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Manifield J, Alexiou C, Megaritis D, Baker K, Adams N, Barry G, Vogiatzis I. Effects of inspiratory muscle training on thoracoabdominal volume regulation in older adults: A randomised controlled trial. Respir Physiol Neurobiol 2024; 326:104278. [PMID: 38735425 DOI: 10.1016/j.resp.2024.104278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/22/2024] [Accepted: 05/04/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVES We investigated the effect of inspiratory muscle training (IMT) on inspiratory muscle strength, functional capacity and respiratory muscle kinematics during exercise in healthy older adults. METHODS 24 adults were randomised into an IMT or SHAM-IMT group. Both groups performed 30 breaths, twice daily, for 8 weeks, at intensities of ∼50 % maximal inspiratory pressure (PImax; IMT) or <15 % PImax (SHAM-IMT). Measurements of PImax, breathing discomfort during a bout of IMT, six-minute walk distance, physical activity levels, and balance were assessed pre- and post-intervention. Respiratory muscle kinematics were assessed via optoelectronic plethysmography (OEP) during constant work rate cycling. RESULTS PImax was significantly improved (by 20.0±11.9 cmH2O; p=0.001) in the IMT group only. Breathing discomfort ratings during IMT significantly decreased (from 3.5±0.9-1.7±0.8). Daily sedentary time was decreased (by 28.0±39.8 min; p=0.042), and reactive balance significantly improved (by 1.2±0.8; p<0.001) in the IMT group only. OEP measures showed a significantly greater contribution of the pulmonary and abdominal rib cage compartments to total tidal volume expansion post-IMT. CONCLUSIONS IMT significantly improves inspiratory muscle strength and breathing discomfort in this population. IMT induces greater rib cage expansion and diaphragm descent during exercise, thereby suggesting a less restrictive effect on thoracic expansion and increased diaphragmatic power generation.
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Affiliation(s)
- James Manifield
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK.
| | - Charikleia Alexiou
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Dimitrios Megaritis
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Katherine Baker
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Nicola Adams
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Gill Barry
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
| | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne NE1 8ST, UK
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2
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Kuronen I, Heinijoki J, Sovijärvi A. Effects of low workload respiratory training with steam inhalation on lung function in stable asthma: A controlled clinical study. Clin Physiol Funct Imaging 2024; 44:100-111. [PMID: 37749950 DOI: 10.1111/cpf.12856] [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: 06/30/2023] [Revised: 09/15/2023] [Accepted: 09/22/2023] [Indexed: 09/27/2023]
Abstract
To investigate effects of low workload respiratory muscle training (RMT) on respiratory muscle power and lung function in asthmatics, we recruited asthmatic persons who performed a 4-week training programme. The training included 20 daily ex- and inhalations with counter pressure 30% from the individual maximal expiratory pressure (MEP). Lung function was measured before and after the training programme and a follow-up period. The study also included several subjective endpoints for respiratory symptoms. A significant increase in a training group (n = 27) compared with a control group (n = 20) was seen in MEP (+12.4%, vs. +3.5%, p = 0.086), maximal inspiratory pressure (MIP) (+21.1% vs. +0.82%, p = 0.023), slow vital capacity (VC) (+3.7% vs. +1.5%, p = 0.023) and in forced expiratory time (FET, +15.5%, vs. -5.0%, p = 0.022). After being a control for group A, also group B performed similar RMT as group A. In the combined group (A and B, n = 47) MEP (11.3%, p = 0.003), MIP (19.73%, p < 0.001), VC (4.1%, p < 0.001) and FET (14.7%, p < 0.001) increased significantly from the baseline. Changes in other lung function variables were not indicative. On a scale of 1-5, the subjects perceived improvement in reduction of mucus secretion in the airways (median 3, p < 0.001), alleviation of coughing (median 3, p < 0.001) and reduction in dyspnoea (median 3, p < 0.001). As a conclusion, low workload respiratory training of 4 weeks improved respiratory muscle power and increased VC in patients with stable asthma.
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Affiliation(s)
| | | | - Anssi Sovijärvi
- Department of Clinical Physiology, University of Helsinki, Helsinki, Finland
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3
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Li W, Zhu X, Wang X, Liu H, Liu J, Xiao H, Dong L, Wang C, Wu Y. A hypotensive protocol of inspiratory muscle strength training: Systematic review and meta-analysis with trial sequential analysis. J Clin Hypertens (Greenwich) 2023; 25:971-982. [PMID: 37803506 PMCID: PMC10631095 DOI: 10.1111/jch.14655] [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: 11/28/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 10/08/2023]
Abstract
The aim of this study was to evaluate the hypotensive effect and optimal protocol of inspiratory muscle resistance training (IMST). Randomized controlled trials using IMST to lower blood pressure (BP) were retrieved from 12 databases as of July 2022. A meta-analysis of BP and heart rate variability (HRV) was performed and a trial sequence analysis was performed using trial sequential analysis (TSA) software. Twelve articles (n = 386 participants) from five countries were included, with a mean quality score of 5.83. IMST achieved significant results in reducing systolic, diastolic, and mean arterial pressure (-7.93 [-12.08, -3.78]; -3.80 [-6.08, -1.53]; -4.90 [-13.76, 3.96]). Furthermore, TSA has shown that the findings for systolic and diastolic BP are conclusive. Finally, considerable variation remained between studies when analyzing HRV. The overall hypotensive effect of IMST was demonstrated by the TSA and was well tolerated in different populations. Of these, two interventions, high resistance or low resistance combined with slow breathing, showed the best efficacy under an 8-week exercise intervention. In addition, the process of lowering BP by modulating sympathetic vagal activity has not been further confirmed in this study. Future long-term interventions, especially those over 3 months, are needed to observe the prolonged antihypertensive effects and modulatory mechanisms; controlling for variables such as respiratory rate and executing more rigorous studies to further explore antihypertensive options.
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Affiliation(s)
- Wenjing Li
- The School of Graduate, Tianjin University of Traditional Chinese MedicineTianjinChina
| | - Xiaoping Zhu
- Nursing DepartmentShanghai Tenth People's HospitalShanghaiChina
| | - Xinai Wang
- The School of Graduate, Tianjin University of Traditional Chinese MedicineTianjinChina
| | - Hao Liu
- The School of Graduate, Tianjin University of Traditional Chinese MedicineTianjinChina
| | - Jingying Liu
- The School of Nursing, Tianjin University of Traditional Chinese MedicineTianjinChina
| | - Hongling Xiao
- The School of Nursing, Tianjin University of Traditional Chinese MedicineTianjinChina
| | - Liang Dong
- Ruijin‐Hainan HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
| | - Chenqi Wang
- The School of Graduate, Tianjin University of Traditional Chinese MedicineTianjinChina
| | - Yaxuan Wu
- The School of Graduate, Tianjin University of Traditional Chinese MedicineTianjinChina
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Sogard AS, Mickleborough TD. The therapeutic role of inspiratory muscle training in the management of asthma: a narrative review. Am J Physiol Regul Integr Comp Physiol 2023; 325:R645-R663. [PMID: 37720997 DOI: 10.1152/ajpregu.00325.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023]
Abstract
Asthma is a disorder of the airways characterized by chronic airway inflammation, hyperresponsiveness, and variable recurring airway obstruction. Treatment options for asthma include pharmacological strategies, whereas nonpharmacological strategies are limited. Established pharmacological approaches to treating asthma may cause unwanted side effects and do not always afford adequate protection against asthma, possibly because of an individual's variable response to medications. A potential nonpharmacological intervention that is most available and cost effective is inspiratory muscle training (IMT), which is a technique targeted at increasing the strength and endurance of the diaphragm and accessory muscles of inspiration. Studies examining the impact of IMT on asthma have reported increases in inspiratory muscle strength and a reduction in the perception of dyspnea and medication use. However, because of the limited number of studies and discordant methods between studies more evidence is required to elucidate in individuals with asthma the efficacy of IMT on inspiratory muscle endurance, exercise capacity, asthma control, symptoms, and quality of life as well as in adolescents with differing severities of asthma. Large randomized controlled trials would be a significant step forward in clarifying the effectiveness of IMT in individuals with asthma. Although IMT may have favorable effects on inspiratory muscle strength, dyspnea, and medication use, the current evidence that IMT is an effective treatment for asthma is inconclusive.
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Affiliation(s)
- Abigail S Sogard
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana, United States
| | - Timothy D Mickleborough
- Department of Kinesiology, School of Public Health-Bloomington, Indiana University, Bloomington, Indiana, United States
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5
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Espinosa-Ramírez M, Riquelme S, Araya F, Rodríguez G, Figueroa-Martínez F, Gabrielli L, Viscor G, Reid WD, Contreras-Briceño F. Effectiveness of Respiratory Muscles Training by Voluntary Isocapnic Hyperpnea Versus Inspiratory Threshold Loading on Intercostales and Vastus Lateralis Muscles Deoxygenation Induced by Exercise in Physically Active Adults. BIOLOGY 2023; 12:biology12020219. [PMID: 36829497 PMCID: PMC9953077 DOI: 10.3390/biology12020219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/24/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
Respiratory muscle training (RMT) improves physical performance, although it is still debated whether this effect depends on the type of training. The purpose of this study was to compare the effects of two different types of RMT, i.e., voluntary isocapnic hyperpnea (VIH) and inspiratory threshold loading (ITL), on the deoxygenation of intercostal (ΔSmO2-m. intercostales) and vastus lateralis (ΔSmO2-m. vastus lateralis) muscles during exercise. Twenty-four participants performed eight weeks of RMT by: (i) VIH (3 days·week-1 for 12 min at 60% maximal voluntary ventilation) or (ii) ITL (5 sets·week-1 of 30 breaths·minute-1 at 60% maximal inspiratory pressure). Cardiopulmonary exercise testing (CPET) included ΔSmO2 (the change from baseline to end of test) of intercostal and vastus lateralis muscles. After RMT, both groups showed decreased ΔSmO2-m. intercostales (VIH = 12.8 ± 14.6%, p = 0.04 (effect size, ES = 0.59), and ITL = 8.4 ± 9.8%, p = 0.04 (ES = 0.48)), without a coincident change of ∆SmO2-m. vastus lateralis. ITL training induced higher V˙O2-peak absolute values than VIH (mean Δ post-pre, ITL = 229 ± 254 mL·min-1 [95% CI 67-391] vs. VIH, 39 ± 153 mL·min-1 [95% CI -58-136.0], p = 0.01). In conclusion, both RMT improved the balance between supply and oxygen consumption levels of m. intercostales during CPET, with ITL also inducing an increase of aerobic capacity.
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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, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Santiago Riquelme
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Felipe Araya
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Guido Rodríguez
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Fernanda Figueroa-Martínez
- Laboratory of Voice, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Luigi Gabrielli
- Advanced Center for Chronic Diseases (ACCDiS), Division of Cardiovascular Diseases, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta #367, Santiago 8380000, Chile
| | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain
| | - W. Darlene Reid
- Department of Physical Therapy and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON M5G 2C4, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON M5G 2A2, Canada
| | - 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
- Advanced Center for Chronic Diseases (ACCDiS), Division of Cardiovascular Diseases, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta #367, Santiago 8380000, Chile
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain
- Millennium Institute for Intelligent Healthcare Engineering, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
- Correspondence: ; Tel.: +56-9-82288153
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Palau P, Domínguez E, Gonzalez C, Bondía E, Albiach C, Sastre C, Martínez ML, Núñez J, López L. Effect of a home-based inspiratory muscle training programme on functional capacity in postdischarged patients with long COVID: the InsCOVID trial. BMJ Open Respir Res 2022; 9:9/1/e001439. [PMID: 36549786 PMCID: PMC9791108 DOI: 10.1136/bmjresp-2022-001439] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Fatigue and exercise intolerance are the most common symptoms in patients with long COVID. AIMS This study aimed to evaluate whether a home-based inspiratory muscle training (IMT) programme improves maximal functional capacity in patients' long COVID after a previous admission due to SARS-CoV-2 pneumonia. METHODS This study was a single-centre, blinded assessor, randomised controlled trial. Twenty-six patients with long COVID and a previous admission due to SARS-CoV-2 pneumonia were randomly assigned to receive either a 12-week IMT or usual care alone (NCT05279430). The physiotherapist and participants were not blinded. Patients allocated to the IMT arm were instructed to train at home twice daily using a threshold inspiratory muscle trainer and to maintain diaphragmatic breathing during the training session. The usual care arm received no intervention.The primary endpoint was the change in peak oxygen consumption (peakVO2). Secondary endpoints were changes in quality of life (QoL), ventilatory efficiency and chronotropic response during exercise (evaluated by chronotropic index-CIx- formula). We used linear mixed regression analysis for evaluating changes in primary and secondary endpoints. RESULTS The mean age of the sample and time to first visit after discharge were 50.4±12.2 years and 362±105 days, respectively. A total of 11 (42.3%) were female. At baseline, the mean of peakVO2, ventilatory efficiency and CIx were 18.9±5 mL/kg/min, 29.4±5.2 and 0.64±0.19, respectively. The IMT arm improved their peakVO2 significantly compared with usual care (+Δ 4.46 mL/kg/min, 95% CI 3.10 to 5.81; p<0.001). Similar positive findings were found when evaluating changes for CIx and some QoL dimensions. We did not find significant changes in ventilatory efficiency. CONCLUSION In long COVID patients with a previous admission due to SARS-CoV-2 pneumonia, IMT was associated with marked improvement in exercise capacity and QoL. TRIAL REGISTRATION NUMBER NCT05279430.
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Affiliation(s)
- Patricia Palau
- Cardiology Department, Hospital Clinico Universitario de Valencia, INCLIVA, Universitat de Valencia, Valencia, Spain
| | - Eloy Domínguez
- Cardiology Department. Hospital Clínico Universitario de Valencia, Universitat Jaume I, Castellón, Spain
| | - Cruz Gonzalez
- Pneumology Department, Hospital Clínico Universitario de Valencia, Hospital Clinico Universitario, Valencia, Spain
| | - Elvira Bondía
- Pneumology Department, Hospital Clínico Universitario de Valencia, Hospital Clinico Universitario, Valencia, Spain
| | - Cristina Albiach
- Cardiology Department, Hospital Clínico Universitario de Valencia, Hospital Clínico Universitario, Valencia, Spain
| | - Clara Sastre
- Cardiology Department. Hospital Clínico Universitario de Valencia. Universitat de València, INCLIVA, Valencia, Spain
| | - Maria Luz Martínez
- Cardiology Department, Hospital Clínico Universitario de Valencia, Hospital Clínico Universitario, Valencia, Spain
| | - Julio Núñez
- Cardiology Department, Hospital Clinico Universitario de Valencia, INCLIVA, Universitat de Valencia, Valencia, Spain
| | - Laura López
- Physiotherapy Department, Universitat de Valencia, Valencia, Spain
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Faghy MA, Shei R, Armstrong NCD, White M, Lomax M. Physiological impact of load carriage exercise: Current understanding and future research directions. Physiol Rep 2022; 10:e15502. [PMID: 36324291 PMCID: PMC9630762 DOI: 10.14814/phy2.15502] [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: 05/21/2022] [Revised: 09/18/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Load carriage (LC) refers to the use of personal protective equipment (PPE) and/or load-bearing apparatus that is mostly worn over the thoracic cavity. A commonplace task across various physically demanding occupational groups, the mass being carried during LC duties can approach the wearer's body mass. When compared to unloaded exercise, LC imposes additional physiological stress that negatively impacts the respiratory system by restricting chest wall movement and altering ventilatory mechanics as well as circulatory responses. Consequently, LC activities accelerate the development of fatigue in the respiratory muscles and reduce exercise performance in occupational tasks. Therefore, understanding the implications of LC and the effects specific factors have on physiological capacities during LC activity are important to the implementation of effective mitigation strategies to ameliorate the detrimental effects of thoracic LC. Accordingly, this review highlights the current physiological understanding of LC activities and outlines the knowledge and efficacy of current interventions and research that have attempted to improve LC performance, whilst also highlighting pertinent knowledge gaps that must be explored via future research activities.
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Affiliation(s)
- Mark A. Faghy
- Biomedical Research Theme, School of Human SciencesUniversity of DerbyDerbyUK
| | - Ren‐Jay Shei
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Nicola C. D. Armstrong
- Defence Science and Technology LaboratorySalisburyUK
- Extreme Environments Laboratory, School of Sport, Health and Exercise ScienceUniversity of PortsmouthPortsmouthUK
| | - Mark White
- Rocky Mountain University of Health ProfessionsProvoUtahUSA
| | - Mitch Lomax
- Extreme Environments Laboratory, School of Sport, Health and Exercise ScienceUniversity of PortsmouthPortsmouthUK
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Polastri M, Palau P, Pehlivan E. Inspiratory muscle training in the rehabilitation of patients with COVID-19. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2022.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Massimiliano Polastri
- Department of Continuity of Care and Integration, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Patricia Palau
- Department of Cardiology, Hospital Clínico Universitario de Valencia, INCLIVA, University of Valencia, Valencia, Spain
| | - Esra Pehlivan
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, University of Health Sciences, Istanbul, Turkey
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9
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Palau P, Domínguez E, Sastre C, Martínez ML, Gonzalez C, Bondía E, Albiach C, Núñez J, López L. Effect of a home-based inspiratory muscular training programme on functional capacity in patients with chronic COVID-19 after a hospital discharge: protocol for a randomised control trial (InsCOVID trial). BMJ Open Respir Res 2022; 9:9/1/e001255. [PMID: 35790316 PMCID: PMC9257865 DOI: 10.1136/bmjresp-2022-001255] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/27/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction Exercise intolerance and fatigue are the most common symptoms in patients with chronic COVID-19 after hospital discharge. Supervised exercise training programmes improve symptoms, but scarce research has been done on home-based exercise programmes on the maximal functional capacity for discharged symptomatic COVID-19 patients. This study evaluates whether a home-based inspiratory muscle training (IMT) programme improves maximal functional capacity in chronic COVID-19 after hospital admission. Methods and analysis This single-centre, assessor-blinded randomised controlled trial, powered for superiority, seeks to evaluate maximal functional capacity as the primary endpoint. A total of 26 eligible patients with a previous admission for acute respiratory syndrome coronavirus 2 pneumonia (>3 months after hospital discharge) will be randomised (1:1) to receive a 12-week programme of IMT versus usual care alone. A blinded assessor will measure outcomes at baseline and after the intervention (12 weeks). An analysis of variance will be used to compare continuous outcomes among the two-intervention groups. As of 21 March 2022, eight patients have been enrolled. Ethics and dissemination The research ethics committee (Comité Ético de Investigación con Medicamentos de l'Hospital Clínic Universitari de València) approved the protocol following the principles of the Declaration of Helsinki and national regulations (Approval Number: 021/226). Findings will be published in peer-reviewed journals and conference publications. Trial registration number NCT05279430.
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Affiliation(s)
- Patricia Palau
- Cardiology Department. Hospital Clínico Universitario de Valencia, INCLIVA. Universitat de València, Valencia, Spain
| | | | - Clara Sastre
- Cardiology Department. Hospital Clínico Universitario de Valencia, INCLIVA. Universitat de València, Valencia, Spain
| | - M Luz Martínez
- Cardiology Deparment, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Cruz Gonzalez
- Pneumology Department, Hospital Clínico Universitario de Valencia. Universitat de València, Valencia, Spain
| | - Elvira Bondía
- Pneumology Department, Hospital Clínico Universitario de Valencia. Universitat de València, Valencia, Spain
| | - Crtstina Albiach
- Cardiology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Julio Núñez
- Cardiology Department. Hospital Clínico Universitario de Valencia, INCLIVA. Universitat de València, Valencia, Spain
| | - Laura López
- Physiotherapy Department, Universitat de València, Valencia, Spain
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10
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Buran Cirak Y, Yilmaz Yelvar GD, Durustkan Elbasi N. Effectiveness of 12-week inspiratory muscle training with manual therapy in patients with COPD: A randomized controlled study. THE CLINICAL RESPIRATORY JOURNAL 2022; 16:317-328. [PMID: 35332685 PMCID: PMC9060133 DOI: 10.1111/crj.13486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/12/2022] [Accepted: 03/08/2022] [Indexed: 12/13/2022]
Abstract
The benefits of inspiratory muscle training (IMT) in patients with COPD were reported. However, its effects are limited in severe COPD patients. Further researches are required in new and complementary modalities demonstrating IMT efficacy in severe COPD patients. This study aims to investigate effects of manual therapy (MT) additional over IMT on functional capacity, respiratory muscle strength, pulmonary function, dyspnea, fatigue, and quality of life in severe COPD patients. Sixty patients with COPD in GOLD stage III-IV were included in this prospective single-blind randomized trial. Patients were randomly assigned to receive either MT additional over IMT at 40% of maximal inspiratory pressure (MIP) (n = 30) or only IMT (n = 30) for 12 weeks. MT group received MT during 12 weeks for 30 min additional to IMT. Pulmonary function, respiratory muscle strength, functional capacity, dyspnea, fatigue, and quality of life were evaluated by spirometry, mouth pressure device, six-minute walk test, Modified Medical Research Council (mMRC) dyspnea scale, fatigue severity scale, and St. George's Respiratory Questionnaire (SGRQ), respectively. MT group had significantly greater improvement in FEV1%, FVC%, PEF%, respiratory muscle strength, function, dyspnea, fatigue, and quality of life compared with IMT group (p < 0.05). 6MWT (p < 0.001, effect size Cohen's d: 0.915), MIP (p < 0.001, effect size Cohen's d: 1.235), and mMRC score (p < 0.001, effect size Cohen's d: 0.982) were significantly improved in IMT with MT group. This study demonstrated that subjects in IMT with MT group had improved outcomes in functional capacity, respiratory muscle strength, pulmonary function, dyspnea, fatigue perception, and quality of life compared with alone IMT group.
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Affiliation(s)
- Yasemin Buran Cirak
- Physiotherapy and Rehabilitation Department, Faculty of Health Science, Istinye University, Istanbul, Turkey
| | - Gul Deniz Yilmaz Yelvar
- Physiotherapy and Rehabilitation Department, Faculty of Health Science, Istinye University, Istanbul, Turkey
| | - Nurgül Durustkan Elbasi
- Physiotherapy and Rehabilitation Department, Faculty of Health Science, Istinye University, Istanbul, Turkey
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11
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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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Smith JR, Hirai DM, Copp SW, Ferguson SK, Holdsworth CT, Hageman KS, Poole DC, Musch TI. Exercise training decreases intercostal and transversus abdominis muscle blood flows in heart failure rats during submaximal exercise. Respir Physiol Neurobiol 2021; 292:103710. [PMID: 34091075 DOI: 10.1016/j.resp.2021.103710] [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: 02/25/2021] [Revised: 05/18/2021] [Accepted: 06/02/2021] [Indexed: 11/30/2022]
Abstract
Diaphragm muscle blood flow (BF) and vascular conductance (VC) are elevated with chronic heart failure (HF) during exercise. Exercise training (ExT) elicits beneficial respiratory muscle and pulmonary system adaptations in HF. We hypothesized that diaphragm BF and VC would be lower in HF rats following ExT than their sedentary counterparts (Sed). Respiratory muscle BFs and mean arterial pressure were measured via radiolabeled microspheres and carotid artery catheter, respectively, during submaximal treadmill exercise (20 m/min, 5 % grade). During exercise, no differences were present between HF + ExT and HF + Sed in diaphragm BFs (201 ± 36 vs. 227 ± 44 mL/min/100 g) or VCs (both, p > 0.05). HF + ExT compared to HF + Sed had lower intercostal BF (27 ± 3 vs. 41 ± 5 mL/min/100 g) and VC (0.21 ± 0.02 vs. 0.31 ± 0.04 mL/min/mmHg/100 g) during exercise (both, p < 0.05). Further, HF + ExT compared to HF + Sed had lower transversus abdominis BF (20 ± 1 vs. 35 ± 6 mL/min/100 g) and VC (0.14 ± 0.02 vs. 0.27 ± 0.05 mL/min/mmHg/100 g) during exercise (both, p < 0.05). These data suggest that exercise training lowers the intercostal and transversus abdominis BF responses in HF rats during submaximal treadmill exercise.
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Affiliation(s)
- Joshua R Smith
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States.
| | - Daniel M Hirai
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Steven W Copp
- Department of Kinesiology, Kansas State University, Manhattan, KS, United States
| | - Scott K Ferguson
- Department of Kinesiology and Exercise Sciences, University of Hawaii, Hilo, HI, United States
| | - Clark T Holdsworth
- Department of Kinesiology, Kansas State University, Manhattan, KS, United States; Department of Anatomy and Physiology, Kansas State University, Manhattan, KS, United States
| | - K Sue Hageman
- Department of Anatomy and Physiology, Kansas State University, Manhattan, KS, United States
| | - David C Poole
- Department of Kinesiology, Kansas State University, Manhattan, KS, United States; Department of Anatomy and Physiology, Kansas State University, Manhattan, KS, United States
| | - Timothy I Musch
- Department of Kinesiology, Kansas State University, Manhattan, KS, United States; Department of Anatomy and Physiology, Kansas State University, Manhattan, KS, United States
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Barnes KR, Ludge AR. Inspiratory Muscle Warm-up Improves 3,200-m Running Performance in Distance Runners. J Strength Cond Res 2021; 35:1739-1747. [PMID: 30640308 DOI: 10.1519/jsc.0000000000002974] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Barnes, KR and Ludge, AR. Inspiratory muscle warm-up improves 3,200-m running performance in distance runners. J Strength Cond Res 35(6): 1739-1747, 2021-This study examined the effects of an inspiratory muscle exercise as part of a warm-up (IMW) using a resisted breathing trainer on running performance. In a randomized crossover design, 17 trained distance runners completed two 3,200-m performance trials on separate days, preceded by 2 different warm-up procedures: IMW or sham IMW (CON). In each condition, subjects performed 30 breaths against either 50% of each athlete's peak strength (IMW) or 30 slow protracted breaths against negligible resistance (CON). Perceived race readiness and inspiratory muscle strength, flow, power, and volume were measured before and after each warm-up. Heart rate (HR), rating of perceived exertion (RPE) and dyspnea (RPD), and expired gases were collected during each trial. A 3,200-m run performance was 2.8% ± 1.5% (20.4-second) faster after IMW (effect size [ES] = 0.37, p = 0.02). After each warm-up condition, there was as small effect on peak inspiratory strength (6.6 ± 4.8%, ES = 0.22, p = 0.02), flow (5.2 ± 4.4%, ES = 0.20, p = 0.03), power (17.6 ± 16.7%, ES = 0.22, p = 0.04), and volume (6.7 ± 6.3%, ES = 0.24, p = 0.01) after IMW compared with CON. There were no differences in HR, minute volume, peak V̇o2, or V̇o2 at each 800-m interval between conditions (ES ≤ 0.13, p > 0.17). There were small differences in RPE at 800 m and 1,600 m (ES = 0.32, p = 0.17; ES = 0.21, p = 0.38, respectively), but no difference at the last 1,600 m (p = 1.0). There was a moderate positive effect on RPD (ES = 0.81, p < 0.001) and race readiness (ES = 0.76, p < 0.01) after IMW. Overall, the data suggest that IMW improves 3,200-m performance because of enhancements in inspiratory muscle function characteristics and reduction in dyspnea.
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Affiliation(s)
- Kyle R Barnes
- Department of Movement Science, Grand Valley State University, Allendale, Michigan
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Manifield J, Chynkiamis N, Alexiou C, Megaritis D, Hume E, Barry G, Vogiatzis I. Acute thoracoabdominal and hemodynamic responses to tapered flow resistive loading in healthy adults. Respir Physiol Neurobiol 2021; 286:103617. [PMID: 33454351 DOI: 10.1016/j.resp.2021.103617] [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: 11/10/2020] [Revised: 12/22/2020] [Accepted: 01/01/2021] [Indexed: 11/17/2022]
Abstract
We investigated the acute physiological responses of tapered flow resistive loading (TFRL) at 30, 50 and 70 % maximal inspiratory pressure (PImax) in 12 healthy adults to determine an optimal resistive load. Increased end-inspiratory rib cage and decreased end-expiratory abdominal volumes equally contributed to the expansion of thoracoabdominal tidal volume (captured by optoelectronic plethysmography). A significant decrease in end-expiratory thoracoabdominal volume was observed from 30 to 50 % PImax, from 30 to 70 % PImax, and from 50 to 70 % PImax. Cardiac output (recorded by cardio-impedance) increased from rest by 30 % across the three loading trials. Borg dyspnoea increased from 2.36 ± 0.20 at 30 % PImax, to 3.45 ± 0.21 at 50 % PImax, and 4.91 ± 0.25 at 70 % PImax. End-tidal CO2 decreased from rest during 30, 50 and 70 %PImax (26.23 ± 0.59, 25.87 ± 1.02 and 24.30 ± 0.82 mmHg, respectively). Optimal intensity for TFRL is at 50 % PImax to maximise global respiratory muscle and cardiovascular loading whilst minimising hyperventilation and breathlessness.
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Affiliation(s)
- James Manifield
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK.
| | - Nikolaos Chynkiamis
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Charikleia Alexiou
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Dimitrios Megaritis
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Emily Hume
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Gill Barry
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
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Saher T, Moiz J, Bhati P, Ali M, Talwar D. Effect of inspiratory muscle training in hypercapnic chronic obstructive pulmonary disease patients during acute care: a randomised clinical trial. COMPARATIVE EXERCISE PHYSIOLOGY 2021. [DOI: 10.3920/cep200017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Weakness of respiratory muscles along with respiratory failure is a common finding in chronic obstructive pulmonary disease (COPD) patients which leads to dyspnoea and hence decreased functional capacity. Despite a sound theoretical rationale regarding the potential role of inspiratory muscles, the role of inspiratory muscle training (IMT) along with the conventional non-invasive ventilation (NIV) on important clinical outcomes has not been investigated in these patients during acute care. 34 hypercapnic stable COPD patients were randomly allocated to one of the interventions that lasted for 10 days: IMT with NIV (n=17), and NIV alone (n=17). IMT was administered 2 times in a day (15 min each time) by threshold loading at an intensity starting from 30% and progressed to 60% of their maximal inspiratory effort (PImax). NIV was given at an optimal pressure titrated for each patient for at least >8 h per day. Outcome measures (respiratory muscle strength, respiratory failure, dyspnoea, and functional capacity) were assessed before and after 10 days of intervention. Clinical characteristics and outcome variables of patients were similar between the groups at baseline. Addition of IMT led to a significantly greater increase in respiratory muscle strength (P=0.01), reduction in dyspnea (modified medical research council dyspnea scale, P=0.001); improved outcomes of respiratory failure (PaCO2, P=0.03; PaO2, P=0.002) and improved functional capacity (6 min walk distance, P=0.001) as compared to NIV alone. A short duration IMT program in addition to NIV was found to be effective in improving respiratory muscle strength, perception of dyspnoea, functional capacity and respiratory failure in hypercapnic COPD patients.
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Affiliation(s)
- T. Saher
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, 110025, India
| | - J.A. Moiz
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, 110025, India
| | - P. Bhati
- Faculty of Physiotherapy, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana, 122505, India
| | - M.S. Ali
- Department of Pulmonary Rehabilitation, Metro Centre for Respiratory Diseases, Metro Hospital and Multispecialty Institute, Noida, Uttar Pradesh, 201301, India
| | - D. Talwar
- Department of Pulmonology Allergy Sleep and Critical Care Medicine, Metro Centre for Respiratory Diseases, Metro Hospital and Multispecialty Institute, Noida, Uttar Pradesh, 201301, India
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Influence of Inspiratory Muscle Training of Various Intensities on the Physical Performance of Long-Distance Runners. J Hum Kinet 2020; 75:127-137. [PMID: 33312301 PMCID: PMC7706668 DOI: 10.2478/hukin-2020-0031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to assess the efficacy of inspiratory muscle training (IMT) at different intensities on the pulmonary function and physiological adaptations of long-distance runners undergoing sports training. This study involved 25 long-distance runners. The subjects were randomly divided into three groups depending on the type of IMT applied: POWERbreathe device (group 1), Threshold IMT device (group 2), and a control group. The following lung variables were evaluated: vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF). Respiratory muscle strength was assessed by maximum inspiratory pressure (PImax) and maximum expiratory pressure (PEmax). Spiroergometric measures included: heart rate (HR), oxygen uptake (VO2max), carbon dioxide production (VCO2max), maximum ventilation (VE) and respiratory exchange rate (RER), which were measured breath by breath using a gas analyser (VYNTUS CPX). Group 1, which used the POWERbreathe device, showed significant increases in all assessed physiological and physical performance variables. In group 2, which used the Threshold device, only VO2max, VE and tRER ventilation were significantly increased to a similar level as that observed in group 1. In the control group, we only observed a significant reduction in saturation. The use of IMT with a higher intensity resulted in significant improvements in all tested variables of lung ventilation and respiratory muscle strength. Also, after training, lactate accumulation was significantly decreased. Physiological characteristics (VO2max/kg) and muscle respiratory strength variables were significantly improved in the group that used the POWERbreathe device after 8 weeks of training.
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Stutz J, Oliveras R, Eiholzer R, Spengler CM. No Decrease in Blood Pressure After an Acute Bout of Intermittent Hyperpnea and Hypoxia in Prehypertensive Elderly. Front Physiol 2020; 11:556220. [PMID: 33123023 PMCID: PMC7566905 DOI: 10.3389/fphys.2020.556220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/08/2020] [Indexed: 11/15/2022] Open
Abstract
Prevalence of hypertension, subjective sleep complaints and snoring increases with age. Worse sleep and snoring, in turn, are independent risk factors to develop hypertension. Both respiratory muscle training (RMT) and intermittent hypoxia (IH) are suggested to have positive effects on these physiological and behavioral variables. This study therefore aimed to test the acute effects of a single bout of RMT, with and without IH, on resting blood pressure (BP) and sleep. Fourteen prehypertensive elderly performed a 60-min session of (a) intermittent voluntary normocapnic hyperpnea (HYP) alone, (b) HYP in combination with IH (HYP&IH) and (c) a sham intervention in randomized order. BP, hemodynamics, heart rate variability (HRV), cardiac baroreflex sensitivity (BRS) and pulse wave velocity (PWV) were assessed before and 15, 30 and 45 min after each intervention. Variables of sleep were assessed with actigraphy, pulse oximetry and with questionnaires during and after the night following each intervention. Neither HYP nor HYP&IH resulted in a decrease in BP. Repeated measures ANOVA revealed no significant interaction effect for systolic BP (p = 0.090), diastolic BP (p = 0.151), HRV parameters, BRS and PWV (all p > 0.095). Fragmentation index was lower after both HYP (−6.5 units) and HYP&IH (−8.4 units) compared to sham, p(ANOVA) = 0.046, although pairwise comparisons reveal no significant differences. There were no other significant effects for the remaining sleep variables. We conclude that one bout of intermittent hyperpnea, alone or in combination with IH, is not effective in lowering blood pressure or improving sleep in prehypertensive elderly.
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Affiliation(s)
- Jan Stutz
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zürich, Zurich, Switzerland
| | - Ruben Oliveras
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zürich, Zurich, Switzerland
| | - Remo Eiholzer
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zürich, Zurich, Switzerland
| | - Christina M Spengler
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zürich, Zurich, Switzerland
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Elnaggar RK. A randomized placebo-controlled study investigating the efficacy of inspiratory muscle training in the treatment of children with bronchial asthma. J Asthma 2020; 58:1661-1669. [PMID: 32900246 DOI: 10.1080/02770903.2020.1821058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the efficacy of inspiratory muscle training (IMT) on respiratory functions, respiratory muscle strength, and asthma symptoms in asthmatic children. METHODS In a randomized placebo-controlled assessor-blinded study, 34 children with asthma were randomized to receive either the IMT at 40% of the maximal inspiratory pressure (IPmax) for 20 min/session, thrice/week, over 12 consecutive weeks (IMT group; n = 17) or placebo IMT at 5% of IPmax (placebo group; n = 17). Additionally, both groups received the conventional respiratory rehabilitation (CRR) program. Outcome measurements performed pre- and post-treatment, included respiratory functions [forced expiratory volume at the first second (FEV1), forced vital capacity (FEV), and FEV1/FVC], respiratory muscle strength [represented by IPmax and maximal expiratory pressure (EPmax), and asthma control test (ACT). RESULTS At a significance level adjusted to P<.008, there were significant post-treatment differences between the IMT and placebo groups in FEV1 (P=.003), FVC (P=.001), FEV1/FVC (P=.004), IPmax (P=.002), EPmax (P=.004), and ACT (P=.001) adjusted to the pretreatment values, in favor of the IMT group. CONCLUSION Incorporation of IMT in the CRR program for children with asthma can improve respiratory function, enhance respiratory muscle strength, and improve children's perception of asthma symptoms.
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Affiliation(s)
- Ragab K Elnaggar
- Department of Physical Therapy and Health Rehabilitation, Collage of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.,Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Ramos I, Barreira S, Viana R. Inspiratory muscle training on lung function of male roller hockey players: a randomized controlled trial pilot study. Porto Biomed J 2020; 5:e075. [PMID: 33195868 PMCID: PMC7657574 DOI: 10.1097/j.pbj.0000000000000075] [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: 05/18/2020] [Accepted: 05/27/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is evidence that inspiratory muscle training (IMT) increases the athlete's performance by decreasing the work of the respiratory muscles during exercise. IMT has shown positive results in the pulmonary function of athletes, and it was hypothesized that 4 weeks of intervention could increase lung function at rest. Investigate the influence of IMT on lung function of male roller hockey players. METHODS Eleven male roller hockey players were randomized and allocated in the experimental group (EG) or control group (CG). Forced expiratory volume in first second, forced vital capacity, and peak expiratory flow (PEF) were assessed with spirometry, in the beginning of the study and 4 weeks later. The EG (n = 6) was submitted to an IMT using a threshold during 4 weeks, 3 times a week, 30 repetitions with 50% of maximal inspiratory pressure. The CG (n = 5) was not submitted to any intervention. RESULTS Baseline pulmonary variables, forced expiratory volume in first second, forced vital capacity, and PEF, sociodemographic, and anthropometric characteristics were not significantly different among EG and CG. Significant increase on PEF (P = .033) was found in the EG after IMT. CONCLUSION IMT with threshold seems to have a positive impact on PEF in roller hockey players. These findings may be corroborated by further controlled randomized studies.
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Affiliation(s)
- Inês Ramos
- Faculty of Health Sciences, Fernando Pessoa University
| | - Sérgio Barreira
- FP-ENAS (UFP Energy, Environment and Health Research Unit), Faculty of Health Sciences, Fernando Pessoa University
| | - Rui Viana
- Faculty of Health Sciences, Fernando Pessoa University
- Physical Medicine and Rehabilitation Department, Centro Hospitalar São João EPE, Porto, Portugal
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Szczepan S, Danek N, Michalik K, Wróblewska Z, Zatoń K. Influence of a Six-Week Swimming Training with Added Respiratory Dead Space on Respiratory Muscle Strength and Pulmonary Function in Recreational Swimmers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5743. [PMID: 32784446 PMCID: PMC7459907 DOI: 10.3390/ijerph17165743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 12/21/2022]
Abstract
The avoidance of respiratory muscle fatigue and its repercussions may play an important role in swimmers' health and physical performance. Thus, the aim of this study was to investigate whether a six-week moderate-intensity swimming intervention with added respiratory dead space (ARDS) resulted in any differences in respiratory muscle variables and pulmonary function in recreational swimmers. A sample of 22 individuals (recreational swimmers) were divided into an experimental (E) and a control (C) group, observed for maximal oxygen uptake (VO2max). The intervention involved 50 min of front crawl swimming performed at 60% VO2max twice weekly for six weeks. Added respiratory dead space was induced via tube breathing (1000 mL) in group E during each intervention session. Respiratory muscle strength variables and pulmonary and respiratory variables were measured before and after the intervention. The training did not increase the inspiratory or expiratory muscle strength or improve spirometric parameters in any group. Only in group E, maximal tidal volume increased by 6.3% (p = 0.01). The ARDS volume of 1000 mL with the diameter of 2.5 cm applied in moderate-intensity swimming training constituted too weak a stimulus to develop respiratory muscles and lung function measured in the spirometry test.
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Affiliation(s)
- Stefan Szczepan
- Department of Swimming, Faculty of Physical Education, University School of Physical Education in Wroclaw, Ignacego Jana Paderewskiego 35, Swimming Pool, 51-612 Wroclaw, Poland;
| | - Natalia Danek
- Department of Physiology and Biochemistry, Faculty of Physical Education, University School of Physical Education in Wroclaw, Ignacego Jana Paderewskiego 35, P-3 Building, 51-612 Wroclaw, Poland; (N.D.); (K.M.)
| | - Kamil Michalik
- Department of Physiology and Biochemistry, Faculty of Physical Education, University School of Physical Education in Wroclaw, Ignacego Jana Paderewskiego 35, P-3 Building, 51-612 Wroclaw, Poland; (N.D.); (K.M.)
| | - Zofia Wróblewska
- Faculty of Pure and Applied Mathematics, Wroclaw University of Science and Technology, Zygmunta Janiszewskiego 14a, C-11 Building, 50-372 Wroclaw, Poland;
| | - Krystyna Zatoń
- Department of Swimming, Faculty of Physical Education, University School of Physical Education in Wroclaw, Ignacego Jana Paderewskiego 35, Swimming Pool, 51-612 Wroclaw, Poland;
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Lomax M, Kapus J, Brown PI, Faghy M. Impact of Weekly Swimming Training Distance on the Ergogenicity of Inspiratory Muscle Training in Well-Trained Youth Swimmers. J Strength Cond Res 2019; 33:2185-2193. [PMID: 31344014 DOI: 10.1519/jsc.0000000000002375] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Lomax, M, Kapus, J, Brown, PI, and Faghy, M. Impact of weekly swimming training distance on the ergogenicity of inspiratory muscle training in well-trained youth swimmers. J Strength Cond Res 33(8): 2185-2193, 2019-The aim of this study was to examine the impact of weekly swimming training distance on the ergogenicity of inspiratory muscle training (IMT). Thirty-three youth swimmers were recruited and separated into a LOW and HIGH group based on weekly training distance (≤31 km·wk and >41 km·wk, respectively). The LOW and HIGH groups were further subdivided into control and IMT groups for a 6-week IMT intervention giving a total of 4 groups: LOWcon, LOWIMT, HIGHcon, and HIGHIMT. Before and after the intervention period, swimmers completed maximal effort 100- and 200-m front crawl swims, with maximal inspiratory and expiratory mouth pressures (PImax and PEmax, respectively) assessed before and after each swim. Inspiratory muscle training increased PImax (but not PEmax) by 36% in LOWIMT and HIGHIMT groups (p ≤ 0.05), but 100- and 200-m swims were faster only in the LOWIMT group (3 and 7% respectively, p ≤ 0.05). Performance benefits only occurred in those training up to 31 km·wk and indicate that the ergogenicity of IMT is affected by weekly training distance. Consequently, training distances are important considerations, among others, when deciding whether or not to supplement swimming training with IMT.
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Affiliation(s)
- Mitch Lomax
- Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Jernej Kapus
- Laboratory of Biodynamics, Faculty of Sports, University of Ljubljana, Ljubljana, Slovenia
| | - Peter I Brown
- English Institute of Sport, Loughborough Performance Center, Loughborough University, Loughborough, United Kingdom
| | - Mark Faghy
- Sport, Outdoor and Exercise Science, University of Derby, Derby, United Kingdom
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Rodriguez RF, Townsend NE, Aughey RJ, Billaut F. Respiratory muscle oxygenation is not impacted by hypoxia during repeated-sprint exercise. Respir Physiol Neurobiol 2018; 260:114-121. [PMID: 30453086 DOI: 10.1016/j.resp.2018.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 11/04/2018] [Accepted: 11/16/2018] [Indexed: 11/16/2022]
Abstract
This study aimed to investigate whether exercise hyperpnoea contributes to an impairment of locomotor muscle oxygenation and performance during repeated-sprint exercise in normoxia and hypoxia. Subjects performed ten 10-s sprints, separated by 30 s of passive rest while breathing either a normoxic (21% O2) or hypoxic (15% O2) gas mixture. Muscle oxygenation of the vastus lateralis and intercostal muscles was examined with near-infrared spectroscopy. Sprint and recovery vastus lateralis deoxyhaemoglobin was elevated in hypoxia by 9.2% (90% confidence interval 0.2 to 18.0) and 14.1% (90% CL 4.9 to 23.3%) compared to normoxia, respectively. There were no clear differences in respiratory muscle deoxyhaemoglobin (-0.1%, 90% CL -2.9 to 0.9%) or oxyhaemoglobin (0.9%, 90% CL -0.8 to 2.6%) between conditions. Maintenance of respiratory muscle oxygenation may contribute to the rise of vastus lateralis deoxyhaemoglobin in hypoxia during intermittent sprint cycling. This manuscript presents data which extends the fact that oxygen competition could be a limiting factor of exercise capacity.
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Affiliation(s)
- Ramón F Rodriguez
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia.
| | | | - Robert J Aughey
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia.
| | - François Billaut
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia; Département de kinésiologie, Université Laval, Québec, QC, Canada.
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Shei RJ. Recent Advancements in Our Understanding of the Ergogenic Effect of Respiratory Muscle Training in Healthy Humans: A Systematic Review. J Strength Cond Res 2018; 32:2665-2676. [PMID: 29985221 PMCID: PMC6105530 DOI: 10.1519/jsc.0000000000002730] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Shei, R-J. Recent advancements in our understanding of the ergogenic effect of respiratory muscle training in healthy humans: a systematic review. J Strength Cond Res 32(9): 2674-2685, 2018-Respiratory muscle training (RMT) has been shown to be an effective ergogenic aid for sport performance. Respiratory muscle training has been documented to improve performance in a wide range of exercise modalities including running, cycling, swimming, and rowing. The physiological effects of RMT that may explain the improvements in performance have been proposed to include diaphragm hypertrophy, muscle fiber-type switching, improved neural control of the respiratory muscles, increased respiratory muscle economy, attenuation of the respiratory muscle metaboreflex, and decreases in perceived breathlessness and exertion. This review summarizes recent studies on the ergogenicity and mechanisms of RMT since 2013 when the topic was last systematically reviewed. Recent evidence confirms the ergogenic effects of RMT and explores different loading protocols, such as concurrent exercise and RMT (i.e., "functional" RMT). These studies suggest that adapting new training protocols may have an additive improvement effect, but evidence of the efficacy of such an approach is conflicting thus far. Other recent investigations have furthered our understanding of the mechanisms underpinning RMT-associated improvements in performance. Importantly, changes in ventilatory efficiency, oxygen delivery, cytokine release, motor recruitment patterns, and respiratory muscle fatigue resistance are highlighted as potential mechanistic factors linking RMT with performance improvements. It is suggested that future investigations focus on development of sport-specific RMT loading protocols, and that further work be undertaken to better understand the mechanistic basis of RMT-induced performance improvements.
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Affiliation(s)
- Ren-Jay Shei
- Division of Pulmonary, Allergy, and Critical Care Medicine, and Gregory Fleming James Cystic Fibrosis Research Center, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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Inspiratory muscle training improves physical performance and cardiac autonomic modulation in older women. Eur J Appl Physiol 2018; 118:1143-1152. [PMID: 29549494 DOI: 10.1007/s00421-018-3844-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 03/08/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Aging impairs the autonomic balance reducing the vagal and increasing the sympathetic components of heart rate variability (HRV) and this could be associated with a decline in physical capacity. Inspiratory muscle training (IMT) is a possible tool to attenuate this physical capacity decline in older women. The aim of this study was to investigate the influence of IMT in the older women on physical capacity and autonomic cardiac modulation at rest and post exercise. METHODS 20 female participants 60-72 years old were randomly allocated in two groups. One group underwent IMT set at 50% of maximum inspiratory pressure (MIP), every day for 4 weeks (IMT-group). The placebo group performed the same training procedure but with a minimal resistance (5% MIP; PLA-group). Every week, the IMT load was readjusted and the HRV evaluated at rest. The six-minute walk test (6MWT) was performed once pre and post IMT-intervention. The IMT-group and PLA-group performed the same test and intervention procedures. RESULTS After a 5 weeks intervention, the MIP had significantly improved in the IMT-group but not in the PLA-group (p < 0.01; es = 1.17). The high frequency power of the HRV spectrum had already improved by the second week (p < 0.01; es = 1.13) and remained elevated until the last week of intervention (p < 0.01; es = 1.43). The same positive results were described in 6MWT distance (p = 0.04; es = 0.39) and the change (∆) of heart rate recovery (HRR) from 1 min (p = 0.02; es = 0.68). CONCLUSION IMT increases HRV, improves 6MWT distance and HRR.
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Shei R, Chapman RF, Gruber AH, Mickleborough TD. Inspiratory muscle training improves exercise capacity with thoracic load carriage. Physiol Rep 2018; 6:e13558. [PMID: 29424007 PMCID: PMC5805854 DOI: 10.14814/phy2.13558] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/05/2017] [Accepted: 12/07/2017] [Indexed: 11/24/2022] Open
Abstract
Thoracic load carriage (LC) exercise impairs exercise performance compared to unloaded exercise, partially due to impaired respiratory mechanics. We investigated the effects of LC on exercise and diaphragmatic fatigue in a constant-load exercise task; and whether inspiratory muscle training (IMT) improved exercise capacity and diaphragmatic fatigue with LC. Twelve recreationally active males completed three separate running trials to exhaustion (Tlim ) at a fixed speed eliciting 70% of their V˙O2max . The first two trials were completed either unloaded (UL) or while carrying a 10 kg backpack (LC). Subjects then completed 6 weeks of either true IMT or placebo-IMT. Posttraining, subjects completed an additional LC trial identical to the pretraining LC trial. Exercise metabolic and ventilatory measures were recorded. Diaphragm fatigue was assessed as the difference between preexercise and postexercise twitch diaphragmatic pressure (Pdi, tw ), assessed by bilateral stimulation of the phrenic nerve with esophageal balloon-tipped catheters measuring intrathoracic pressures. Tlim was significantly shorter (P < 0.001) with LC compared with UL by 42.9 (29.1)% (1626.5 (866.7) sec and 2311.6 (1246.5) sec, respectively). The change in Pdi, tw from pre- to postexercise was significantly greater (P = 0.001) in LC (-13.9 (5.3)%) compared with UL (3.8 (6.5)%). Six weeks of IMT significantly improved Tlim compared to pretraining (P = 0.029, %Δ +29.3 (15.7)% IMT, -8.8 (27.2)% Placebo), but did not alter the magnitude of diaphragmatic fatigue following a run to exhaustion (P > 0.05). Minute ventilation and breathing mechanics were unchanged post-IMT (P > 0.05). Six weeks of flow-resistive IMT improved exercise capacity, but did not mitigate diaphragmatic fatigue following submaximal, constant-load running to volitional exhaustion with LC.
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Affiliation(s)
- Ren‐Jay Shei
- Division of Pulmonary, Allergy, and Critical Care MedicineDepartment of MedicineUniversity of Alabama at BirminghamBirminghamAlabama
- Department of KinesiologySchool of Public Health‐BloomingtonIndiana UniversityBloomingtonIndiana
| | - Robert F. Chapman
- Department of KinesiologySchool of Public Health‐BloomingtonIndiana UniversityBloomingtonIndiana
| | - Allison H. Gruber
- Department of KinesiologySchool of Public Health‐BloomingtonIndiana UniversityBloomingtonIndiana
| | - Timothy D. Mickleborough
- Department of KinesiologySchool of Public Health‐BloomingtonIndiana UniversityBloomingtonIndiana
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Kim DS, Jeon BH. Effects of 8 Weeks of Inspiratory Muscle Training on Pulmonary Function and Maximum Inspiratory Pressure and Skill-related Physical Fitness in Women. THE ASIAN JOURNAL OF KINESIOLOGY 2018. [DOI: 10.15758/ajk.2018.20.1.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Respiratory Effects of Thoracic Load Carriage Exercise and Inspiratory Muscle Training as a Strategy to Optimize Respiratory Muscle Performance with Load Carriage. ACTA ACUST UNITED AC 2017; 5:49-64. [PMID: 29630067 DOI: 10.1007/s40362-017-0046-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Many occupational and recreational settings require the use of protective and/or load-bearing apparatuses worn over the thoracic cavity, known as thoracic load carriage (LC). Compared to normal, unloaded exercise, thoracic LC exercise places an additional demand on the respiratory and limb locomotor systems by altering ventilatory mechanics as well as circulatory responses to exercise, thus accelerating the development of fatigue in the diaphragm and accessory respiratory muscles compared to unloaded exercise. This may be a consequence of the unique demands of thoracic LC, which places an additional mass load on the thoracic cavity and can restrict chest wall expansion. Therefore it is important to find effective strategies to ameliorate the detrimental effects of thoracic LC. Inspiratory muscle training is an intervention that aims to increase the strength and endurance of the diaphragm and accessory inspiratory muscle and may therefore be a useful strategy to optimize performance with thoracic LC.
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Salvadego D, Sartorio A, Agosti F, Tringali G, Patrizi A, Isola M, LoMauro A, Aliverti A, Grassi B. Respiratory muscle endurance training reduces the O2 cost of cycling and perceived exertion in obese adolescents. Am J Physiol Regul Integr Comp Physiol 2017; 313:R487-R495. [DOI: 10.1152/ajpregu.00396.2016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 07/17/2017] [Accepted: 07/17/2017] [Indexed: 11/22/2022]
Abstract
In obesity, the increased O2 cost of breathing negatively affects the O2 cost of exercise and exercise tolerance. The purpose of the study was to determine whether, in obese adolescents, the addition of respiratory muscle endurance training (RMET) (isocapnic hyperpnea) to a standard body mass reduction program decreases the O2 cost of exercise and perceived exertion. Nine male obese adolescents [16.0 ± 1.4 yr ( x ± SD), body mass 114.4 ± 22.3 kg] underwent 3 wk of RMET (5 days/week) in addition to a standard body mass reduction program. Eight age- and sex-matched obese adolescents underwent only the standard program (CTRL). Before and after interventions, patients performed on a cycle ergometer: incremental exercise; 12-min exercises at a constant work rate (CWR) of 65% and 120% at the gas exchange threshold (GET) determined before the intervention. Breath-by-breath pulmonary ventilation (V̇e) and O2 uptake (V̇o2), heart rate (HR), and ratings of perceived exertion for dyspnea/respiratory discomfort (RPER) and leg effort (RPEL) were determined. Body mass decreased (by ~3.0 kg) after both RMET ( P = 0.003) and CTRL ( P = 0.002). Peak V̇o2 was not affected by both interventions. Peak work rate was slightly, but significantly ( P = 0.04), greater after RMET but not after CTRL. During CWR < GET, no changes were observed after both interventions. During CWR > GET, the O2 cost of cycling at the end of exercise ( P = 0.02), the slope of V̇o2 vs. time (3–12 min) ( P = 0.01), RPER ( P = 0.01), and RPEL ( P = 0.01) decreased following RMET, but not following CTRL. HR decreased after both RMET ( P = 0.02) and CTRL ( P = 0.03), whereas V̇e did not change. In obese adolescents RMET, superimposed on a standard body mass reduction program, lowered the O2 cost of cycling and perceived exertion during constant heavy-intensity exercise.
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Affiliation(s)
- Desy Salvadego
- Department of Medicine, University of Udine, Udine, Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Division of Metabolic Diseases and Auxology, Piancavallo, Italy
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Milan and Piancavallo, Italy
| | - Fiorenza Agosti
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Milan and Piancavallo, Italy
| | - Gabriella Tringali
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Milan and Piancavallo, Italy
| | - Alessandra Patrizi
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, Milan and Piancavallo, Italy
| | - Miriam Isola
- Department of Medicine, University of Udine, Udine, Italy
| | - Antonella LoMauro
- Department of Electronics, Information and Bioengineering, Politecnico, Milan, Italy; and
| | - Andrea Aliverti
- Department of Electronics, Information and Bioengineering, Politecnico, Milan, Italy; and
| | - Bruno Grassi
- Department of Medicine, University of Udine, Udine, Italy
- Institute of Bioimaging and Molecular Physiology, National Research Council, Milan, Italy
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Leelarungrayub J, Pinkaew D, Yankai A, Chautrakoon B, Kuntain R. Simple artificial training device for respiratory muscle strength and lung volumes in healthy young male and female subjects: A pilot study. J Bodyw Mov Ther 2017; 21:995-1002. [DOI: 10.1016/j.jbmt.2016.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 11/16/2016] [Accepted: 11/23/2016] [Indexed: 11/28/2022]
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Chuang HY, Chang HY, Fang YY, Guo SE. The effects of threshold inspiratory muscle training in patients with chronic obstructive pulmonary disease: A randomised experimental study. J Clin Nurs 2017; 26:4830-4838. [PMID: 28382660 DOI: 10.1111/jocn.13841] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To investigate the effects of threshold inspiratory muscle training in patients with stages II through IV chronic obstructive pulmonary disease using maximum inspiratory pressure, baseline dyspnoea index, 6-minute walk test and quality of life. BACKGROUND A threshold inspiratory muscle training device provides pressure for inspiratory muscle strength, but there is limited information on the effects of threshold inspiratory muscle training starting at low pressure training. DESIGN Randomised experimental design. METHODS A total of 55 patients completed this study between September 2013-April 2014. The experimental group (n = 27) was provided medical treatment and routine care, along with five sessions of threshold inspiratory muscle training per week (21-30 min per session), accompanied by a progressive increase in the pressure threshold over a period of 8 weeks. The control group (n = 28) was provided medical treatment and routine care only, without intervention. In the inferential analysis, p values <.05 were considered to indicate statistical significance. RESULTS After 8 weeks in the experimental group, mean maximum inspiratory pressure improved by -17.6 ± 0.18 cmH2 O, mean 6-minute walk test improved by 47.8 ± 1.46 m, and the baseline dyspnoea index increased from 4.48 ± 2.12 points to 9.0 ± 2.27 points. These data and quality of life were statistically different between the experimental and the control groups (p < .05). CONCLUSIONS The threshold inspiratory muscle training can reduce patients' difficulties with respect to daily activities, thereby reducing the burden on the family, and improving prognosis in patients with moderate-to-very severe chronic obstructive pulmonary disease.
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Affiliation(s)
| | - Hsiao-Yun Chang
- Department of Nursing, Fooyin University, Kaohsiung City, Taiwan
| | - Yueh-Yen Fang
- Department of Nursing, Fooyin University, Kaohsiung City, Taiwan
| | - Su-Er Guo
- Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology (CGUST), Pu-tz, Taiwan.,Chronic Diseases and Health Promotion Research Center, CGUST, Pu-tz, Taiwan
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Wong ML, Anderson RG, Garcia K, Housmann EM, McHale E, Goldberger GS, Cahalin LP. The effect of inspiratory muscle training on respiratory variables in a patient with ankylosing spondylitis: A case report. Physiother Theory Pract 2017; 33:805-814. [PMID: 28715240 DOI: 10.1080/09593985.2017.1346023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Ankylosing Spondylitis (AS) presents with both musculoskeletal and cardiorespiratory pathophysiological manifestations. Inspiratory muscle training (IMT) may be a useful intervention to address deficits in respiratory and functional status. CASE DESCRIPTION A 25-year-old male with AS initially sought treatment for low back and right hip pain, but 7 weeks of IMT was also provided due to abnormal respiratory performance. OUTCOMES At baseline, the patient presented with a resting respiratory rate (RR) of 14.5 breaths/minute, tidal volume (TV) of 0.76 L, minute ventilation (VE) of 10.87 L/min, and end tidal CO2 (PetCO2) of 30.56 mmHg. Baseline exercise test results revealed a VO2max of 44 ml/kg/min and VE to CO2 output (VE/VCO2) slope of 30. Baseline MIP, SMIP, and MEP were 54 cm H2O, 507 PTU, and 87 cm H2O, respectively, and increased to 176 cm H2O, 807 PTU, and 151 cm H2O, respectively, after IMT. The VO2max increased to 51 ml/kg/min with decreases in the VE/VCO2 slope (29), resting RR (12 breaths/minute), resting TV (0.52 L), and resting VE (6.83 L/min) after IMT. Improvements during postural challenges were also observed. DISCUSSION This case demonstrates the clinical utility of respiratory gas analysis and respiratory performance measures to identify functional deficits and manage a patient with AS. The improvements in respiratory performance at rest, during postural challenges, and during maximal exercise after a relatively short period of IMT highlights the role IMT may have to improve functional status in patients with AS. Further investigation of IMT in patients with AS is warranted.
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Affiliation(s)
- Marlon L Wong
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Rachael G Anderson
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Kelsey Garcia
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Elissa M Housmann
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Erin McHale
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Gregory S Goldberger
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
| | - Lawrence P Cahalin
- a Department of Physical Therapy , Leonard M. Miller School of Medicine, University of Miami , Miami , FL , USA
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Leelarungrayub J, Pinkaew D, Puntumetakul R, Klaphajone J. Effects of a simple prototype respiratory muscle trainer on respiratory muscle strength, quality of life and dyspnea, and oxidative stress in COPD patients: a preliminary study. Int J Chron Obstruct Pulmon Dis 2017; 12:1415-1425. [PMID: 28553094 PMCID: PMC5440008 DOI: 10.2147/copd.s131062] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background The aim of this study was to evaluate the efficiency of a simple prototype device for training respiratory muscles in lung function, respiratory muscle strength, walking capacity, quality of life (QOL), dyspnea, and oxidative stress in patients with COPD. Methods Thirty COPD patients with moderate severity of the disease were randomized into three groups: control (n=10, 6 males and 4 females), standard training (n=10, 4 males and 6 females), and prototype device (n=10, 5 males and 5 females). Respiratory muscle strength (maximal inspiratory pressure [PImax] and maximal expiratory pressure [PEmax]), lung function (forced vital capacity [FVC], percentage of FVC, forced expiratory volume in 1 second [FEV1], percentage of FEV1 [FEV1%], and FEV1/FVC), 6-minute walking distance (6MWD), QOL, and oxidative stress markers (total antioxidant capacity [TAC]), glutathione (GSH), malondialdehyde (MDA), and nitric oxide (NO) were evaluated before and after 6 weeks of training. Moreover, dyspnea scores were assessed before; during week 2, 4, and 6 of training; and at rest after training. Results All parameters between the groups had no statistical difference before training, and no statistical change in the control group after week 6. FVC, FEV1/FVC, PImax, PEmax, QOL, MDA, and NO showed significant changes after 6 weeks of training with either the standard or prototype device, compared to pre-training. FEV1, FEV1%, 6MWD, TAC, and GSH data did not change statistically. Furthermore, the results of significant changes in all parameters were not statistically different between training groups using the standard and prototype device. The peak dyspnea scores increased significantly in week 4 and 6 when applying the standard or prototype device, and then lowered significantly at rest after 6 weeks of training, compared to pre-training. Conclusion This study proposes that a simple prototype device can be used clinically in COPD patients as a standard device to train respiratory muscles, improving lung function and QOL, as well as involving MDA and NO levels.
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Affiliation(s)
- Jirakrit Leelarungrayub
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai
| | - Decha Pinkaew
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai
| | - Rungthip Puntumetakul
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen
| | - Jakkrit Klaphajone
- Department of Rehabilitation Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Schenk P, Eber E, Funk GC, Fritz W, Hartl S, Heininger P, Kink E, Kühteubl G, Oberwaldner B, Pachernigg U, Pfleger A, Schandl P, Schmidt I, Stein M. [Non-invasive and invasive out of hospital ventilation in chronic respiratory failure : Consensus report of the working group on ventilation and intensive care medicine of the Austrian Society of Pneumology]. Wien Klin Wochenschr 2016; 128 Suppl 1:S1-36. [PMID: 26837865 DOI: 10.1007/s00508-015-0899-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The current consensus report was compiled under the patronage of the Austrian Society of Pneumology (Österreichischen Gesellschaft für Pneumologie, ÖGP) with the intention of providing practical guidelines for out-of-hospital ventilation that are in accordance with specific Austrian framework parameters and legal foundations. The guidelines are oriented toward a 2004 consensus ÖGP recommendation concerning the setup of long-term ventilated patients and the 2010 German Respiratory Society S2 guidelines on noninvasive and invasive ventilation of chronic respiratory insufficiency, adapted to national experiences and updated according to recent literature. In 11 chapters, the initiation, adjustment, and monitoring of out-of-hospital ventilation is described, as is the technical equipment and airway access. Additionally, the different indications-such as chronic obstructive pulmonary diseases, thoracic restrictive and neuromuscular diseases, obesity hypoventilation syndrome, and pediatric diseases-are discussed. Furthermore, the respiratory physiotherapy of adults and children on invasive and noninvasive long-term ventilation is addressed in detail.
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Affiliation(s)
- Peter Schenk
- Abteilung für Pulmologie, Landesklinikum Hochegg, Hocheggerstraße 88, 2840, Grimmenstein, Österreich.
| | - Ernst Eber
- Klinische Abteilung für Pädiatrische Pulmonologie und Allergologie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Graz, Österreich
| | - Georg-Christian Funk
- I. Interne Lungenabteilung, Pulmologisches Zentrum, Sozialmedizinisches Zentrum Baumgartner Höhe, Otto Wagner Spital, Wien, Österreich
| | - Wilfried Fritz
- Klinische Abteilung für Lungenkrankheiten, Universitätsklinik für Innere Medizin, Universitätsklinikum Graz, Graz, Österreich
| | - Sylvia Hartl
- I. Interne Lungenabteilung, Pulmologisches Zentrum, Sozialmedizinisches Zentrum Baumgartner Höhe, Otto Wagner Spital, Wien, Österreich
| | | | - Eveline Kink
- Abteilung für Lungenkrankheiten, Landeskrankenhaus Hörgas-Enzenbach, Eisbach, Österreich
| | - Gernot Kühteubl
- Abteilung für Pulmologie, Landesklinikum Hochegg, Hocheggerstraße 88, 2840, Grimmenstein, Österreich
| | | | - Ulrike Pachernigg
- Klinische Abteilung für Pädiatrische Pulmonologie und Allergologie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Graz, Österreich
| | - Andreas Pfleger
- Klinische Abteilung für Pädiatrische Pulmonologie und Allergologie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Graz, Österreich
| | - Petra Schandl
- 1. Allgemeine Intensivstation, Wilhelminenspital, Wien, Österreich
| | - Ingrid Schmidt
- I. Interne Lungenabteilung, Pulmologisches Zentrum, Sozialmedizinisches Zentrum Baumgartner Höhe, Otto Wagner Spital, Wien, Österreich
| | - Markus Stein
- Abteilung für Pneumologie, Landeskrankenhaus Hochzirl-Natters, Standort Natters, Natters, Österreich
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Nepomuceno Júnior BRV, Gómez TB, Gomes Neto M. Use of Powerbreathe® in inspiratory muscle training for athletes: systematic review. FISIOTERAPIA EM MOVIMENTO 2016. [DOI: 10.1590/1980-5918.029.004.ao19] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: Inspiratory muscle training (IMT) has been used as part of athletic training. It is beneficial due to an increase in respiratory capacity, and can be related to the optimization of exercise tolerance. There are a growing number of publications on the subject, however the methodological rigor of these publications is still unknown. Objective: To perform a systematic literature review in order to analyze the effects of Powerbreathe® on inspiratory muscle training by athletes. Methods: Original scientific studies published in English, from 2000 to 2015, were included. Their typology was classified. The literature search was performed in the Lilacs, Medline, Pubmed, and Scielo databases using the following keywords: inspiratory muscle training, athletes, and Sports medicine (in English), treinamento muscular inspiratório, atleta, medicina esportiva (in Portuguese). Results: Inspiratory muscle training with specific linear resistance has been used in some athletic training, and its results are promising. However, its application is still recent and generally supported by experiments with limited population and which do not properly define the confounding factors for the results. Conclusion: The state of the art suggests that IMT is useful as a respiratory therapy supporting the training of athletes for some specific sports. However, there is a scarcity of studies of high methodological quality, thus requiring further experiments on the subject.
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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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Boone J, Vandekerckhove K, Coomans I, Prieur F, Bourgois JG. An integrated view on the oxygenation responses to incremental exercise at the brain, the locomotor and respiratory muscles. Eur J Appl Physiol 2016; 116:2085-2102. [PMID: 27613650 DOI: 10.1007/s00421-016-3468-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 08/31/2016] [Indexed: 12/26/2022]
Abstract
In the past two decades oxygenation responses to incremental ramp exercise, measured non-invasively by means of near-infrared spectroscopy at different locations in the body, have advanced the insights on the underpinning mechanisms of the whole-body pulmonary oxygen uptake ([Formula: see text]) response. In healthy subjects the complex oxygenation responses at the level of locomotor and respiratory muscles, and brain were simplified and quantified by the detection of breakpoints as a deviation in the ongoing response pattern as work rate increases. These breakpoints were located in a narrow intensity range between 75 and 90 % of the maximal [Formula: see text] and were closely related to traditionally determined thresholds in pulmonary gas exchange (respiratory compensation point), blood lactate measurements (maximal lactate steady state), and critical power. Therefore, it has been assumed that these breakpoints in the oxygenation patterns at different sites in the body might be equivalent and could, therefore, be used interchangeably. In the present review the typical oxygenation responses (at locomotor and respiratory muscle level, and cerebral level) are described and a possible framework is provided showing the physiological events that might link the breakpoints at different body sites with the thresholds determined from pulmonary gas exchange and blood lactate measurements. However, despite a possible physiological association, several arguments prevent the current practical application of these breakpoints measured at a single site as markers of exercise intensity making it highly questionable whether measurements of the oxygenation response at one single site can be used as a reflection of whole-body responses to different exercise intensities.
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Affiliation(s)
- Jan Boone
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium.
- Center of Sports Medicine, Ghent University Hospital, Ghent, Belgium.
| | | | - Ilse Coomans
- Department of Pediatric Cardiology, Ghent University Hospital, Ghent, Belgium
| | - Fabrice Prieur
- CIAMS, Univ Paris-Sud, Université Paris Saclay, 91405, Orsay Cedex, France
- CIAMS Université d'Orléans, 45067, Orléans, France
| | - Jan G Bourgois
- Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, 9000, Ghent, Belgium
- Center of Sports Medicine, Ghent University Hospital, Ghent, Belgium
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Granados J, Gillum TL, Castillo W, Christmas KM, Kuennen MR. “Functional” Respiratory Muscle Training During Endurance Exercise Causes Modest Hypoxemia but Overall is Well Tolerated. J Strength Cond Res 2016; 30:755-62. [DOI: 10.1519/jsc.0000000000001151] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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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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Inspiratory high frequency airway oscillation attenuates resistive loaded dyspnea and modulates respiratory function in young healthy individuals. PLoS One 2014; 9:e91291. [PMID: 24651392 PMCID: PMC3961233 DOI: 10.1371/journal.pone.0091291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 02/10/2014] [Indexed: 11/27/2022] Open
Abstract
Direct chest-wall percussion can reduce breathlessness in Chronic Obstructive Pulmonary Disease and respiratory function may be improved, in health and disease, by respiratory muscle training (RMT). We tested whether high-frequency airway oscillation (HFAO), a novel form of airflow oscillation generation can modulate induced dyspnoea and respiratory strength and/or patterns following 5 weeks of HFAO training (n = 20) compared to a SHAM-RMT (conventional flow-resistive RMT) device (n = 15) in healthy volunteers (13 males; aged 20–36 yrs). HFAO causes oscillations with peak-to-peak amplitude of 1 cm H2O, whereas the SHAM-RMT device was identical but created no pressure oscillation. Respiratory function, dyspnoea and ventilation during 3 minutes of spontaneous resting ventilation, 1 minute of maximal voluntary hyperventilation and 1 minute breathing against a moderate inspiratory resistance, were compared PRE and POST 5-weeks of training (2×30 breaths at 70% peak flow, 5 days a week). Training significantly reduced NRS dyspnoea scores during resistive loaded ventilation, both in the HFAO (p = 0.003) and SHAM-RMT (p = 0.005) groups. Maximum inspiratory static pressure (cm H2O) was significantly increased by HFAO training (vs. PRE; p<0.001). Maximum inspiratory dynamic pressure was increased by training in both the HFAO (vs. PRE; p<0.001) and SHAM-RMT (vs. PRE; p = 0.021) groups. Peak inspiratory flow rate (L.s−1) achieved during the maximum inspiratory dynamic pressure manoeuvre increased significantly POST (vs. PRE; p = 0.001) in the HFAO group only. HFAO reduced inspiratory resistive loading–induced dyspnoea and augments static and dynamic maximal respiratory manoeuvre performance in excess of flow-resistive IMT (SHAM-RMT) in healthy individuals without the respiratory discomfort associated with RMT.
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Tanner DA, Duke JW, Stager JM. Ventilatory patterns differ between maximal running and cycling. Respir Physiol Neurobiol 2013; 191:9-16. [PMID: 24211317 DOI: 10.1016/j.resp.2013.10.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 10/25/2013] [Accepted: 10/29/2013] [Indexed: 10/26/2022]
Abstract
To determine the effect of exercise mode on ventilatory patterns, 22 trained men performed two maximal graded exercise tests; one running on a treadmill and one cycling on an ergometer. Tidal flow-volume (FV) loops were recorded during each minute of exercise with maximal loops measured pre and post exercise. Running resulted in a greater VO2peak than cycling (62.7±7.6 vs. 58.1±7.2mLkg(-1)min(-1)). Although maximal ventilation (VE) did not differ between modes, ventilatory equivalents for O2 and CO2 were significantly larger during maximal cycling. Arterial oxygen saturation (estimated via ear oximeter) was also greater during maximal cycling, as were end-expiratory (EELV; 3.40±0.54 vs. 3.21±0.55L) and end-inspiratory lung volumes, (EILV; 6.24±0.88 vs. 5.90±0.74L). Based on these results we conclude that ventilatory patterns differ as a function of exercise mode and these observed differences are likely due to the differences in posture adopted during exercise in these modes.
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Affiliation(s)
- David A Tanner
- Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, IN, USA
| | - Joseph W Duke
- Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, IN, USA
| | - Joel M Stager
- Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, IN, USA.
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McConnell AK. CrossTalk opposing view: respiratory muscle training does improve exercise tolerance. J Physiol 2013; 590:3397-8; discussion 3399-400. [PMID: 22855045 DOI: 10.1113/jphysiol.2012.235572] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Alison K McConnell
- Centre for Sports Medicine and Human Performance, Brunel University, London UB8 3PH,
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Wilhite DP, Mickleborough TD, Laymon AS, Chapman RF. Increases in $$ \dot{V} $$ O2max with “live high–train low” altitude training: role of ventilatory acclimatization. Eur J Appl Physiol 2012; 113:419-26. [DOI: 10.1007/s00421-012-2443-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 06/11/2012] [Indexed: 11/24/2022]
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