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Kayo T, Suzuki M, Mitsuma T, Fukuda F. The effect of acupuncture on exercise capacity in patients with COPD is mediated by improvements of dyspnea and leg fatigue: a causal mediation analysis using data from a randomized controlled trial. BMC Complement Med Ther 2024; 24:44. [PMID: 38245778 PMCID: PMC10799440 DOI: 10.1186/s12906-024-04353-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 01/13/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Acupuncture is known to improve exercise capacity in patients with chronic obstructive pulmonary disease (COPD), but its mechanism remains unknown. Whether acupuncture improves exercise capacity in patients with COPD through alleviation of leg fatigue and dyspnea is examined by applying causal mediation analysis to previous trial data. METHODS Sixty-two patients with COPD completed treatments with either real or placebo acupuncture once a week for 12 weeks. Walk distance measured using the 6-minute walk test and intensities of leg fatigue and dyspnea in the modified Borg scale were evaluated at baseline and after treatment. The intervention effect of acupuncture against the placebo acupuncture on two mediators, changes in leg fatigue and dyspnea, and whether they mediated improvements in walk distance, were analyzed. RESULTS Linear regression analysis showed that the unstandardized regression coefficients [95% confidence interval (CI)] for the intervention effect by acupuncture were -4.9 (-5.8--4.0) in leg fatigue and -3.6 (-4.3--2.9) in dyspnea. Mediation analysis showed that when changes in leg fatigue were considered as a mediator, direct effect, indirect effect and proportion mediated were 47.1 m (95% CI, 4.6-85.1), 34.3 m (-2.1-82.1), and 42.1%, respectively, and when changes in dyspnea were considered as a mediator, they were 9.8 m (-32.9-49.9), 72.5 m (31.3-121.0), and 88.1%, respectively, and the effects of joint mediator were -5.8 m (-55.4-43.9), 88.9 m (32.7-148.5), and 107.0%, respectively. CONCLUSION The improvement in exercise capacity by acupuncture is explained by changes in both leg fatigue and dyspnea.
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Affiliation(s)
- Takumi Kayo
- Department of Acupuncture and Moxibustion, Faculty of Acupuncture and Moxibustion, Meiji University of Integrative Medicine, Nantan, Kyoto, Japan.
- Department of Kampo Medical Research Institute, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu, Fukushima, Japan.
| | - Masao Suzuki
- Department of Kampo Medical Research Institute, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu, Fukushima, Japan
| | - Tadamichi Mitsuma
- Department of Kampo Medical Research Institute, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu, Fukushima, Japan
| | - Fumihiko Fukuda
- Department of Acupuncture and Moxibustion, Faculty of Acupuncture and Moxibustion, Meiji University of Integrative Medicine, Nantan, Kyoto, Japan.
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Aitken CR, Sharma P, Louis M, Walsh J, Stewart GM, Sabapathy S, Adams L, Morris NR. Examining the repeatability of a novel test to measure exertional dyspnoea in chronic obstructive pulmonary disease. Respir Physiol Neurobiol 2021; 296:103826. [PMID: 34864520 DOI: 10.1016/j.resp.2021.103826] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 11/10/2021] [Accepted: 11/14/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Exertional dyspnoea(ED) is a hallmark of chronic obstructive pulmonary disease(COPD). We examined the repeatability and face validity of the end-exercise ED(EDend) response during the Dyspnoea Challenge and compared those to the six-minute walk test (6MWT) in COPD. METHODS Twenty-six individuals with COPD(13 Females, age:69 ± 5.5yrs, FEV1:63.4 ± 11.9 %) completed 2 × 6MWTs and 4 x Dyspnoea Challenges on three occasions. The challenge consisted of a two-minute treadmill walk at 80 % of 6MWT speed(3.9 ± 0.5 km·hr-1) at either a low(LIDC:5.3 ± 2%) or high angle of incline(HIDC:9.5 ± 3%). Dyspnoea(0-10 scale), heart rate(HR) and oxygen saturation(SpO2) were monitored continuously. RESULTS Mean 6MWT distance was 488 ± 58 m. End-exercise ED and HR were higher in the HIDC(EDend 6.2 ± 2.0; HR: 123 ± 17beats·min-1) compared to the LIDC(EDend 4.2 ± 2.0; HR: 119 ± 15beats·min-1) and the 6MWT(EDend 4.3 ± 2.0; HR: 115 ± 16beats·min-1)(P < 0.01). SpO2 was not different between 6MWT, LIDC or HIDC(P = 0.34). The intraclass correlation coefficient(ICC) for each intensity was excellent (HIDC, ICC = 0.88, LIDC, ICC = 0.93, P < 0.001) with neither reporting bias(HIDC, P = 0.63; LIDC, P = 0.94). CONCLUSIONS The Dyspnoea Challenge is a simple measure of ED that appears to have both repeatability and face validity. With further optimisation, this test may enhance the field-based clinical assessment of ED.
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Affiliation(s)
- Craig R Aitken
- School of Health Sciences and Social Work, Southport, QLD, Australia; Allied Health Research Collaborative. The Prince Charles Hospital Brisbane, QLD, Australia; Heart Lung Institute. The Prince Charles Hospital Brisbane, QLD, Australia.
| | - Pramod Sharma
- School of Health Sciences and Social Work, Southport, QLD, Australia
| | - Menaka Louis
- School of Health Sciences and Social Work, Southport, QLD, Australia
| | - James Walsh
- School of Health Sciences and Social Work, Southport, QLD, Australia; Allied Health Research Collaborative. The Prince Charles Hospital Brisbane, QLD, Australia; Heart Lung Institute. The Prince Charles Hospital Brisbane, QLD, Australia
| | - Glenn M Stewart
- School of Health Sciences and Social Work, Southport, QLD, Australia; Allied Health Research Collaborative. The Prince Charles Hospital Brisbane, QLD, Australia; Heart Lung Institute. The Prince Charles Hospital Brisbane, QLD, Australia; Menzies Health Institute of Queensland, Griffith University, Southport, QLD, Australia
| | - Surendran Sabapathy
- School of Health Sciences and Social Work, Southport, QLD, Australia; Menzies Health Institute of Queensland, Griffith University, Southport, QLD, Australia
| | - Lewis Adams
- School of Health Sciences and Social Work, Southport, QLD, Australia
| | - Norman R Morris
- School of Health Sciences and Social Work, Southport, QLD, Australia; Allied Health Research Collaborative. The Prince Charles Hospital Brisbane, QLD, Australia; Heart Lung Institute. The Prince Charles Hospital Brisbane, QLD, Australia; Menzies Health Institute of Queensland, Griffith University, Southport, QLD, Australia
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Morishima T, Tsuchiya Y, Ueda H, Ochi E. Muscular endurance and muscle metabolic responses to 8 weeks of omega-3 polyunsaturated fatty acids supplementation. Physiol Rep 2020; 8:e14546. [PMID: 32812384 PMCID: PMC7435031 DOI: 10.14814/phy2.14546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND It has been well known that exercise training improves muscular endurance; however, whether nutritional strategies can be used to enhance muscular endurance remains unclear. Herein, we tested the hypothesis that 8 weeks of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation, known to promote oxygen availability and lipid metabolism, would attenuate muscular fatigue caused by numerous muscle contractions. METHODS Nineteen healthy men were randomly assigned to a placebo group (n = 9) and fish oil group (n = 10) in a double-blind fashion. The fish oil group consumed EPA-rich fish oil that contains 600-mg EPA and 260-mg DHA per day for 8 weeks. The placebo group received matching capsules for the same duration of time. After the 8-week intervention, subjects performed muscular endurance test that was repeated knee extensions with weights equal to 40% of the subject's body weight. RESULTS Maximal repetitions to exhaustion were recorded. In addition, maximum isometric voluntary muscle contraction (MVC), muscle metabolism using near-infrared spectroscopy, and blood lactate were measured during the test. Subjects in both groups reached exhaustion after the muscular endurance test, while the maximal repetitions did not differ between the groups. Similarly, there is no significant difference in oxygen saturation in muscle tissue (StO2), an index of muscle oxygen availability, between the groups. Also, MVC and blood lactate did not change between groups. CONCLUSION In conclusion, the present study provided evidence that muscle fatigue caused by knee extensions cannot be attenuated by EPA and DHA supplementation in healthy subjects.
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Affiliation(s)
| | - Yosuke Tsuchiya
- Laboratory of Health and Sports SciencesMeiji Gakuin UniversityKanagawaJapan
| | - Hisashi Ueda
- Faculty of Health and Medical ScienceTeikyo Heisei UniversityChibaJapan
| | - Eisuke Ochi
- Sports Research CenterHosei UniversityTokyoJapan
- Faculty of Bioscience and Applied ChemistryHosei UniversityTokyoJapan
- Graduate School of Sports and Health StudiesHosei UniversityTokyoJapan
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Faghy MA, Lomax M, Brown PI. Active recovery strategy and lactate clearance in elite swimmers. J Sports Med Phys Fitness 2018; 59:1487-1491. [PMID: 30468357 DOI: 10.23736/s0022-4707.18.09228-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Swimming requires sustained high performance, with limited recovery between heats, recovery strategies are essential to performance but are often self-regulated and sub-optimal. Accordingly, we investigated a physiologically determined recovery protocol. METHODS Fifteen (m=9, f=6) international junior age group swimmers participated in this study. The average age of the participants was 15.8±1.5 years. All participants completed a lactate elevation protocol (8 x 50 m sprints), followed by one of three recovery strategies: 1) velocity at lactate threshold (VLT); 2) coach prescribed protocol (COA); and 3) national governing body recommendations (NGB) and thereafter a 200-m time trial. RESULTS [lac-]B was similar between trials at baseline (pooled data: 1.3±0.4 mmol.l-1, P>0.05) but increased following 8x50 m sprints (pooled data 9.5±3.5 mmol.l-1, P<0.05) and reduced in all conditions (mean reduction 6.4±1.7 mmol.l-1). [lac-]B remained elevated following NGB (5.6±0.8 mmol.l-1, P<0.05) compared with COA (2.3±1.7 mmol.l-1) and VLT (1.7±1.2 mmol.l-1) but was blunted during the 200-m time trial in VLT (6.4±1.7 mmol.l-1, P<0.05). Time trial performance was similar between trials; VLT (2.24±0.12 min), COA (2.23±0.14 min) and NGB (2.22±0.13 min, P>0.05). CONCLUSIONS Despite similar performance, individually prescribed recovery strategy with a physiological basis will preserve repeated exercise performance performed on the same day.
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Affiliation(s)
- Mark A Faghy
- Human Science Research Centre, University of Derby, Derby, UK -
| | - Mitch Lomax
- Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
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Abstract
This essay expounds on fundamental, quantitative elements of the exercise ventilation in children, which was the subject of the Tom Rowland Lecture given at the NASPEM 2018 Conference. Our knowledge about how much ventilation rises during aerobic exercise is reasonably solid; our understanding of its governance is a work in progress, but our grasp of dyspnea and ventilatory limitation in children (if it occurs) remains embryonic. This manuscript summarizes ventilatory mechanics during dynamic exercise, then proceeds to outline our current understanding of mechanisms of dyspnea, particularly during exercise (exertional dyspnea). Most research in this field has been done in adults, and the vast majority of these studies in patients with chronic obstructive pulmonary disease. To what extent conclusions drawn from this literature apply to children and adolescents-both healthy and those with cardiopulmonary disease-will be discussed. The few, recent, pertinent, pediatric studies will be reviewed in an attempt to provide an empirical basis for proposing a hypothetical model to study exertional dyspnea in youth. Just as somatic growth will have consequences for ventilatory and exercise capacity, so too will neural developmental plasticity and experience affect perception of dyspnea. Our path to understand how these evolving inputs and influences summate during a child's life will be Columbus' India.
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Garske LA, Lal R, Stewart IB, Morris NR, Cross TJ, Adams L. Exertional dyspnea associated with chest wall strapping is reduced when external dead space substitutes for part of the exercise stimulus to ventilation. J Appl Physiol (1985) 2017; 122:1179-1187. [DOI: 10.1152/japplphysiol.00051.2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 01/30/2017] [Accepted: 01/30/2017] [Indexed: 11/22/2022] Open
Abstract
Chest wall strapping has been used to assess mechanisms of dyspnea with restrictive lung disease. This study examined the hypothesis that dyspnea with restriction depends principally on the degree of reflex ventilatory stimulation. We compared dyspnea at the same (iso)ventilation when added dead space provided a component of the ventilatory stimulus during exercise. Eleven healthy men undertook a randomized controlled crossover trial that compared four constant work exercise conditions: 1) control (CTRL): unrestricted breathing at 90% gas exchange threshold (GET); 2) CTRL+dead space (DS): unrestricted breathing with 0.6-l dead space, at isoventilation to CTRL due to reduced exercise intensity; 3) CWS: chest wall strapping at 90% GET; and 4) CWS+DS: chest strapping with 0.6-l dead space, at isoventilation to CWS with reduced exercise intensity. Chest strapping reduced forced vital capacity by 30.4 ± 2.2% (mean ± SE). Dyspnea at isoventilation was unchanged with CTRL+DS compared with CTRL (1.93 ± 0.49 and 2.17 ± 0.43, 0–10 numeric rating scale, respectively; P = 0.244). Dyspnea was lower with CWS+DS compared with CWS (3.40 ± 0.52 and 4.51 ± 0.53, respectively; P = 0.003). Perceived leg fatigue was reduced with CTRL+DS compared with CTRL (2.36 ± 0.48 and 2.86 ± 0.59, respectively; P = 0.049) and lower with CWS+DS compared with CWS (1.86 ± 0.30 and 4.00 ± 0.79, respectively; P = 0.006). With unrestricted breathing, dead space did not change dyspnea at isoventilation, suggesting that dyspnea does not depend on the mode of reflex ventilatory stimulation in healthy individuals. With chest strapping, dead space presented a less potent stimulus to dyspnea, raising the possibility that leg muscle work contributes to dyspnea perception independent of the ventilatory stimulus. NEW & NOTEWORTHY Chest wall strapping was applied to healthy humans to simulate restrictive lung disease. With chest wall strapping, dyspnea was reduced when dead space substituted for part of a constant exercise stimulus to ventilation. Dyspnea associated with chest wall strapping depended on the contribution of leg muscle work to ventilatory stimulation. Chest wall strapping might not be a clinically relevant model to determine whether an alternative reflex ventilatory stimulus mimics the intensity of exertional dyspnea.
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Affiliation(s)
- Luke A. Garske
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
- Respiratory and Sleep Medicine, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Ravin Lal
- Allied Health Sciences and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Ian B. Stewart
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Norman R. Morris
- Allied Health Sciences and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Troy J. Cross
- Allied Health Sciences and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Queensland, Australia
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota; and
| | - Lewis Adams
- Allied Health Sciences and Menzies Health Institute of Queensland, Griffith University, Gold Coast, Queensland, Australia
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Spathis A, Booth S, Moffat C, Hurst R, Ryan R, Chin C, Burkin J. The Breathing, Thinking, Functioning clinical model: a proposal to facilitate evidence-based breathlessness management in chronic respiratory disease. NPJ Prim Care Respir Med 2017; 27:27. [PMID: 28432286 PMCID: PMC5435098 DOI: 10.1038/s41533-017-0024-z] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 02/24/2017] [Accepted: 02/27/2017] [Indexed: 01/31/2023] Open
Abstract
Refractory breathlessness is a highly prevalent and distressing symptom in advanced chronic respiratory disease. Its intensity is not reliably predicted by the severity of lung pathology, with unhelpful emotions and behaviours inadvertently exacerbating and perpetuating the problem. Improved symptom management is possible if clinicians choose appropriate non-pharmacological approaches, but these require engagement and commitment from both patients and clinicians. The Breathing Thinking Functioning clinical model is a proposal, developed from current evidence, that has the potential to facilitate effective symptom control, by providing a rationale and focus for treatment.
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Affiliation(s)
- Anna Spathis
- Department of Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
- University of Cambridge, Cambridge, UK.
| | | | - Catherine Moffat
- Department of Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Rhys Hurst
- Department of Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Chloe Chin
- Department of Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Julie Burkin
- Department of Palliative Care, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Shei RJ, Paris HLR, Wilhite DP, Chapman RF, Mickleborough TD. The role of inspiratory muscle training in the management of asthma and exercise-induced bronchoconstriction. PHYSICIAN SPORTSMED 2016; 44:327-334. [PMID: 27094568 DOI: 10.1080/00913847.2016.1176546] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Asthma is a pathological condition comprising of a variety of symptoms which affect the ability to function in daily life. Due to the high prevalence of asthma and associated healthcare costs, it is important to identify low-cost alternatives to traditional pharmacotherapy. One of these low cost alternatives is the use of inspiratory muscle training (IMT), which is a technique aimed at increasing the strength and endurance of the diaphragm and accessory muscles of respiration. IMT typically consists of taking voluntary inspirations against a resistive load across the entire range of vital capacity while at rest. In healthy individuals, the most notable benefits of IMT are an increase in diaphragm thickness and strength, a decrease in exertional dyspnea, and a decrease in the oxygen cost of breathing. Due to the presence of expiratory flow limitation in asthma and exercise-induced bronchoconstriction, dynamic lung hyperinflation is common. As a result of varying operational lung volumes, due in part to hyperinflation, the respiratory muscles may operate far from the optimal portion of the length-tension curve, and thus may be forced to operate against a low pulmonary compliance. Therefore, the ability of these muscles to generate tension is reduced, and for any given level of ventilation, the work of breathing is increased as compared to non-asthmatics. Evidence that IMT is an effective treatment for asthma is inconclusive, due to limited data and a wide variation in study methodologies. However, IMT has been shown to decrease dyspnea, increase inspiratory muscle strength, and improve exercise capacity in asthmatic individuals. In order to develop more concrete recommendations regarding IMT as an effective low-cost adjunct in addition to traditional asthma treatments, we recommend that a standard treatment protocol be developed and tested in a placebo-controlled clinical trial with a large representative sample.
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Affiliation(s)
- Ren-Jay Shei
- a Human Performance Laboratories, Department of Kinesiology, School of Public Health-Bloomington , Indiana University , Bloomington , IN , USA
| | - Hunter L R Paris
- a Human Performance Laboratories, Department of Kinesiology, School of Public Health-Bloomington , Indiana University , Bloomington , IN , USA
| | - Daniel P Wilhite
- a Human Performance Laboratories, Department of Kinesiology, School of Public Health-Bloomington , Indiana University , Bloomington , IN , USA
| | - Robert F Chapman
- a Human Performance Laboratories, Department of Kinesiology, School of Public Health-Bloomington , Indiana University , Bloomington , IN , USA
| | - Timothy D Mickleborough
- a Human Performance Laboratories, Department of Kinesiology, School of Public Health-Bloomington , Indiana University , Bloomington , IN , USA
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Physiological and functional failure in chronic obstructive pulmonary disease, congestive heart failure and cancer: a debilitating intersection of sarcopenia, cachexia and breathlessness. Curr Opin Support Palliat Care 2016; 10:236-41. [DOI: 10.1097/spc.0000000000000222] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Dalhousie Pictorial Scales Measuring Dyspnea and Perceived Exertion during Exercise for Children and Adolescents. Ann Am Thorac Soc 2016; 12:718-26. [PMID: 25695139 DOI: 10.1513/annalsats.201410-477oc] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
RATIONALE Alternative scales to measure dyspnea and perceived exertion have been sought due to concerns regarding understanding and validity of any Borg scale in pediatric populations. OBJECTIVES To demonstrate content validity of Dalhousie Dyspnea and Perceived Exertion Scales developed for children and adolescents. METHODS We obtained ratings for dyspnea and perceived exertion using both Borg CR-10 and Dalhousie Scales during incremental cycle exercise in 100 children and adolescents, healthy or with respiratory disease. Content validity was determined by correlating perceived leg exertion rating versus heart rate or %peak work capacity and dyspnea rating versus ventilation expressed as %peak ventilation. The stimulus-perceptual response was modeled as a quadratic function with a delay term. Reproducibility, cross-modality usage, and language effects were assessed in a small group of Italian children during treadmill exercise. MEASUREMENTS AND MAIN RESULTS Pictorial ratings of dyspnea and perceived exertion measured by both scale ratings rose as expected with increasing exercise intensity in children and adolescents, demonstrating excellent correlation between perceived leg exertion versus exercise intensity and dyspnea rating versus ventilation (median Spearman ρ ≥ 0.9) with either scale. There were no systematic differences in dyspnea or perceived exertion ratings between children with or without respiratory disease. Understandability and reproducibility of the Dalhousie scales was affirmed in Italian-speaking subjects performing treadmill exercise. CONCLUSIONS Dalhousie Dyspnea and Perceived Exertion Scales offer an alternative to the Borg scale for use during exercise in pediatric subjects. Children and adolescents exhibit large variation in patterns of ratings of dyspnea and perceived exertion in incremental exercise.
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Sharma P, Morris NR, Adams L. Effect of experimental modulation of mood on perception of exertional dyspnea in healthy subjects. J Appl Physiol (1985) 2015; 120:114-20. [PMID: 26565017 DOI: 10.1152/japplphysiol.00122.2015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 11/08/2015] [Indexed: 11/22/2022] Open
Abstract
In many diseases across a range of pathologies (e.g., cardiopulmonary, neuromuscular, and cancer), chronic dyspnea, particularly on exertion, is a major debilitating symptom often associated with clinical anxiety/depression. This study aims to explore the interaction between mood state and exertional dyspnea in a healthy population. Following familiarization, 20 healthy subjects (27-54 years old) performed six 5-min treadmill tests on three separate days. On each day subjects viewed randomly assigned images designed to induce positive, negative, or neutral mood states (International Affective Picture System). For each condition, at minute intervals, subjects rated dyspnea (sensory and affective domains) in the first test and mood (valence and arousal domains) in the second test. Oxygen uptake (V̇O2 , liters/min), carbon dioxide production (V̇CO2, liters/min), ventilation (V̇E, liters/min), respiratory frequency (f(R), beats/min), and heart rate (HR, bpm), were measured throughout the exercise. V̇O2, V̇CO2, V̇E, HR, and f(R) were not statistically significantly different among the three mood states (P > 0.05). Mood valence was significantly higher with parallel viewing of positive (last 2-min mean ± SE = 6.9 ± 0.2) compared with negative pictures (2.4 ± 0.2; P < 0.001). Both sensory and affective domains of dyspnea were significantly higher during negative (sensory: 5.6 ± 0.3; affective: 3.3 ± 0.5) compared with positive mood (sensory: 4.4 ± 0.4, P < 0.001; affective: 2.1 ± 0.4, P = 0.002). These findings suggest that positive mood alleviates both the sensory and affective domains of exertional dyspnea in healthy subjects. Thus the treatment of anxiety/depression in dyspenic populations could be a worthwhile therapeutic strategy in increasing symptom-limited exercise tolerance, thereby contributing to improved quality of life.
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Affiliation(s)
- Pramod Sharma
- Menzies Health Institute Queensland, School of Allied Health Sciences, Heart Foundation Research Centre, Griffith University, Gold Coast Campus, Australia
| | - Norman R Morris
- Menzies Health Institute Queensland, School of Allied Health Sciences, Heart Foundation Research Centre, Griffith University, Gold Coast Campus, Australia
| | - Lewis Adams
- Menzies Health Institute Queensland, School of Allied Health Sciences, Heart Foundation Research Centre, Griffith University, Gold Coast Campus, Australia
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Faghy MA, Brown PI. Training the inspiratory muscles improves running performance when carrying a 25 kg thoracic load in a backpack. Eur J Sport Sci 2015; 16:585-94. [PMID: 26274785 DOI: 10.1080/17461391.2015.1071878] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Load carriage (LC) exercise in physically demanding occupations is typically characterised by periods of low-intensity steady-state exercise and short duration, high-intensity exercise while carrying an external mass in a backpack; this form of exercise is also known as LC exercise. This induces inspiratory muscle fatigue and reduces whole-body performance. Accordingly we investigated the effect of inspiratory muscle training (IMT, 50% maximal inspiratory muscle pressure (PImax) twice daily for six week) upon running time-trial performance with thoracic LC. Nineteen healthy males formed a pressure threshold IMT (n = 10) or placebo control group (PLA; n = 9) and performed 60 min LC exercise (6.5 km h(-1)) followed by a 2.4 km running time trial (LCTT) either side of a double-blind six week intervention. Prior to the intervention, PImax was reduced relative to baseline, post-LC and post-LCTT in both groups (pooled data: 13 ± 7% and 16 ± 8%, respectively, p < .05) and similar changes were observed post-PLA. Post-IMT only, resting PImax increased +31% (p < .05) and relative to pre-IMT was greater post-LC (+19%) and post-LCTT (+18%, p < .05), however, the relative reduction in PImax at each time point was unchanged (13 ± 11% and 17 ± 9%, respectively, p > .05). In IMT only, heart rate and perceptual responses were reduced post-LC (p < .05). Time-trial performance was unchanged post-PLA and improved 8 ± 4% after IMT (p < .05). In summary, when wearing a 25 kg backpack, IMT attenuated the cardiovascular and perceptual responses to steady-state exercise and improved high-intensity time-trial performance which we attribute in part to reduced relative work intensity of the inspiratory muscles due to improved inspiratory muscle strength. These findings have real-world implications for occupational contexts.
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Affiliation(s)
- Mark A Faghy
- a School of Science, University of Derby , Derby , UK
| | - Peter I Brown
- b English Institute of Sport, Loughborough High Performance Centre , Loughborough , UK
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Sharma P, Morris NR, Adams L. The effect of different exercise modalities on dyspnea and leg fatigue in healthy subjects. Respir Physiol Neurobiol 2015; 210:44-50. [DOI: 10.1016/j.resp.2015.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 02/06/2015] [Accepted: 02/09/2015] [Indexed: 11/26/2022]
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