex in response to 5 weeks of RMT and 5 weeks of detraining. An experimental group (2F, 6M; 26 ± 4years) completed 5 weeks of RMT and tibialis anterior (TA) training (each 5 days/week at 50% of maximal inspiratory pressure (MIP) and 50% maximal isometric force, respectively) followed by 5 weeks of no training (detraining) while a control group (1F, 7M; 24 ± 1years) underwent no intervention. Prior to training (PRE), post-training (POST) and post-detraining (DETR), all participants underwent a loaded breathing task (LBT) to failure (60% MIP) while heart rate and mean arterial blood pressure (MAP) were measured. Five weeks of training increased RM (18 ± 9%, P < 0.001) and TA (+34 ± 19%, P < 0.001) strength and both remained elevated after 5 weeks of detraining (MIP-POST vs. MIP-DETR: 154 ± 31 vs. 153 ± 28 cmH2O, respectively, P = 0.853; TA-POST vs. TA-DETR: 86 ± 19 vs. 85 ± 16 N, respectively, P = 0.982). However, the rise in MAP during LBT was attenuated POST (-11 ± 17%, P = 0.003) and DETR (-9 ± 9%, P = 0.007) during the iso-time LBT. The control group had no change in MIP (P = 0.33), TA strength (P = 0.385), or iso-time MAP (P = 0.867) during LBT across all time points. In conclusion, RM and TA have similar temporal strength gains and the attenuation of the respiratory muscle metaboreflex remains after 5 weeks of detraining.
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Affiliation(s)
- Jason S. Chan
- Department of Kinesiology and Health SciencesFaculty of HealthUniversity of WaterlooWaterlooOntarioCanada
| | - Leah M. Mann
- Department of Kinesiology and Health SciencesFaculty of HealthUniversity of WaterlooWaterlooOntarioCanada
| | - Connor J. Doherty
- Department of Kinesiology and Health SciencesFaculty of HealthUniversity of WaterlooWaterlooOntarioCanada
| | - Sarah A. Angus
- Department of Kinesiology and Health SciencesFaculty of HealthUniversity of WaterlooWaterlooOntarioCanada
| | - Benjamin P. Thompson
- Department of Kinesiology and Health SciencesFaculty of HealthUniversity of WaterlooWaterlooOntarioCanada
| | - Michaela C. Devries
- Department of Kinesiology and Health SciencesFaculty of HealthUniversity of WaterlooWaterlooOntarioCanada
| | - Richard L. Hughson
- Department of Kinesiology and Health SciencesFaculty of HealthUniversity of WaterlooWaterlooOntarioCanada
- Schlegel‐UW Research Institute for AgingWaterlooOntarioCanada
| | - Paolo B. Dominelli
- Department of Kinesiology and Health SciencesFaculty of HealthUniversity of WaterlooWaterlooOntarioCanada
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16
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Gerson EAM, Dominelli PB, Leahy MG, Kipp S, Guenette JA, Archiza B, Sheel AW. The effect of proportional assist ventilation on the electrical activity of the human diaphragm during exercise. Exp Physiol 2023; 108:296-306. [PMID: 36420595 PMCID: PMC10103863 DOI: 10.1113/ep090808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/10/2022] [Indexed: 11/25/2022]
Abstract
NEW FINDINGS What is the central question of this study? What is the effect of lowering the normally occurring work of breathing on the electrical activity and pressure generated by the diaphragm during submaximal exercise in healthy humans? What is the main finding and its importance? Ventilatory assist during exercise elicits a proportional lowering of both the work performed by the diaphragm and diaphragm electrical activity. These findings have implications for exercise training studies using proportional assist ventilation to reduce diaphragm work in patients with cardiopulmonary disease. ABSTRACT We hypothesized that when a proportional assist ventilator (PAV) is applied in order to reduce the pressure generated by the diaphragm, there would be a corresponding reduction in electrical activity of the diaphragm. Healthy participants (five male and four female) completed an incremental cycle exercise test to exhaustion in order to calculate workloads for subsequent trials. On the experimental day, participants performed submaximal cycling, and three levels of assisted ventilation were applied (low, medium and high). Ventilatory parameters, pulmonary pressures and EMG of the diaphragm (EMGdi ) were obtained. To compare the PAV conditions with spontaneous breathing intervals, ANOVA procedures were used, and significant effects were evaluated with a Tukey-Kramer test. Significance was set at P < 0.05. The work of breathing was not different between the lowest level of unloading and spontaneous breathing (P = 0.151) but was significantly lower during medium (25%, P = 0.02) and high (36%, P < 0.001) levels of PAV. The pressure-time product of the diaphragm (PTPdi ) was lower across PAV unloading conditions (P < 0.05). The EMGdi was significantly lower in medium and high PAV conditions (P = 0.035 and P < 0.001, respectively). The mean reductions of EMGdi with PAV unloading were 14, 22 and 39%, respectively. The change in EMGdi for a given lowering of PTPdi with the PAV was significantly correlated (r = 0.61, P = 0.01). Ventilatory assist during exercise elicits a reduction in the electrical activity of the diaphragm, and there is a proportional lowering of the work of breathing. Our findings have implications for exercise training studies using assisted ventilation to reduce diaphragm work in patients with cardiopulmonary disease.
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Affiliation(s)
- Emily A. M. Gerson
- School of KinesiologyThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Michael G. Leahy
- School of KinesiologyThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - Shalaya Kipp
- School of KinesiologyThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - Jordan A. Guenette
- School of KinesiologyThe University of British ColumbiaVancouverBritish ColumbiaCanada
- Centre for Heart Lung InnovationProvidence ResearchThe University of British Columbia, St. Paul's HospitalVancouverBritish ColumbiaCanada
- Department of Physical TherapyFaculty of MedicineThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - Bruno Archiza
- School of KinesiologyThe University of British ColumbiaVancouverBritish ColumbiaCanada
- Department of PhysiotherapyCardiopulmonary Physiotherapy LaboratoryNucleus of Research in Physical Exercise, Federal University of Sao CarlosSao CarlosBrazil
| | - Andrew William Sheel
- School of KinesiologyThe University of British ColumbiaVancouverBritish ColumbiaCanada
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17
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Gibbons TD. Reply to Kenney. J Appl Physiol (1985) 2023; 134:131-132. [PMID: 36592407 DOI: 10.1152/japplphysiol.00699.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Travis D Gibbons
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Science, University of British Columbia-Okanagan, Kelowna, British Columbia, Canada
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18
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Ryan BJ, Seeley AD, Pitsas DM, Mayer TA, Caldwell AR, Ceaser TG, Luippold AJ, Charkoudian N, Salgado RM. Influence of graded hypercapnia on endurance exercise performance in healthy humans. Am J Physiol Regul Integr Comp Physiol 2022; 323:R638-R647. [PMID: 36094451 PMCID: PMC9602925 DOI: 10.1152/ajpregu.00132.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/22/2022] [Accepted: 09/06/2022] [Indexed: 11/22/2022]
Abstract
Military and/or emergency services personnel may be required to perform high-intensity physical activity during exposure to elevated inspired carbon dioxide (CO2). Although many of the physiological consequences of hypercapnia are well characterized, the effects of graded increases in inspired CO2 on self-paced endurance performance have not been determined. The aim of this study was to compare the effects of 0%, 2%, and 4% inspired CO2 on 2-mile run performance, as well as physiological and perceptual responses during time trial exercise. Twelve physically active volunteers (peak oxygen uptake = 49 ± 5 mL·kg-1·min-1; 3 women) performed three experimental trials in a randomized, single-blind, crossover manner, breathing 21% oxygen with either 0%, 2%, or 4% CO2. During each trial, participants completed 10 min of walking at ∼40% peak oxygen uptake followed by a self-paced 2-mile treadmill time trial. One participant was unable to complete the 4% CO2 trial due to lightheadedness during the run. Compared with the 0% CO2 trial, run performance was 5 ± 3% and 7 ± 3% slower in the 2% and 4% CO2 trials, respectively (both P < 0.001). Run performance was significantly slower with 4% versus 2% CO2 (P = 0.046). The dose-dependent performance impairments were accompanied by stepwise increases in mean ventilation, despite significant reductions in running speed. Dyspnea and headache were significantly elevated during the 4% CO2 trial compared with both the 0% and 2% trials. Overall, our findings show that graded increases in inspired CO2 impair endurance performance in a stepwise manner in healthy humans.
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Affiliation(s)
- Benjamin J Ryan
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Afton D Seeley
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Dina M Pitsas
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Thomas A Mayer
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Aaron R Caldwell
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Tyrone G Ceaser
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Adam J Luippold
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Roy M Salgado
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts
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López-Pérez ME, Romero-Arenas S, Giráldez-García MA, Colomer-Poveda D, Márquez G. Acute psychophysiological responses during exercise while using resistive respiratory devices: A systematic review. Physiol Behav 2022; 256:113968. [PMID: 36155205 DOI: 10.1016/j.physbeh.2022.113968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 10/31/2022]
Abstract
Different studies have observed that respiratory muscle training (RMT) improve the endurance and strength of the respiratory muscles, having a positive impact on performance of endurance sports. Nevertheless, it remains to be clarified how to improve the efficiency of such training. The objective of this systematic review was to evaluate the acute physiological responses produced by training the respiratory muscles during exercise with flow resistive devices because such information may support us improve the efficiency of this type of training. A search in the Medline, Science Direct, Web of Science and Scopus databases was conducted, following the PRISMA guidelines. The methodological quality of the articles was assessed using the PEDro scale. Nineteen studies met the inclusion criteria and a total of 212 subjects were included in the studies. The RMT method used in all studies was flow resistive loading, whereas the constant load exercise was the most common type of exercise among the studies. The results obtained seem to indicate that the use of this type of training during exercise reduces the performance, the lactate (La-) values and the ventilation, whereas the end - tidal partial pressure of carbon dioxide (PCO2) is increased.
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Affiliation(s)
- María E López-Pérez
- Department of Physical Education, IES El Palmeral, Hermano Lázaro s/n, Vera, Almería 04620, Spain.
| | | | - Manuel A Giráldez-García
- Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - David Colomer-Poveda
- Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruña, A Coruña, Spain
| | - Gonzalo Márquez
- Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruña, A Coruña, Spain
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20
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Dominelli PB. Respiratory muscle metaboreflex: Connecting the 'dots'. Exp Physiol 2022; 107:1013-1014. [PMID: 35866454 DOI: 10.1113/ep090659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 11/08/2022]
Affiliation(s)
- Paolo B Dominelli
- Department of Kinesiology and Health Science, Faculty of Health, University of Waterloo
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21
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Bastir M, González Ruíz JM, Rueda J, Garrido López G, Gómez-Recio M, Beyer B, San Juan AF, Navarro E. Variation in human 3D trunk shape and its functional implications in hominin evolution. Sci Rep 2022; 12:11762. [PMID: 35817835 PMCID: PMC9273616 DOI: 10.1038/s41598-022-15344-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/22/2022] [Indexed: 11/25/2022] Open
Abstract
This study investigates the contribution of external trunk morphology and posture to running performance in an evolutionary framework. It has been proposed that the evolution from primitive to derived features of torso shape involved changes from a mediolaterally wider into a narrower, and antero-posteriorly deeper into a shallower, more lightly built external trunk configuration, possibly in relation to habitat-related changes in locomotor and running behaviour. In this context we produced experimental data to address the hypothesis that medio-laterally narrow and antero-posteriorly shallow torso morphologies favour endurance running capacities. We used 3D geometric morphometrics to relate external 3D trunk shape of trained, young male volunteers (N = 27) to variation in running velocities during different workloads determined at 45–50%, 70% and 85% of heart rate reserve (HRR) and maximum velocity. Below 85% HRR no relationship existed between torso shape and running velocity. However, at 85% HRR and, more clearly, at maximum velocity, we found highly statistically significant relations between external torso shape and running performance. Among all trained subjects those with a relatively narrow, flat torso, a small thoracic kyphosis and a more pronounced lumbar lordosis achieved significantly higher running velocities. These results support the hypothesis that external trunk morphology relates to running performance. Low thoracic kyphosis with a flatter ribcage may affect positively respiratory biomechanics, while increased lordosis affects trunk posture and may be beneficial for lower limb biomechanics related to leg return. Assuming that running workload at 45–50% HRR occurs within aerobic metabolism, our results may imply that external torso shape is unrelated to the evolution of endurance running performance.
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Affiliation(s)
- Markus Bastir
- Paleoanthropology Group, Museo Nacional de Ciencias Naturales, CSIC, J.G. Abascal 2, 28006, Madrid, Spain.
| | - José María González Ruíz
- Paleoanthropology Group, Museo Nacional de Ciencias Naturales, CSIC, J.G. Abascal 2, 28006, Madrid, Spain
| | - Javier Rueda
- Department of Health and Human Performance, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040, Madrid, Spain
| | - Gonzalo Garrido López
- Department of Health and Human Performance, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040, Madrid, Spain
| | - Marta Gómez-Recio
- Paleoanthropology Group, Museo Nacional de Ciencias Naturales, CSIC, J.G. Abascal 2, 28006, Madrid, Spain
| | - Benoit Beyer
- Laboratory of Functional Anatomy (LAF), Faculty of Motor Skills Sciences, Université Libre de Bruxelles, Brussels, Belgium
| | - Alejandro F San Juan
- Department of Health and Human Performance, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040, Madrid, Spain
| | - Enrique Navarro
- Department of Health and Human Performance, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040, Madrid, Spain
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22
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Shiozawa K, Kashima H, Mizuno S, Ishida K, Katayama K. Blood pressure and celiac artery blood flow responses during increased inspiratory muscle work in healthy males. Exp Physiol 2022; 107:1094-1104. [PMID: 35770992 DOI: 10.1113/ep090504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/23/2022] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Increased work of breathing and the accumulation of metabolites have neural and cardiovascular consequences through a respiratory muscle-induced metaboreflex. The influence of respiratory muscle-induced metaboreflex on splanchnic blood flow in humans remains unknown. What is the main finding and its importance? Celiac artery blood flow decreased gradually during inspiratory resistive breathing, accompanied by a progressive increase in arterial blood pressure. It is possible that respiratory muscle-induced metaboreflex contributes to splanchnic blood flow regulation. ABSTRACT The purpose of this study was to clarify the effect of increasing inspiratory muscle work on celiac artery blood flow. Eleven healthy young males completed the study. The subjects performed voluntary hyperventilation with or without inspiratory resistance (loading or non-loading trial) (tidal volume of 40% of vital capacity and breathing frequency of 20 breaths/min). The loading trial was conducted with inspiratory resistance (40% of maximal inspiratory pressure) and was terminated when the subjects could no longer maintain the target tidal volume or breathing frequency. The non-loading trial was conducted without inspiratory resistance and was the same length as the loading trial. Arterial blood pressure was recorded using finger photoplethysmography, and celiac artery blood flow was measured using Doppler ultrasound. Mean arterial blood pressure (MAP) increased gradually during the loading trial (89.0±10.8 to 103.9±17.3 mmHg, mean ± SD) but not in the non-loading trial (88.7±5.9 to 90.4±9.9 mmHg). Celiac artery blood flow and celiac vascular conductance decreased gradually during the loading trial (601.2±155.7 to 482.6±149.5 mL/min and 6.9±2.2 to 4.8±1.7 mL/min/mmHg, respectively), but were unchanged in the non-loading trial (630.7±157.1 to 635.6±195.7 mL/min and 7.1±1.8 to 7.2±2.9 mL/min/mmHg, respectively). These results show that increasing inspiratory muscle work affects splanchnic blood flow regulation, and we suggest that it is possibly mediated by the inspiratory muscle-induced metaboreflex. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Kana Shiozawa
- Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hideaki Kashima
- Department of Health Sciences, Prefectural University of Hiroshima, Japan
| | - Sahiro Mizuno
- Research and Development, Hosei University, Tokyo, Japan
| | - Koji Ishida
- Graduate School of Medicine, Nagoya University, Nagoya, Japan.,Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Keisho Katayama
- Graduate School of Medicine, Nagoya University, Nagoya, Japan.,Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
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23
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Cavalcanti JD, Fregonezi GAF, Sarmento AJ, Bezerra T, Gualdi LP, Pennati F, Aliverti A, Resqueti VR. Electrical activity and fatigue of respiratory and locomotor muscles in obstructive respiratory diseases during field walking test. PLoS One 2022; 17:e0266365. [PMID: 35363800 PMCID: PMC8975118 DOI: 10.1371/journal.pone.0266365] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 03/18/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction In subjects with obstructive respiratory diseases the increased work of breathing during exercise can trigger greater recruitment and fatigue of respiratory muscles. Associated with these changes, lower limb muscle dysfunctions, further contribute to exercise limitations. We aimed to assess electrical activity and fatigue of two respiratory and one locomotor muscle during Incremental Shuttle Walking Test (ISWT) in individuals with obstructive respiratory diseases and compare with healthy. Methods This is a case-control study. Seventeen individuals with asthma (asthma group) and fifteen with chronic obstructive pulmonary disease (COPD group) were matched with healthy individuals (asthma and COPD control groups). Surface electromyographic (sEMG) activity of sternocleidomastoid (SCM), scalene (ESC), and rectus femoris (RF) were recorded during ISWT. sEMG activity was analyzed in time and frequency domains at baseline and during the test (33%, 66%, and 100% of ISWT total time) to obtain, respectively, signal amplitude and power spectrum density (EMG median frequency [MF], high- and low-frequency bands, and high/low [H/L] ratio). Results Asthma group walked a shorter distance than controls (p = 0.0007). sEMG amplitudes of SCM, ESC, and RF of asthma and COPD groups were higher at 33% and 66% of ISWT compared with controls groups (all p<0.05). SCM and ESC of COPD group remained higher until 100% of the test. MF of ESC and RF decreased in asthma group (p = 0.016 and p < 0.0001, respectively) versus controls, whereas MF of SCM (p < 0.0001) decreased in COPD group compared with controls. H/L ratio of RF decreased (p = 0.002) in COPD group versus controls. Conclusion Reduced performance is accompanied by increased electromyographic activity of SCM and ESC and activation of RF in individuals with obstructive respiratory diseases during ISWT. These are susceptible to be more pronounced respiratory and peripheral muscle fatigue than healthy subjects during exercise.
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Affiliation(s)
- Jéssica D. Cavalcanti
- Departamento de Fisioterapia, Laboratório PneumoCardioVascular—Hospital Universitário Onofre Lopes / Empresa Brasileira de Serviços Hospitalares & Laboratório de Inovação Tecnológica em Reabilitação, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brasil
| | - Guilherme Augusto F. Fregonezi
- Departamento de Fisioterapia, Laboratório PneumoCardioVascular—Hospital Universitário Onofre Lopes / Empresa Brasileira de Serviços Hospitalares & Laboratório de Inovação Tecnológica em Reabilitação, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brasil
| | - Antonio J. Sarmento
- Departamento de Fisioterapia, Laboratório PneumoCardioVascular—Hospital Universitário Onofre Lopes / Empresa Brasileira de Serviços Hospitalares & Laboratório de Inovação Tecnológica em Reabilitação, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brasil
| | - Thiago Bezerra
- Departamento de Fisioterapia, Laboratório PneumoCardioVascular—Hospital Universitário Onofre Lopes / Empresa Brasileira de Serviços Hospitalares & Laboratório de Inovação Tecnológica em Reabilitação, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brasil
| | - Lucien P. Gualdi
- Faculdade de Ciências da Saúde do Trairí, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brasil
| | - Francesca Pennati
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Vanessa R. Resqueti
- Departamento de Fisioterapia, Laboratório PneumoCardioVascular—Hospital Universitário Onofre Lopes / Empresa Brasileira de Serviços Hospitalares & Laboratório de Inovação Tecnológica em Reabilitação, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brasil
- * E-mail:
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24
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Ruggiero L, Harrison SWD, Rice CL, McNeil CJ. Neuromuscular fatigability at high altitude: Lowlanders with acute and chronic exposure, and native highlanders. Acta Physiol (Oxf) 2022; 234:e13788. [PMID: 35007386 PMCID: PMC9286620 DOI: 10.1111/apha.13788] [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: 10/14/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 01/18/2023]
Abstract
Ascent to high altitude is accompanied by a reduction in partial pressure of inspired oxygen, which leads to interconnected adjustments within the neuromuscular system. This review describes the unique challenge that such an environment poses to neuromuscular fatigability (peripheral, central and supraspinal) for individuals who normally reside near to sea level (SL) (<1000 m; ie, lowlanders) and for native highlanders, who represent the manifestation of high altitude-related heritable adaptations across millennia. Firstly, the effect of acute exposure to high altitude-related hypoxia on neuromuscular fatigability will be examined. Under these conditions, both supraspinal and peripheral fatigability are increased compared with SL. The specific mechanisms contributing to impaired performance are dependent on the exercise paradigm and amount of muscle mass involved. Next, the effect of chronic exposure to high altitude (ie, acclimatization of ~7-28 days) will be considered. With acclimatization, supraspinal fatigability is restored to SL values, regardless of the amount of muscle mass involved, whereas peripheral fatigability remains greater than SL except when exercise involves a small amount of muscle mass (eg, knee extensors). Indeed, when whole-body exercise is involved, peripheral fatigability is not different to acute high-altitude exposure, due to competing positive (haematological and muscle metabolic) and negative (respiratory-mediated) effects of acclimatization on neuromuscular performance. In the final section, we consider evolutionary adaptations of native highlanders (primarily Himalayans of Tibet and Nepal) that may account for their superior performance at altitude and lesser degree of neuromuscular fatigability compared with acclimatized lowlanders, for both single-joint and whole-body exercise.
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Affiliation(s)
- Luca Ruggiero
- Laboratory of Physiomechanics of Locomotion Department of Pathophysiology and Transplantation University of Milan Milan Italy
| | - Scott W. D. Harrison
- School of Kinesiology Faculty of Health Sciences The University of Western Ontario London Ontario Canada
| | - Charles L. Rice
- School of Kinesiology Faculty of Health Sciences The University of Western Ontario London Ontario Canada
- Department of Anatomy and Cell Biology Schulich School of Medicine and Dentistry The University of Western Ontario London Ontario Canada
| | - Chris J. McNeil
- Centre for Heart, Lung & Vascular Health School of Health and Exercise Sciences University of British Columbia Kelowna British Columbia Canada
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25
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Dominelli PB, Molgat-Seon Y. Sex, gender and the pulmonary physiology of exercise. Eur Respir Rev 2022; 31:31/163/210074. [PMID: 35022254 PMCID: PMC9488949 DOI: 10.1183/16000617.0074-2021] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/09/2021] [Indexed: 01/11/2023] Open
Abstract
In this review, we detail how the pulmonary system's response to exercise is impacted by both sex and gender in healthy humans across the lifespan. First, the rationale for why sex and gender differences should be considered is explored, and then anatomical differences are highlighted, namely that females typically have smaller lungs and airways than males. Thereafter, we describe how these anatomical differences can impact functional aspects such as respiratory muscle energetics and activation, mechanical ventilatory constraints, diaphragm fatigue, and pulmonary gas exchange in healthy adults and children. Finally, we detail how gender can impact the pulmonary response to exercise. Biological sex can influence the pulmonary response to exercise in healthy individuals across the lifespanhttps://bit.ly/3ejMDrv
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Affiliation(s)
| | - Yannick Molgat-Seon
- Dept of Kinesiology and Applied Health, University of Winnipeg, Winnipeg, MB, Canada.,Centre for Heart and Lung Innovation, Providence Health Care Research Institute, St Paul's Hospital, Vancouver, BC, Canada
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26
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Duke JW, Lewandowski AJ, Abman SH, Lovering AT. Physiological aspects of cardiopulmonary dysanapsis on exercise in adults born preterm. J Physiol 2022; 600:463-482. [PMID: 34961925 PMCID: PMC9036864 DOI: 10.1113/jp281848] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/03/2021] [Indexed: 02/03/2023] Open
Abstract
Progressive improvements in perinatal care and respiratory management of preterm infants have resulted in increased survival of newborns of extremely low gestational age over the past few decades. However, the incidence of bronchopulmonary dysplasia, the chronic lung disease after preterm birth, has not changed. Studies of the long-term follow-up of adults born preterm have shown persistent abnormalities of respiratory, cardiovascular and cardiopulmonary function, possibly leading to a lower exercise capacity. The underlying causes of these abnormalities are incompletely known, but we hypothesize that dysanapsis, i.e. discordant growth and development, in the respiratory and cardiovascular systems is a central structural feature that leads to a lower exercise capacity in young adults born preterm than those born at term. We discuss how the hypothesized system dysanapsis underscores the observed respiratory, cardiovascular and cardiopulmonary limitations. Specifically, adults born preterm have: (1) normal lung volumes but smaller airways, which causes expiratory airflow limitation and abnormal respiratory mechanics but without impacts on pulmonary gas exchange efficiency; (2) normal total cardiac size but smaller cardiac chambers; and (3) in some cases, evidence of pulmonary hypertension, particularly during exercise, suggesting a reduced pulmonary vascular capacity despite reduced cardiac output. We speculate that these underlying developmental abnormalities may accelerate the normal age-associated decline in exercise capacity, via an accelerated decline in respiratory, cardiovascular and cardiopulmonary function. Finally, we suggest areas of future research, especially the need for longitudinal and interventional studies from infancy into adulthood to better understand how preterm birth alters exercise capacity across the lifespan.
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Affiliation(s)
- Joseph W. Duke
- Northern Arizona University, Department of Biological Sciences, Flagstaff, AZ, USA
| | - Adam J. Lewandowski
- University of Oxford, Oxford Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, Oxford, UK
| | - Steven H. Abman
- University of Colorado Anschutz School of Medicine, Department of Pediatrics, Aurora, CO, USA
- Pediatric Heart Lung Center, Children’s Hospital Colorado, Aurora, CO, USA
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27
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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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28
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Travers G, Kippelen P, Trangmar SJ, González-Alonso J. Physiological Function during Exercise and Environmental Stress in Humans-An Integrative View of Body Systems and Homeostasis. Cells 2022; 11:383. [PMID: 35159193 PMCID: PMC8833916 DOI: 10.3390/cells11030383] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 11/26/2022] Open
Abstract
Claude Bernard's milieu intérieur (internal environment) and the associated concept of homeostasis are fundamental to the understanding of the physiological responses to exercise and environmental stress. Maintenance of cellular homeostasis is thought to happen during exercise through the precise matching of cellular energetic demand and supply, and the production and clearance of metabolic by-products. The mind-boggling number of molecular and cellular pathways and the host of tissues and organ systems involved in the processes sustaining locomotion, however, necessitate an integrative examination of the body's physiological systems. This integrative approach can be used to identify whether function and cellular homeostasis are maintained or compromised during exercise. In this review, we discuss the responses of the human brain, the lungs, the heart, and the skeletal muscles to the varying physiological demands of exercise and environmental stress. Multiple alterations in physiological function and differential homeostatic adjustments occur when people undertake strenuous exercise with and without thermal stress. These adjustments can include: hyperthermia; hyperventilation; cardiovascular strain with restrictions in brain, muscle, skin and visceral organs blood flow; greater reliance on muscle glycogen and cellular metabolism; alterations in neural activity; and, in some conditions, compromised muscle metabolism and aerobic capacity. Oxygen supply to the human brain is also blunted during intense exercise, but global cerebral metabolism and central neural drive are preserved or enhanced. In contrast to the strain seen during severe exercise and environmental stress, a steady state is maintained when humans exercise at intensities and in environmental conditions that require a small fraction of the functional capacity. The impact of exercise and environmental stress upon whole-body functions and homeostasis therefore depends on the functional needs and differs across organ systems.
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Affiliation(s)
- Gavin Travers
- The European Astronaut Centre, The European Space Agency, Linder Höhe, 51147 Cologne, Germany;
| | - Pascale Kippelen
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge UB8 3PH, UK;
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
| | - Steven J. Trangmar
- School of Life and Health Sciences, University of Roehampton, London SW15 4JD, UK;
| | - José González-Alonso
- Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge UB8 3PH, UK;
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge UB8 3PH, UK
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29
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Webb KL, Dominelli PB, Baker SE, Klassen SA, Joyner MJ, Senefeld JW, Wiggins CC. Influence of High Hemoglobin-Oxygen Affinity on Humans During Hypoxia. Front Physiol 2022; 12:763933. [PMID: 35095551 PMCID: PMC8795792 DOI: 10.3389/fphys.2021.763933] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/22/2021] [Indexed: 01/11/2023] Open
Abstract
Humans elicit a robust series of physiological responses to maintain adequate oxygen delivery during hypoxia, including a transient reduction in hemoglobin-oxygen (Hb-O2) affinity. However, high Hb-O2 affinity has been identified as a beneficial adaptation in several species that have been exposed to high altitude for generations. The observed differences in Hb-O2 affinity between humans and species adapted to high altitude pose a central question: is higher or lower Hb-O2 affinity in humans more advantageous when O2 availability is limited? Humans with genetic mutations in hemoglobin structure resulting in high Hb-O2 affinity have shown attenuated cardiorespiratory adjustments during hypoxia both at rest and during exercise, providing unique insight into this central question. Therefore, the purpose of this review is to examine the influence of high Hb-O2 affinity during hypoxia through comparison of cardiovascular and respiratory adjustments elicited by humans with high Hb-O2 affinity compared to those with normal Hb-O2 affinity.
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Affiliation(s)
- Kevin L. Webb
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
| | | | - Sarah E. Baker
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
| | - Stephen A. Klassen
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Michael J. Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
| | - Jonathon W. Senefeld
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
| | - Chad C. Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, United States
- *Correspondence: Chad C. Wiggins,
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30
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Da Silva KJ, Silva LC, Felippe LC, Silva-Cavalcante MD, Franco-Alvarenga PE, Learsi S, Ataide-Silva T, Bertuzzi R, Lima-Silva AE, Ferreira GA. Airflow restriction mask induces greater central fatigue after a non-exhaustive high-intensity interval exercise. Scand J Med Sci Sports 2021; 32:487-497. [PMID: 34787931 DOI: 10.1111/sms.14099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/23/2021] [Accepted: 11/12/2021] [Indexed: 11/26/2022]
Abstract
The airflow restriction mask (ARM) is a practical and inexpensive device for respiratory muscle training. Wearing an ARM has recently been combined with high-intensity interval exercise (HIIE), but its effect on neuromuscular fatigue is unknown. The present study investigated the effects of ARM wearing on neuromuscular fatigue after an HIIE session. Fourteen healthy men performed two HIIE sessions (4x4min at 90% HRmax, 3min recovery at 70% HRmax) with or without an ARM. Neuromuscular fatigue was quantified via pre- to post-HIIE changes in maximal voluntary contraction (MVC), voluntary activation (VA, central fatigue), and potentialized evoked twitch force at 100, 10, and 1 Hz (peripheral fatigue). Blood pH and lactate were measured before and after the HIIE session, while HR, SpO2 , dyspnea, physical sensation of effort (P-RPE), and Task Effort and Awareness (TEA) were recorded every bout. The exercise-induced decrease in MVC was higher (p<0.05) in the ARM (-28±12%) than in the control condition (-20±11%). The VA decreased (p<0.05) in the ARM (-11±9%) but not in the control condition (-4±5%, p>0.05). Pre- to post-HIIE declines in evoked twitch at 100, 10, and 1 Hz were similar (p>0.05) between ARM and control conditions (ARM: -18±10, -43±11 and -38±12%; Control: -18±14, -43±12 and -37±17%). When compared with the control, the HIIE bout wearing ARM was marked by higher heart rate, plasma lactate concentration, dyspnea, P-RPE and TEA, as well as lower SpO2 and blood pH. In conclusion, ARM increases perceptual and physiological stress during a HIIE, which may lead to a greater post-exercise central fatigue.
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Affiliation(s)
- Kleber J Da Silva
- Academic Center of Vitoria, Federal University of Pernambuco, Vitoria de Santo Antao, Pernambuco, Brazil.,Human Performance Research Group, Federal University of Technology Parana, Curitiba, Parana, Brazil
| | - Lucas C Silva
- Academic Center of Vitoria, Federal University of Pernambuco, Vitoria de Santo Antao, Pernambuco, Brazil
| | - Leandro C Felippe
- Academic Center of Vitoria, Federal University of Pernambuco, Vitoria de Santo Antao, Pernambuco, Brazil.,Human Performance Research Group, Federal University of Technology Parana, Curitiba, Parana, Brazil
| | - Marcos D Silva-Cavalcante
- Academic Center of Vitoria, Federal University of Pernambuco, Vitoria de Santo Antao, Pernambuco, Brazil.,Human Performance Research Group, Federal University of Technology Parana, Curitiba, Parana, Brazil
| | - Paulo E Franco-Alvarenga
- Exercise Psychophysiology Research Group, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil.,Estacio de Sa University, UNESA, Resende, Rio de Janeiro, Brazil
| | - Sara Learsi
- Academic Center of Vitoria, Federal University of Pernambuco, Vitoria de Santo Antao, Pernambuco, Brazil
| | - Thays Ataide-Silva
- Department of nutrition, Federal University of Alagoas, Maceio, Alagoas, Brazil
| | - Romulo Bertuzzi
- Endurance Performance Research Group, School of Physical Education and Sport, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
| | - Adriano E Lima-Silva
- Academic Center of Vitoria, Federal University of Pernambuco, Vitoria de Santo Antao, Pernambuco, Brazil.,Human Performance Research Group, Federal University of Technology Parana, Curitiba, Parana, Brazil
| | - Guilherme A Ferreira
- Academic Center of Vitoria, Federal University of Pernambuco, Vitoria de Santo Antao, Pernambuco, Brazil.,Human Performance Research Group, Federal University of Technology Parana, Curitiba, Parana, Brazil
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31
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Effect of Moderate- or High-Intensity Inspiratory Muscle Strength Training on Maximal Inspiratory Mouth Pressure and Swimming Performance in Highly Trained Competitive Swimmers. Int J Sports Physiol Perform 2021; 17:343-349. [PMID: 34686614 DOI: 10.1123/ijspp.2021-0119] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/24/2021] [Accepted: 06/24/2021] [Indexed: 11/18/2022]
Abstract
PURPOSE Inspiratory muscle strength training (IMST) can improve exercise performance. Increased maximal inspiratory mouth pressure (MIP) could be beneficial for swimmers to enhance their performance. This study aimed to clarify the effect of high-intensity IMST for 6 weeks on MIP and swimming performance in highly trained competitive swimmers. METHODS Thirty male highly trained competitive swimmers were assigned to high-intensity IMST (HI; n = 10), moderate-intensity IMST (MOD; n = 10), and control (n = 10) groups. The 6-week IMST intervention comprised twice daily sessions for 6 d/wk at inspiratory pressure threshold loads equivalent to 75% MIP (HI) and 50% MIP (MOD). Before and after the intervention, MIP and swimming performance were assessed. Swimming performance was evaluated in free and controlled frequency breathing 100-m freestyle swimming time trials in a 25-m pool. For controlled frequency breathing, participants took 1 breath every 6 strokes. RESULTS The MIP values after 2 and 6 weeks of IMST in the HI and MOD groups were significantly higher than those before IMST (P = .0001). The magnitudes of the MIP increases after 6 weeks of IMST did not differ between the HI (13.4% [8.7%]) and MOD (13.1% [10.1%]) groups (P = .44). The 100-m freestyle swimming times under the controlled frequency condition were significantly shorter after IMST than those before IMST in both the HI (P = .046) and MOD (P = .042) groups. CONCLUSIONS Inspiratory pressure threshold load equivalent to 50% MIP could be sufficient to improve MIP and swimming performance under the controlled frequency breathing condition in highly trained competitive swimmers.
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Espinosa-Ramírez M, Moya-Gallardo E, Araya-Román F, Riquelme-Sánchez S, Rodriguez-García G, Reid WD, Viscor G, Araneda OF, Gabrielli L, Contreras-Briceño F. Sex-Differences in the Oxygenation Levels of Intercostal and Vastus Lateralis Muscles During Incremental Exercise. Front Physiol 2021; 12:738063. [PMID: 34658921 PMCID: PMC8517227 DOI: 10.3389/fphys.2021.738063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 09/10/2021] [Indexed: 01/04/2023] Open
Abstract
This study aimed to examine sex differences in oxygen saturation in respiratory (SmO2-m.intercostales) and locomotor muscles (SmO2-m.vastus lateralis) while performing physical exercise. Twenty-five (12 women) healthy and physically active participants were evaluated during an incremental test with a cycle ergometer, while ventilatory variables [lung ventilation ( V . E), tidal volume (Vt), and respiratory rate (RR)] were acquired through the breath-by-breath method. SmO2 was acquired using the MOXY® devices on the m.intercostales and m.vastus lateralis. A two-way ANOVA (sex × time) indicated that women showed a greater significant decrease of SmO2-m.intercostales, and men showed a greater significant decrease of SmO2-m.vastus lateralis. Additionally, women reached a higher level of ΔSmO2-m.intercostales normalized to V . E (L⋅min-1) (p < 0.001), whereas men had a higher level of ΔSmO2-m.vastus lateralis normalized to peak workload-to-weight (watts⋅kg-1, PtW) (p = 0.049), as confirmed by Student's t-test. During an incremental physical exercise, women experienced a greater cost of breathing, reflected by greater deoxygenation of the respiratory muscles, whereas men had a higher peripheral load, indicated by greater deoxygenation of the locomotor muscles.
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Affiliation(s)
- Maximiliano Espinosa-Ramírez
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Moya-Gallardo
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Felipe Araya-Román
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Santiago Riquelme-Sánchez
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Guido Rodriguez-García
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - W Darlene Reid
- Physical Therapy, Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.,KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Oscar F Araneda
- Laboratory of Integrative Physiology of Biomechanics and Physiology of Effort (LIBFE), Faculty of Medicine, Kinesiology School, Universidad de los Andes, Santiago, Chile
| | - Luigi Gabrielli
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Division of Cardiovascular Diseases, Faculty of Medicine, Advanced Center for Chronic Diseases (ACCDiS), Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Felipe Contreras-Briceño
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain.,Division of Cardiovascular Diseases, Faculty of Medicine, Advanced Center for Chronic Diseases (ACCDiS), Pontificia Universidad Católica de Chile, Santiago, Chile
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Theodorou AA, Zinelis PT, Malliou VJ, Chatzinikolaou PN, Margaritelis NV, Mandalidis D, Geladas ND, Paschalis V. Acute L-Citrulline Supplementation Increases Nitric Oxide Bioavailability but Not Inspiratory Muscle Oxygenation and Respiratory Performance. Nutrients 2021; 13:nu13103311. [PMID: 34684312 PMCID: PMC8537281 DOI: 10.3390/nu13103311] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to investigate whether acute L-citrulline supplementation would affect inspiratory muscle oxygenation and respiratory performance. Twelve healthy males received 6 g of L-citrulline or placebo in a double-blind crossover design. Pulmonary function (i.e., forced expired volume in 1 s, forced vital capacity and their ratio), maximal inspiratory pressure (MIP), fractional exhaled nitric oxide (NO•), and sternocleidomastoid muscle oxygenation were measured at baseline, one hour post supplementation, and after an incremental resistive breathing protocol to task failure of the respiratory muscles. The resistive breathing task consisted of 30 inspirations at 70% and 80% of MIP followed by continuous inspirations at 90% of MIP until task failure. Sternocleidomastoid muscle oxygenation was assessed using near-infrared spectroscopy. One-hour post-L-citrulline supplementation, exhaled NO• was significantly increased (19.2%; p < 0.05), and this increase was preserved until the end of the resistive breathing (16.4%; p < 0.05). In contrast, no difference was observed in the placebo condition. Pulmonary function and MIP were not affected by the L-citrulline supplementation. During resistive breathing, sternocleidomastoid muscle oxygenation was significantly reduced, with no difference noted between the two supplementation conditions. In conclusion, a single ingestion of 6 g L-citrulline increased NO• bioavailability but not the respiratory performance and inspiratory muscle oxygenation.
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Affiliation(s)
- Anastasios A. Theodorou
- Department of Life Sciences, School of Sciences, European University Cyprus, Nicosia 1516, Cyprus
- Correspondence:
| | - Panagiotis T. Zinelis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (P.T.Z.); (V.J.M.); (D.M.); (N.D.G.); (V.P.)
| | - Vassiliki J. Malliou
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (P.T.Z.); (V.J.M.); (D.M.); (N.D.G.); (V.P.)
| | - Panagiotis N. Chatzinikolaou
- Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, 61122 Serres, Greece; (P.N.C.); (N.V.M.)
| | - Nikos V. Margaritelis
- Department of Physical Education and Sport Science at Serres, Aristotle University of Thessaloniki, 61122 Serres, Greece; (P.N.C.); (N.V.M.)
- Dialysis Unit, 424 General Military Hospital of Thessaloniki, 56429 Thessaloniki, Greece
| | - Dimitris Mandalidis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (P.T.Z.); (V.J.M.); (D.M.); (N.D.G.); (V.P.)
| | - Nickos D. Geladas
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (P.T.Z.); (V.J.M.); (D.M.); (N.D.G.); (V.P.)
| | - Vassilis Paschalis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (P.T.Z.); (V.J.M.); (D.M.); (N.D.G.); (V.P.)
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D'Alleva M, Gonnelli F, Vaccari F, Boirie Y, Montaurier C, Thivel D, Isacco L, Vermorel M, Lazzer S. Energy cost of walking and body composition changes during a 9-month multidisciplinary weight reduction program and 4-month follow-up in adolescents with obesity. Appl Physiol Nutr Metab 2021; 47:1-9. [PMID: 34516928 DOI: 10.1139/apnm-2021-0273] [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
The purpose of the present study was to investigate changes in the energy cost of locomotion during walking (Cw) related to changes in body mass (BM, kg) and body composition in adolescents with obesity. Twenty-six (12 boys and 14 girls) obese adolescents (mean: body mass index, 33.6 ± 3.7 kg·m-2; 42.7 ± 4.5% fat mass (FM)) followed a 9-month multidisciplinary inpatient weight-reduction program consisting of lifestyle education, moderate energy restriction, and regular physical activity in a specialised institution. At baseline (M0), the end of the 9-month program (M9), and after the 4-month follow-up (M13), oxygen consumption and carbon dioxide production of the standardised activity program were assessed by whole-body indirect calorimetry over 24 hours, and body composition was assessed by dual-energy X-ray absorptiometry. At M9, adolescents showed an 18% reduction in BM (p < 0.001) and 40% in total FM, while fat-free mass (kg) remained stable in boys but decreased by ∼6% in girls (p = 0.001). Similarly, the mean Cw decreased by 20% (p < 0.001). At M13, BM, FM, and Cw were slightly higher compared with at M9. In conclusion, moderate energy restriction and regular moderate physical activities improved walking economy, improved exercise tolerance, and induced beneficial changes in the body composition of adolescents with obesity. Novelty: Reduction of FM in the trunk region, and consequently reducing the work carried out by respiratory muscles, contributes to reducing Cw in adolescents with obesity. A lower walking cost can be effective in improving exercise tolerance and quality of life in obese adolescents.
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Affiliation(s)
- Mattia D'Alleva
- Department of Medicine, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
| | - Federica Gonnelli
- Department of Medicine, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
| | - Filippo Vaccari
- Department of Medicine, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
| | - Yves Boirie
- CHU Clermont-Ferrand, Department of Clinical Nutrition, Clermont-Ferrand, France
- Clermont-Auvergne University, INRAE, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
| | - Christophe Montaurier
- Clermont-Auvergne University, INRAE, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
| | - David Thivel
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions, CRNH Auvergne, Clermont-Ferrand, France
- School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Laurie Isacco
- Clermont Auvergne University, EA 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions, CRNH Auvergne, Clermont-Ferrand, France
| | - Michel Vermorel
- Clermont-Auvergne University, INRAE, UNH, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France
| | - Stefano Lazzer
- Department of Medicine, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
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Effects of the Elevation Training Mask® 2.0 on dyspnea and respiratory muscle mechanics, electromyography, and fatigue during exhaustive cycling in healthy humans. J Sci Med Sport 2021; 25:167-172. [PMID: 34538564 DOI: 10.1016/j.jsams.2021.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Examine the effects of the Elevation Training Mask® 2.0 (ETM) on dyspnea, and respiratory muscle function and fatigue during exercise. DESIGN Randomized crossover. METHODS 10 healthy participants completed 2 time-to-exhaustion (TTE) cycling tests while wearing the ETM or under a sham control condition. During the sham, participants were told they were breathing air equivalent to "9000 ft" (matched to the selected resistance valves on the ETM according to the manufacturer), but they were breathing room air. Dyspnea and leg discomfort were assessed using the modified 0-10 category-ratio Borg scale. Qualitative dyspnea descriptors at peak exercise were selected from a list of 15. Crural diaphragmatic electromyography (EMGdi) and transdiaphragmatic pressure (Pdi) were measured via a multipair esophageal electrode balloon catheter. Participants performed maximal respiratory maneuvers before and after exercise to estimate the degree of respiratory muscle fatigue. RESULTS Exercise with the ETM resulted in a significant decrease in TTE (p = 0.015), as well as increased dyspnea at baseline (p = 0.032) and during the highest equivalent submaximal exercise time (p = 0.0001). The increase in dyspnea with the ETM was significantly correlated with the decrease in exercise time (r = 0.73, p = 0.020). EMGdi and Pdi were significantly increased with the ETM at all time points (all p < 0.05). There was a significant increase in the selection frequency of "my breath does not go in all the way" at peak exercise with the ETM (p = 0.02). The ETM did not induce respiratory muscle fatigue. CONCLUSIONS Exercising with the ETM appears to decrease exercise performance, in part, by increasing the sensation of dyspnea.
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Sel K, Osman D, Jafari R. Non-Invasive Cardiac and Respiratory Activity Assessment From Various Human Body Locations Using Bioimpedance. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2021; 2:210-217. [PMID: 34458855 PMCID: PMC8388562 DOI: 10.1109/ojemb.2021.3085482] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Objective: Bioimpedance sensing is a powerful technique that measures the tissue impedance and captures important physiological parameters including blood flow, lung movements, muscle contractions, body fluid shifts, and other cardiovascular parameters. This paper presents a comprehensive analysis of the modality at different arterial (ulnar, radial, tibial, and carotid arteries) and thoracic (side-rib cage and top thoracolumbar fascia) body regions and offers insights into the effectiveness of capturing various cardiac and respiratory activities. Methods: We assess the bioimpedance performance in estimating inter-beat (IBI) and inter -breath intervals (IBrI) on six-hours of data acquired in a pilot-study from five healthy participants at rest. Results: Overall, we achieve mean errors as low as 0.003 ± 0.002 and 0.67 ± 0.28 seconds for IBI and IBrI estimations, respectively. Conclusions: The results show that bioimpedance can be effectively used to monitor cardiac and respiratory activities both at limbs and upper body and demonstrate a strong potential to be adopted by wearables that aim to provide high-fidelity physiological sensing to address precision medicine needs.
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Affiliation(s)
- Kaan Sel
- Texas A&M University, College Station, TX 77843 USA
| | - Deen Osman
- Texas A&M University, College Station, TX 77843 USA
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37
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Intercostal Muscles Oxygenation and Breathing Pattern during Exercise in Competitive Marathon Runners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168287. [PMID: 34444039 PMCID: PMC8393870 DOI: 10.3390/ijerph18168287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 01/24/2023]
Abstract
The study aimed to evaluate the association between the changes in ventilatory variables (tidal volume (Vt), respiratory rate (RR) and lung ventilation (V.E)) and deoxygenation of m.intescostales (∆SmO2-m.intercostales) during a maximal incremental exercise in 19 male high-level competitive marathon runners. The ventilatory variables and oxygen consumption (V.O2) were recorded breath-by-breath by exhaled gas analysis. A near-infrared spectroscopy device (MOXY®) located in the right-hemithorax allowed the recording of SmO2-m.intercostales. To explore changes in oxygen levels in muscles with high demand during exercise, a second MOXY® records SmO2-m.vastus laterallis. The triphasic model of exercise intensity was used for evaluating changes in SmO2 in both muscle groups. We found that ∆SmO2-m.intercostales correlated with V.O2-peak (r = 0.65; p = 0.002) and the increase of V.E (r = 0.78; p = 0.001), RR (r = 0.54; p = 0.001), but not Vt (p = 0.210). The interaction of factors (muscles × exercise-phases) in SmO2 expressed as an arbitrary unit (a.u) was significant (p = 0.005). At VT1 there was no difference (p = 0.177), but SmO2-m.intercostales was higher at VT2 (p < 0.001) and V.O2-peak (p < 0.001). In high-level competitive marathon runners, the m.intercostales deoxygenation during incremental exercise is directly associated with the aerobic capacity and increased lung ventilation and respiratory rate, but not tidal volume. Moreover, it shows less deoxygenation than m.vastus laterallis at intensities above the aerobic ventilatory threshold.
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Istfan R, Gómez CA, Applegate M, Rozenberg D, Reid WD, Roblyer D. Hemodynamics of the sternocleidomastoid measured with frequency domain near-infrared spectroscopy towards non-invasive monitoring during mechanical ventilation. BIOMEDICAL OPTICS EXPRESS 2021; 12:4147-4162. [PMID: 34457405 PMCID: PMC8367268 DOI: 10.1364/boe.430423] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 06/13/2023]
Abstract
Mechanical ventilation (MV) is used to assist spontaneous breathing in critically ill patients in the intensive care unit (ICU). MV is a cornerstone of critical care medicine but it is now known that inspiratory muscle dysfunction due to injury, disuse, and/or atrophy during MV plays a major role in outcomes for these patients. For example, prolonged MV is strongly correlated with dysfunction of the sternocleidomastoid (SCM), an accessory inspiratory muscle that has been linked to weaning failure from MV. Hemodynamic monitoring of the SCM may provide an important non-invasive and real-time means to monitor MV. In this work, we first conducted multi-layer Monte Carlo simulations to confirm the ability of near infrared light to detect changes in the oxygenation of the SCM over wide ranges of skin tones and adipose layer thicknesses. We then optimized a custom digital frequency domain near-infrared spectroscopy (FD-NIRS) system for continuous 10 Hz measurements of the SCM at 730 nm and 850 nm. A healthy volunteer study was conducted (N=10); subjects performed sets of isometric neck flexions of the SCM. Substantial changes in oxyhemoglobin + oxymyoglobin (oxy[Hb + Mb]), deoxyhemoglobin + deoxymyoglobin (deoxy[Hb + Mb]), and total hemoglobin + myoglobin (total[Hb + Mb]) were observed during sustained and intermittent isometric flexions. There were notable sex differences observed in the magnitude of hemodynamic changes (∼2x larger changes in males for oxy[Hb + Mb] and deoxy[Hb + Mb]). The magnitude of hemodynamic changes when taking into account µs' changes during flexions was ∼ 2-2.5x larger as compared to assuming constant scattering (CS), which is a common assumption used for continuous wave (CW) NIRS methods. This study suggests that FD-NIRS provides improved accuracy for hemodynamic monitoring of the SCM compared to CW-NIRS, and that FD-NIRS may provide value for SCM monitoring during MV.
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Affiliation(s)
- Raeef Istfan
- Department of Biomedical Engineering, Boston University, Boston, MA 02125, USA
| | - Carlos A. Gómez
- Department of Biomedical Engineering, Boston University, Boston, MA 02125, USA
| | - Matthew Applegate
- Department of Biomedical Engineering, Boston University, Boston, MA 02125, USA
| | - Dmitry Rozenberg
- Department of Medicine, Respirology and Lung Transplantation, University Health Network, University of Toronto, Toronto, ON, Canada
| | - W. Darlene Reid
- Department of Physical Therapy, University of Toronto, Toronto ON, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Darren Roblyer
- Department of Biomedical Engineering, Boston University, Boston, MA 02125, USA
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Lässing J, Falz R, Schulze A, Pökel C, Vondran M, Schröter T, Borger MA, Busse M. Decreased exercise capacity in young athletes using self-adapted mouthguards. Eur J Appl Physiol 2021; 121:1881-1888. [PMID: 33713202 PMCID: PMC8192374 DOI: 10.1007/s00421-021-04659-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/01/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE There is evidence of both the preventive effects and poor acceptance of mouthguards. There are various effects on performance depending on the type of mouthguard model. Hemodynamic responses to wearing a mouthguard have not been described. The aim of this study was to investigate the effects of self-adapted mouthguards with breathing channels (SAMGvent). METHODS In this randomized crossover study, 17 healthy, active subjects (age 25.12 ± 2.19 years) underwent body plethysmography and performed two incremental exertion tests wearing a (SAMGvent) and not wearing (CON) a mouthguard. Blood lactate, spirometrics, and thoracic impedance were measured during these maximum exercise tests. RESULTS The mean values using a SAMGvent revealed significantly greater airway resistance compared to CON (0.53 ± 0.16 kPa·L-1 vs. 0.35 ± 0.10 kPa·L-1, respectively; p = < 0.01). At maximum load, ventilation with SAMGvent was less than CON (118.4 ± 28.17 L min-1 vs. 128.2 ± 32.16 L min-1, respectively; p = < 0.01). At submaximal loads, blood lactate responses with SAMGvent were higher than CON (8.68 ± 2.20 mmol·L-1 vs. 7.89 ± 1.65 mmol·L-1, respectively; p < 0.01). Maximum performance with a SAMGvent was 265.9 ± 59.9 W, and without a mouthguard was 272.9 ± 60.8 W (p < 0.01). Maximum stroke volume was higher using a SAMGvent than without using a mouthguard (138.4 ± 29.9 mL vs. 130.2 ± 21.2 mL, respectively; p < 0.01). CONCLUSION Use of a self-adapted mouthguard led to increased metabolic effort and a significant reduction in ventilation parameters. Unchanged oxygen uptake may be the result of cardiopulmonary compensation and increased breathing efforts, which slightly affects performance. These results and the obvious preventive effects of mouthguards support their use in sports.
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Affiliation(s)
- Johannes Lässing
- Institute of Sport Medicine and Prevention, University of Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany.
| | - Roberto Falz
- Institute of Sport Medicine and Prevention, University of Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Antina Schulze
- Institute of Sport Medicine and Prevention, University of Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Christoph Pökel
- Institute of Sport Medicine and Prevention, University of Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
| | - Maximilian Vondran
- University Department for Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
- Department of Cardiovascular Surgery, Philipps-University Marburg, University Hospital Gießen and Marburg, Marburg, Germany
| | - Thomas Schröter
- University Department for Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Michael A Borger
- University Department for Cardiac Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Martin Busse
- Institute of Sport Medicine and Prevention, University of Leipzig, Marschnerstraße 29a, 04109, Leipzig, Germany
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Zhang X, Zhao R, Wang G, Chen Y, Ding P, Yang X, Zhao Z, Zhang Y. Island sternocleidomastoid myocutaneous flap for posterior pharyngeal wall defect repair after anterior cervical spine surgery. Int Wound J 2021; 19:169-177. [PMID: 33999495 PMCID: PMC8684854 DOI: 10.1111/iwj.13612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/19/2021] [Accepted: 04/27/2021] [Indexed: 12/04/2022] Open
Abstract
Injuries and tumours of the cervical spine represent therapeutic challenges to the treating surgeon due to the complex anatomical relationships and biomechanical features. The anterior cervical midline (ACM) and anterior cervical retropharyngeal (ACR) approaches are effective and safe surgical approaches for certain cervical spine lesions, such as cervical spine neoplasms, atlantoaxial subluxation, and certain odontoid fractures. Posterior pharyngeal wall defects (PPWDs) is one of the most frequently encountered surgical morbidities after anterior cervical spine surgery (ACSS). However, limited information has been published concerning effective approaches for PPWD reconstruction after ACSS. The manuscript aimed to describe a novel application of the island sternocleidomastoid myocutaneous flap (ISMF) in the management of PPWDs after ACSS, including surgery with the ACM approach and ACR approach. From April 2015 to November 2019, the clinical data of three patients with PPWDs repaired using the ISMF in Peking university third hospital were retrospectively analysed. The observational indexes are as follows: postoperative survival of the flap, wound healing 2 weeks after surgery, eating and pronunciation function 2 months after surgery. The above indexes of these three cases recovered well. Three patients did not have any persistent PPWD after repair with the ISMF and did not require any further surgical procedures related to the cervical spine.
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Affiliation(s)
- Xinling Zhang
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Runlei Zhao
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Guanhuier Wang
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Yujie Chen
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Pengbing Ding
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Xin Yang
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Zhenmin Zhao
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Yuan Zhang
- Department of Otolaryngology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Doherty CJ, Mann LM, Angus SA, Chan JS, Molgat-Seon Y, Dominelli PB. Impact of wearing a surgical and cloth mask during cycle exercise. Appl Physiol Nutr Metab 2021; 46:753-762. [PMID: 33960846 DOI: 10.1139/apnm-2021-0190] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We sought to determine the impact of wearing cloth or surgical masks on the cardiopulmonary responses to moderate-intensity exercise. Twelve subjects (n = 5 females) completed three, 8-min cycling trials while breathing through a non-rebreathing valve (laboratory control), cloth, or surgical mask. Heart rate (HR), oxyhemoglobin saturation (SpO2), breathing frequency, mouth pressure, partial pressure of end-tidal carbon dioxide (PetCO2) and oxygen (PetO2), dyspnea were measured throughout exercise. A subset of n = 6 subjects completed an additional exercise bout without a mask (ecological control). There were no differences in breathing frequency, HR or SpO2 across conditions (all p > 0.05). Compared with the laboratory control (4.7 ± 0.9 cmH2O [mean ± SD]), mouth pressure swings were smaller with the surgical mask (0.9 ± 0.7; p < 0.0001), but similar with the cloth mask (3.6 ± 4.8 cmH2O; p = 0.66). Wearing a cloth mask decreased PetO2 (-3.5 ± 3.7 mm Hg) and increased PetCO2 (+2.0 ± 1.3 mm Hg) relative to the ecological control (both p < 0.05). There were no differences in end-tidal gases between mask conditions and laboratory control (both p > 0.05). Dyspnea was similar between the control conditions and the surgical mask (p > 0.05) but was greater with the cloth mask compared with laboratory (+0.9 ± 1.2) and ecological (+1.5 ± 1.3) control conditions (both p < 0.05). Wearing a mask during short-term moderate-intensity exercise may increase dyspnea but has minimal impact on the cardiopulmonary response. Novelty: Wearing surgical or cloth masks during exercise has no impact on breathing frequency, tidal volume, oxygenation, and heart rate However, there are some changes in inspired and expired gas fractions that are physiologically irrelevant. In young healthy individuals, wearing surgical or cloth masks during submaximal exercise has few physiological consequences.
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Affiliation(s)
- Connor J Doherty
- Department of Kinesiology, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Leah M Mann
- Department of Kinesiology, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Sarah A Angus
- Department of Kinesiology, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Jason S Chan
- Department of Kinesiology, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
| | - Yannick Molgat-Seon
- Centre for Heart Lung Innovation, St. Paul's Hospital, The University of British Columbia, Vancouver, British Columbia, Canada.,The Gupta Faculty of Kinesiology and Applied Health, University of Winnipeg, Winnipeg, Manitoba, Canada
| | - Paolo B Dominelli
- Department of Kinesiology, Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada
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42
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Archiza B, Leahy MG, Kipp S, Sheel AW. An integrative approach to the pulmonary physiology of exercise: when does biological sex matter? Eur J Appl Physiol 2021; 121:2377-2391. [PMID: 33903937 DOI: 10.1007/s00421-021-04690-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/12/2021] [Indexed: 11/30/2022]
Abstract
Historically, many studies investigating the pulmonary physiology of exercise (and biomedical research in general) were performed exclusively or predominantly with male research participants. This has led to an incomplete understanding of the pulmonary response to exercise. More recently, important sex-based differences with respect to the human respiratory system have been identified. The purpose of this review is to summarize current findings related to sex-based differences in the pulmonary physiology of exercise. To that end, we will discuss how morphological sex-based differences of the respiratory system affect the respiratory response to exercise. Moreover, we will discuss sex-based differences of the physiological integrative responses to exercise, and how all these differences can influence the regulation of breathing. We end with a brief discussion of pregnancy and menopause and the accompanying ventilatory changes observed during exercise.
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Affiliation(s)
- Bruno Archiza
- School of Kinesiology, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T 0B8, Canada.
| | - Michael G Leahy
- School of Kinesiology, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T 0B8, Canada
| | - Shalaya Kipp
- School of Kinesiology, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T 0B8, Canada
| | - A William Sheel
- School of Kinesiology, University of British Columbia, 2553 Wesbrook Mall, Vancouver, BC, V6T 0B8, Canada
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43
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Respiratory Support Adjustments and Monitoring of Mechanically Ventilated Patients Performing Early Mobilization: A Scoping Review. Crit Care Explor 2021; 3:e0407. [PMID: 33912837 PMCID: PMC8078339 DOI: 10.1097/cce.0000000000000407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Supplemental Digital Content is available in the text. Objectives: This scoping review is aimed to summarize current knowledge on respiratory support adjustments and monitoring of metabolic and respiratory variables in mechanically ventilated adult patients performing early mobilization. Data Sources: Eight electronic databases were searched from inception to February 2021, using a predefined search strategy. Study Selection: Two blinded reviewers performed document selection by title, abstract, and full text according to the following criteria: mechanically ventilated adult patients performing any mobilization intervention, respiratory support adjustments, and/or monitoring of metabolic/respiratory real-time variables. Data Extraction: Four physiotherapists extracted relevant information using a prespecified template. Data Synthesis: From 1,208 references screened, 35 documents were selected for analysis, where 20 (57%) were published between 2016 and 2020. Respiratory support settings (ventilatory modes or respiratory variables) were reported in 21 documents (60%). Reported modes were assisted (n = 11) and assist-control (n = 9). Adjustment of variables and modes were identified in only seven documents (20%). The most frequent respiratory variable was the Fio2, and only four studies modified the level of ventilatory support. Mechanical ventilator brand/model used was not specified in 26 documents (74%). Monitoring of respiratory, metabolic, and both variables were reported in 22 documents (63%), four documents (11%) and 10 documents (29%), respectively. These variables were reported to assess the physiologic response (n = 21) or safety (n = 13). Monitored variables were mostly respiratory rate (n = 26), pulse oximetry (n = 22), and oxygen consumption (n = 9). Remarkably, no study assessed the work of breathing or effort during mobilization. Conclusions: Little information on respiratory support adjustments during mobilization of mechanically ventilated patients was identified. Monitoring of metabolic and respiratory variables is also scant. More studies on the effects of adjustments of the level/mode of ventilatory support on exercise performance and respiratory muscle activity monitoring for safe and efficient implementation of early mobilization in mechanically ventilated patients are needed.
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Dominelli PB, Wiggins CC, Roy TK, Secomb TW, Curry TB, Joyner MJ. The Oxygen Cascade During Exercise in Health and Disease. Mayo Clin Proc 2021; 96:1017-1032. [PMID: 33714599 PMCID: PMC8026750 DOI: 10.1016/j.mayocp.2020.06.063] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/08/2020] [Accepted: 06/29/2020] [Indexed: 12/28/2022]
Abstract
The oxygen transport cascade describes the physiological steps that bring atmospheric oxygen into the body where it is delivered and consumed by metabolically active tissue. As such, the oxygen cascade is fundamental to our understanding of exercise in health and disease. Our narrative review will highlight each step of the oxygen transport cascade from inspiration of atmospheric oxygen down to mitochondrial consumption in both healthy active males and females along with clinical conditions. We will focus on how different steps interact along with principles of homeostasis, physiological redundancies, and adaptation. In particular, we highlight some of the parallels between elite athletes and clinical conditions in terms of the oxygen cascade.
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Affiliation(s)
| | - Chad C Wiggins
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Tuhin K Roy
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Timothy W Secomb
- Departments of Physiology and Mathematics, University of Arizona, Tucson
| | - Timothy B Curry
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN
| | - Michael J Joyner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.
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45
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Ramsook AH, Peters CM, Leahy MG, Archiza B, Mitchell RA, Jasinovic T, Koehle MS, Guenette JA, Sheel AW. Reply to Beltrami. Exp Physiol 2021; 106:791-792. [PMID: 33538367 DOI: 10.1113/ep089394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Andrew H Ramsook
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Heart Lung Innovation, The University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Carli M Peters
- School of Kinesiology, Faculty of Education, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael G Leahy
- School of Kinesiology, Faculty of Education, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Bruno Archiza
- School of Kinesiology, Faculty of Education, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Reid A Mitchell
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Heart Lung Innovation, The University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Tin Jasinovic
- Department of Family Practice, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael S Koehle
- School of Kinesiology, Faculty of Education, The University of British Columbia, Vancouver, British Columbia, Canada.,Department of Family Practice, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jordan A Guenette
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Heart Lung Innovation, The University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada.,School of Kinesiology, Faculty of Education, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew William Sheel
- Centre for Heart Lung Innovation, The University of British Columbia and St. Paul's Hospital, Vancouver, British Columbia, Canada.,School of Kinesiology, Faculty of Education, The University of British Columbia, Vancouver, British Columbia, Canada
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Hardy TA, Paula-Ribeiro M, Silva BM, Lyall GK, Birch KM, Ferguson C, Taylor BJ. The cardiovascular consequences of fatiguing expiratory muscle work in otherwise resting healthy humans. J Appl Physiol (1985) 2021; 130:421-434. [PMID: 33356985 DOI: 10.1152/japplphysiol.00116.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In 11 healthy adults (25 ± 4 yr; 2 female, 9 male subjects), we investigated the effect of expiratory resistive loaded breathing [65% maximal expiratory mouth pressure (MEP), 15 breaths·min-1, duty cycle 0.5; ERLPm] on mean arterial pressure (MAP), leg vascular resistance (LVR), and leg blood flow ([Formula: see text]). On a separate day, a subset of five male subjects performed ERL targeting 65% of maximal expiratory gastric pressure (ERLPga). ERL-induced expiratory muscle fatigue was confirmed by a 17 ± 5% reduction in MEP (P < 0.05) and a 16 ± 12% reduction in the gastric twitch pressure response to magnetic nerve stimulation (P = 0.09) from before to after ERLPm and ERLPga, respectively. From rest to task failure in ERLPm and ERLPga, MAP increased (ERLPm = 31 ± 10 mmHg, ERLPga = 18 ± 9 mmHg, both P < 0.05), but group mean LVR and [Formula: see text] were unchanged (ERLPm: LVR = 0.78 ± 0.21 vs. 0.97 ± 0.36 mmHg·mL-1·min, [Formula: see text] = 133 ± 34 vs. 152 ± 74 mL·min-1; ERLPga: LVR = 0.70 ± 0.21 vs. 0.84 ± 0.33 mmHg·mL-1·min, [Formula: see text] = 160 ± 48 vs. 179 ± 110 mL·min-1) (all P ≥ 0.05). Interestingly, [Formula: see text] during ERLPga oscillated within each breath, increasing (∼66%) and decreasing (∼50%) relative to resting values during resisted expirations and unresisted inspirations, respectively. In conclusion, fatiguing expiratory muscle work did not affect group mean LVR or [Formula: see text] in otherwise resting humans. We speculate that any sympathetically mediated peripheral vasoconstriction was counteracted by transient mechanical effects of high intra-abdominal pressures during ERL.NEW & NOTEWORTHY Fatiguing expiratory muscle work in otherwise resting humans elicits an increase in sympathetic motor outflow; whether limb blood flow ([Formula: see text]) and leg vascular resistance (LVR) are affected remains unknown. We found that fatiguing expiratory resistive loaded breathing (ERL) did not affect group mean [Formula: see text] or LVR. However, within-breath oscillations in [Formula: see text] may reflect a sympathetically mediated vasoconstriction that was counteracted by transient increases in [Formula: see text] due to the mechanical effects of high intra-abdominal pressure during ERL.
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Affiliation(s)
- Tim A Hardy
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Marcelle Paula-Ribeiro
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom.,Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Bruno M Silva
- Department of Physiology, Federal University of São Paulo, São Paulo, Brazil
| | - Gemma K Lyall
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Karen M Birch
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Carrie Ferguson
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Bryan J Taylor
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom.,Department of Cardiovascular Diseases, Mayo Clinic, Jacksonville, Florida
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Hardy TA, How SC, Taylor BJ. The Effect of Preexercise Expiratory Muscle Loading on Exercise Tolerance in Healthy Men. Med Sci Sports Exerc 2021; 53:421-430. [PMID: 32735113 DOI: 10.1249/mss.0000000000002468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Acute nonfatiguing inspiratory muscle loading transiently increases diaphragm excitability and global inspiratory muscle strength and may improve subsequent exercise performance. We investigated the effect of acute expiratory muscle loading on expiratory muscle function and exercise tolerance in healthy men. METHODS Ten males cycled at 90% of peak power output to the limit of tolerance (TLIM) after 1) 2 × 30 expiratory efforts against a pressure-threshold load of 40% maximal expiratory gastric pressure (PgaMAX) (EML-EX) and 2) 2 × 30 expiratory efforts against a pressure-threshold load of 10% PgaMAX (SHAM-EX). Changes in expiratory muscle function were assessed by measuring the mouth pressure (PEMAX) and PgaMAX responses to maximal expulsive efforts and magnetically evoked (1 Hz) gastric twitch pressure (Pgatw). RESULTS Expiratory loading at 40% of PgaMAX increased PEMAX (10% ± 5%, P = 0.001) and PgaMAX (9% ± 5%, P = 0.004). Conversely, there was no change in PEMAX (166 ± 40 vs 165 ± 35 cm H2O, P = 1.000) or PgaMAX (196 ± 38 vs 192 ± 39 cm H2O, P = 0.215) from before to after expiratory loading at 10% of PgaMAX. Exercise time was not different in EML-EX versus SHAM-EX (7.91 ± 1.96 vs 8.09 ± 1.77 min, 95% CI = -1.02 to 0.67, P = 0.651). Similarly, exercise-induced expiratory muscle fatigue was not different in EML-EX versus SHAM-EX (-28% ± 12% vs -26% ± 7% reduction in Pgatw amplitude, P = 0.280). Perceptual ratings of dyspnea and leg discomfort were not different during EML-EX versus SHAM-EX. CONCLUSION Acute expiratory muscle loading enhances expiratory muscle function but does not improve subsequent severe-intensity exercise tolerance in healthy men.
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Affiliation(s)
- Tim A Hardy
- Faculty of Biological Sciences, School of Biomedical Sciences, University of Leeds, Leeds, UNITED KINGDOM
| | - Stephen C How
- School of Sport and Exercise, University of Gloucestershire, Gloucester, UNITED KINGDOM
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Shimizu K, Shiozawa K, Ishida K, Saito M, Mizuno S, Akima H, Katayama K. Age and sex differences in blood pressure responses during hyperpnoea. Exp Physiol 2021; 106:736-747. [PMID: 33428277 DOI: 10.1113/ep089171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 01/06/2021] [Indexed: 01/13/2023]
Abstract
NEW FINDINGS What is the central question of this study? Increased respiratory muscle activation is associated with neural and cardiovascular consequences via the respiratory muscle-induced metaboreflex. Does ageing and/or sex influence the arterial blood pressure response during voluntary normocapnic incremental hyperpnoea? What is the main finding and its importance? The increase in blood pressure during hyperpnoea was smaller in younger females than in older females, whereas no difference was found between older males and older females. The blunted respiratory muscle-induced metaboreflex in younger females is normalized with advancing age, whereas ageing has no such effect in males. ABSTRACT We hypothesized that older females (OF) have a greater arterial blood pressure response to increased respiratory muscle work compared with younger females (YF) and that no such difference exists between older males (OM) and younger males (YM). To test these hypotheses, cardiovascular responses during voluntary normocapnic incremental hyperpnoea were evaluated and compared between older and younger subjects. An incremental respiratory endurance test (IRET) was performed as follows: target minute ventilation was initially set at 30% of the maximal voluntary ventilation (MVV12) and was increased by 10% of MVV12 every 3 min. The test was terminated when the subject could not maintain the target percentage of MVV12. Heart rate and mean arterial blood pressure (MAP) were recorded continuously. The increase in MAP from baseline (ΔMAP) during the IRET in OM (+24.0 ± 14.7 mmHg, mean ± SD) did not differ (P = 0.144) from that in YM (+24.3 ± 13.4 mmHg), but it was greater (P = 0.004) in OF (+31.2 ± 11.6 mmHg) than in YF (+10.3 ± 5.5 mmHg). No significant difference in ΔMAP during the IRET was observed between OM and OF (P = 0.975). These results suggest that the respiratory muscle-induced metaboreflex is blunted in YF, but it could be normalized with advancing age. In males, ageing has little effect on the respiratory muscle-induced metaboreflex. These results show no sex difference in the respiratory muscle-induced metaboreflex in older adults.
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Affiliation(s)
- Kaori Shimizu
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan
| | - Kana Shiozawa
- Department of Sports and Fitness, Faculty of Wellness, Shigakkan University, Obu, Japan.,Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Koji Ishida
- Graduate School of Medicine, Nagoya University, Nagoya, Japan.,Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Mitsuru Saito
- Applied Physiology Laboratory, Toyota Technological Institute, Nagoya, Japan
| | - Sahiro Mizuno
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan.,Research Fellowship for Young Scientists of Japan Society for the Promotion of Science
| | - Hiroshi Akima
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan.,Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Keisho Katayama
- Graduate School of Medicine, Nagoya University, Nagoya, Japan.,Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
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Respiratory impact of a grand tour: insight from professional cycling. Eur J Appl Physiol 2021; 121:1027-1036. [PMID: 33420604 DOI: 10.1007/s00421-020-04587-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/04/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this study was to evaluate the respiratory function and symptom perception in professional cyclists completing a Grand Tour (GT). METHODS Nine male cyclists completed La Vuelta or Tour de France (2018/19). At study entry, airway inflammation was measured via fractional exhaled nitric oxide (FeNO). Respiratory symptoms and pulmonary function were assessed prior to the first stage (Pre-GT), at the second rest day (Mid-GT) and prior to the final stage of the GT (Late-GT). Sniff nasal inspiratory pressure (SNIP) was assessed at pre and late-GT timepoints. RESULTS Seven cyclists reported respiratory symptoms during the race (with a prominence of upper airway issues). Symptom severity increased either mid or late-GT for most cyclists. A decline in FEV1 from pre-to-mid GT (- 0.27 ± 0.24 l, - 5.7%) (P = 0.02) and pre-to-late GT (- 0.27 ± 0.13 l, - 5.7%) (P < 0.001) was observed. Similarly, a decline in FVC (- 0.22 ± 0.17 l, - 3.7%) (P = 0.01) and FEF25-75 (- 0.49 ± 0.34 l/s, - 11%) (P = 0.02) was observed pre-to-late GT. Overall, eight (89%) and six (67%) demonstrated a clinically meaningful decline (> 200 ml) in FEV1 and FVC during the GT follow-up, respectively. SNIP remained unchanged pre-to-late GT (n = 5), however, a positive correlation was observed between ΔSNIP and ΔFVC (r = 0.99, P = 0.002). CONCLUSION GT competition is associated with a high prevalence of upper respiratory symptoms and a meaningful decline in lung function in professional cyclists. Further research is now required to understand the underpinning physiological mechanisms and determine the impact on overall respiratory health and elite cycling performance and recovery.
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50
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Louvaris Z, Rodrigues A, Dacha S, Gojevic T, Janssens W, Vogiatzis I, Gosselink R, Langer D. High-intensity exercise impairs extradiaphragmatic respiratory muscle perfusion in patients with COPD. J Appl Physiol (1985) 2020; 130:325-341. [PMID: 33119468 DOI: 10.1152/japplphysiol.00659.2020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The study investigated whether high-intensity exercise impairs inspiratory and expiratory muscle perfusion in patients with chronic obstructive pulmonary disease (COPD). We compared respiratory local muscle perfusion between constant-load cycling[sustained at 80% peak work rate (WRpeak)] and voluntary normocapnic hyperpnea reproducing similar work of breathing (WoB) in 18 patients [forced expiratory volume in the first second (FEV1): 58 ± 24% predicted]. Local muscle blood flow index (BFI), using indocyanine green dye, and fractional oxygen saturation (%StiO2) were simultaneously assessed by near-infrared spectroscopy (NIRS) over the intercostal, scalene, rectus abdominis, and vastus lateralis muscles. Cardiac output (impedance cardiography), WoB (esophageal/gastric balloon catheter), and diaphragmatic and extradiaphragmatic respiratory muscle electromyographic activity (EMG) were also assessed throughout cycling and hyperpnea. Minute ventilation, breathing pattern, WoB, and respiratory muscle EMG were comparable between cycling and hyperpnea. During cycling, cardiac output and vastus lateralis BFI were significantly greater compared with hyperpnea [by +4.2 (2.6-5.9) L/min and +4.9 (2.2-7.8) nmol/s, respectively] (P < 0.01). Muscle BFI and %StiO2 were, respectively, lower during cycling compared with hyperpnea in scalene [by -3.8 (-6.4 to -1.2) nmol/s and -6.6 (-8.2 to -5.1)%], intercostal [by -1.4 (-2.4 to -0.4) nmol/s and -6.0 (-8.6 to -3.3)%], and abdominal muscles [by -1.9 (-2.9 to -0.8) nmol/s and -6.3 (-9.1 to -3.4)%] (P < 0.001). The difference in respiratory (scalene and intercostal) muscle BFI between cycling and hyperpnea was associated with greater dyspnea (Borg CR10) scores (r = -0.54 and r = -0.49, respectively, P < 0.05). These results suggest that in patients with COPD, 1) locomotor muscle work during high-intensity exercise impairs extradiaphragmatic respiratory muscle perfusion and 2) insufficient adjustment in extradiaphragmatic respiratory muscle perfusion during high-intensity exercise may partly explain the increased sensations of dyspnea.NEW & NOTEWORTHY We simultaneously assessed the blood flow index (BFI) in three respiratory muscles during hyperpnea and high-intensity constant-load cycling sustained at comparable levels of work of breathing and respiratory neural drive in patients with COPD. We demonstrated that high-intensity exercise impairs respiratory muscle perfusion, as intercostal, scalene, and abdominal BFI increased during hyperpnea but not during cycling. Insufficient adjustment in respiratory muscle perfusion during exercise was associated with greater dyspnea sensations in patients with COPD.
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Affiliation(s)
- Zafeiris Louvaris
- Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium.,Clinical Department of Respiratory Diseases, UZ Leuven, BREATHE Department CHROMETA, KU Leuven, Leuven, Belgium
| | - Antenor Rodrigues
- Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium.,Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina, Brazil.,Research Aimed at Muscle Performance Laboratory (RAMP), Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - Sauwaluk Dacha
- Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium.,Faculty of Associated Medical Sciences, Department of Physical Therapy, Chiang Mai University, Chiang Mai, Thailand
| | - Tin Gojevic
- Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium
| | - Wim Janssens
- Clinical Department of Respiratory Diseases, UZ Leuven, BREATHE Department CHROMETA, KU Leuven, Leuven, Belgium
| | - Ioannis Vogiatzis
- Faculty of Health and Life Sciences, Department of Sport, Exercise, and Rehabilitation, Northumbria University Newcastle, Newcastle, United Kingdom
| | - Rik Gosselink
- Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium.,Clinical Department of Respiratory Diseases, UZ Leuven, BREATHE Department CHROMETA, KU Leuven, Leuven, Belgium
| | - Daniel Langer
- Faculty of Movement and Rehabilitation Sciences, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium.,Clinical Department of Respiratory Diseases, UZ Leuven, BREATHE Department CHROMETA, KU Leuven, Leuven, Belgium
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