scholarly journals Critical inspiratory pressure - new methodology for evaluating and training the inspiratory musculature for recreational cyclists: study protocol for a randomized control trial

2019 ◽  
Author(s):  
Patricia Rehder-Santos ◽  
Vinicius Minatel ◽  
Juliana Cristina Milan-Mattos ◽  
Étore De Favari Signini ◽  
Raphael Martins de Abreu ◽  
...  

Abstract Background: Inspiratory muscle training(IMT) has brought great benefits to improving physical performance in healthy individuals. However, there is no consensus regarding the best training load as in most cases the maximum inspiratory pressure(MIP) has been used, whereby 60% of MIP is the most used. Therefore, the prescription of an IMT protocol that takes into account respiratory muscle strength and endurance may bring additional benefits to the commonly used protocols as respiratory muscles differ from other muscles because of their greater muscular resistance. Thus, IMT using inspiratory critical pressure(PThC) appears as an alternative since the calculation of PThC considers these characteristics. Therefore, the aim of this study is to propose a new IMT protocol to determine the best training load for recreational cyclists. Methods: Thirty recreational cyclists(between 20-40 years) will be randomized to the SHAM Group(SG), the PThC Group(PCG) and the 60% of MIP Group(60G), taking into account age and aerobic functional capacity. All participants will undergo the following evaluations: pulmonary function test(PFT), respiratory muscle strength test(RMS), cardiopulmonary test(CPET), incremental respiratory muscle endurance test(iRME) [maximum sustained respiratory pressure for 1 minute(PThMAX)] and constant load test(CLT) (95%, 100% and 105% of PThMÁX) using a linear load inspiratory resistor(PowerBreathe K5). The PThC will be calculated from the inspiratory muscle endurance time(TLIM) and inspiratory loads of each CLT. The IMT will last 11 weeks(3 times/week and 1 hour/session). The session will consist of 5-minute warm-ups(50% of the training load) and 3 sets of 15-minute breaths (100% of the training load), with a 1 minute interval between them. RMS, iRME, CLT and CPET will be performed before, at week 3 and 7(to adjust the training load) and after training. PFT will be performed before and after training. The data will be analyzed by specific statistical tests (parametric or non-parametric) according to the data distribution and their respective variances. The p <0.05 will be established. Conclusions: It is expected that the results of this study will enable the training performed with PThC to be used by health professionals as a new tool to evaluate and prescribe IMT. Clinical Trial: ClinicalTrial.gov, ID Number NCT02984189. Registered in December 6, 2016, https://clinicaltrials.gov/ct2/show/NCT02984189.

2019 ◽  
Author(s):  
Patricia Rehder-Santos ◽  
Vinicius Minatel ◽  
Juliana Cristina Milan-Mattos ◽  
Étore De Favari Signini ◽  
Raphael Martins de Abreu ◽  
...  

Abstract Background: Inspiratory muscle training (IMT) has brought great benefits in terms of improving physical performance in healthy individuals. However, there is no consensus regarding the best training load being in most cases the maximal inspiratory pressure (MIP) is used, mainly the intensity of 60% of MIP. So, the prescription of an IMT protocol that considers respiratory muscle strength and endurance may bring additional benefits to commonly used protocols, since the respiratory muscles that differ from other muscles because of their greater muscular resistance. Thus, IMT using inspiratory critical pressure (PThC) can be an alternative as the calculation of PThC considers these characteristics. Therefore, the aim of this study is to propose a new IMT protocol to determine the best training load for recreational cyclists. Methods: Thirty recreational cyclists (between 20-40 years) will be randomized into the SHAM Group (SG), the PThC Group (PCG) and the 60% of MIP Group (60G), according to age and aerobic functional capacity. All participants will undergo the following evaluations: pulmonary function test (PFT), respiratory muscle strength test (RMS), cardiopulmonary test (CPET), incremental respiratory muscle endurance test (iRME) [maximal sustained respiratory pressure for 1 minute (PThMAX)] and constant load test (CLT) (95%, 100% and 105% of PThMÁX) using a linear load inspiratory resistor (PowerBreathe K5). The PThC will be calculated from the inspiratory muscle endurance time (TLIM) and inspiratory loads of each CLT. The IMT will last 11 weeks (3 times/week and 1 hour/session). The session will consist of 5-minute warm-ups (50% of the training load) and 3 sets of 15-minute breaths (100% of the training load), with a 1-minute interval between them. RMS, iRME, CLT and CPET will be performed beforehand, at week 3 and 7 (to adjust the training load) and after training. PFT will be performed before and after training. The data will be analyzed using specific statistical tests (parametric or non-parametric) according to the data distribution and their respective variances. The p <0.05 will be established. Discussions: It is expected that the results of this study will enable the training performed with PThC to be used by health professionals as a new tool to evaluate and prescribe IMT. Clinical Trial: ClinicalTrial.gov, ID Number NCT02984189. Registered on December 6, 2016, https://clinicaltrials.gov/ct2/show/NCT02984189. Keywords: Physical Exercise, Physiotherapy, Physical Performance, Critical Power, Respiratory Muscle


1989 ◽  
Vol 66 (2) ◽  
pp. 943-948 ◽  
Author(s):  
H. I. Chen ◽  
C. S. Kuo

To investigate the effects of gender and age on respiratory muscle function, 160 healthy volunteers (80 males, 80 females) were divided into four age groups. Twenty-eight of the male subjects were smokers. After the subjects were familiarized with the experimental procedure, respiratory muscle strength, inspiratory muscle endurance, and spirometric function, including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, tidal volume, breathing rate, and duty cycle, were measured. The respiratory muscle strength was indicated by the maximal static inspiratory and expiratory pressures (PImmax and PEmmax). Inspiratory muscle endurance was determined by the time the subject was able to sustain breathing against an inspiratory pressure load on a modified Nickerson-Keens device. The results showed that 1) except for inspiratory muscle endurance and FEV1/FVC, men had greater respiratory muscle and pulmonary functions than women, 2) respiratory muscle function and pulmonary function decreased with age, 3) smoking tended to lower duty cycle and FEV1/FVC and to enhance PE,mmax, and 4) inspiratory muscle endurance was greater in men who were physically active than in those who were sedentary. Therefore we conclude that there are sexual and age differences in respiratory muscle strength and pulmonary function and that smoking or physical activity may affect respiratory muscle function.


Author(s):  
Paulina Okrzymowska ◽  
Monika Kurzaj ◽  
Wojciech Seidel ◽  
Krystyna Rożek-Piechura

Background: According to the literature, inspiratory muscle fatigue may increase after swimming training (ST). This study aimed to examine the efficacy of 8-week inspiratory muscular training (IMT) in disabled swimmers, combined with standard sports training, on selected parameters of lung ventilation and the function of respiratory muscles. Methods: A total of 16 disabled swimming division athletes from Wroclaw’s ‘Start’ Regional Sports Association qualified for the study. The subjects were randomly divided into two groups (ST and IMT). Both groups participated in swimming training for 8 weeks (8 times a week). The IMT group additionally participated in inspiratory muscle training (8 weeks). In all respondents, a functional lung test and the respiratory muscle strength was measured. Results: After 8 weeks of training, a significant increase in ventilation parameters and respiratory muscle strength was observed only in the IMT group. In ST group 1, a 20% improvement in the strength of inspiratory muscles was achieved. Conclusions: The inclusion of IMT is an important element that complements swimming training, allowing for greater increases in lung ventilation parameters and the strength of respiratory muscles in disabled swimmers.


2016 ◽  
Vol 29 (2) ◽  
pp. 343-350 ◽  
Author(s):  
Simone Regina Posser ◽  
Sheila Cristina Cecagno-Zanini ◽  
Fabiana Piovesan ◽  
Camila Pereira Leguisamo

Abstract Introduction: Individuals with chronic kidney disease (CKD) undergoing hemodialysis (HD) present low cardiorespiratory fitness and functional capacity. Metabolic changes, due to the disease, can result in a variety of pathophysiological conditions that favor the development of respiratory muscle weakness. However, very little is known about the performance of the respiratory muscles and the influence of HD on them. Aim: To evaluate and correlate pulmonary function, functional capacity and respiratory muscle strength in patients with CKD undergoing HD. Methods: Cross-sectional study comprising 23 patients with CKD, that met the following inclusion criteria: patients of both genders, who perform HD three times a week for a minimum period of three months. Respiratory muscle strength was evaluated using a respiratory pressure meter, lung function through spirometry and functional capacity through the 6-minute walk test (6MWT) before the HD session. Results: All patients were male and mean age was 50.2 ± 15.8 years. The median duration of HD was 3 (1.5 to 6.0) years. The mean values obtained in comparison to those predicted were MIP% 36.0 ± 13.6, MEP% 49.5 ± 15.8, FVC% 93.8 ± 21.1, FEV1% 93.7 ± 21.1, FVC/VEF1% 104.1 ± 10.3, and 6MWT% 66.33 ± 20.53. A statistically significant positive correlation was observed between the 6MWT and MIP (r = .63, p =.001) and MEP (r = .67, p < .001), between the MIP and MEP (r =.79, p < .001) and between the FEV1 and FVC (r = .91, p < .001). Conclusion: Patients with CKD undergoing HD present changes in respiratory muscle strength, with the predicted values decreasing for age and gender, as well as the distance covered in the 6MWT, although, with normal spirometric values. Functional capacity was dependent on respiratory muscle strength, as well as the values of MIP and MEP, and the values of FVC and FEV1.


Author(s):  
Monika Piotrowska ◽  
Paulina Okrzymowska ◽  
Wojciech Kucharski ◽  
Krystyna Rożek-Piechura

Regardless of the management regime for heart failure (HF), there is strong evidence supporting the early implementation of exercise-based cardiac rehabilitation (CR). Respiratory therapy is considered to be an integral part of such secondary prevention protocols. The aim of the study was to evaluate the effect of inspiratory muscle training (IMT) on exercise tolerance and the functional parameters of the respiratory system in patients with heart failure involved in cardiac rehabilitation. The study included 90 patients with HF who took part in the second-stage 8-week cycle of cardiac rehabilitation (CR). They were randomly divided into three groups: Group I underwent CR and IMT; Group II only CR; and patients in Group III underwent only the IMT. Before and after the 8-week cycle, participants were assessed for exercise tolerance and the functional parameters of respiratory muscle strength. Significant statistical improvement concerned the majority of the hemodynamic parameters, lung function parameters, and respiratory muscle strength in the first group. Moreover, the enhancement in the exercise tolerance in the CR + IMT group was accompanied by a negligible change in the HRpeak. The results confirm that the addition of IMT to the standard rehabilitation process of patients with heart failure can increase the therapeutic effect while influencing some of the parameters measured by exercise electrocardiography and respiratory function.


Author(s):  
Reid A. Mitchell ◽  
Scott T. Apperely ◽  
Satvir S. Dhillon ◽  
Julia Zhang ◽  
Kyle G. Boyle ◽  
...  

This case report characterizes the physiological responses to incremental cycling and determines the effects of 12 weeks of inspiratory muscle training (IMT) on respiratory muscle strength, exercise capacity and dyspnea in a physically active 59-year-old female, four years after a left-sided extra-pleural pneumonectomy (EPP). On separate days, a symptom limited incremental exercise test and a constant work rate (CWR) test at 75% of peak work rate (WR) were completed, followed by 12 weeks of IMT and another CWR test. IMT consisted of two sessions of 30 repetitions twice daily for 5 days per week. Physiological and perceptual variables were measured throughout each exercise test. The participant had a total lung capacity that was 43% predicted post-EPP. A rapid and shallow breathing pattern was adopted throughout exercise, and the ratio of minute ventilation to carbon dioxide output was elevated for a given work rate. Oxygen uptake was 74%predicted and WR was 88%predicted. Following IMT, maximal inspiratory pressure improved by 36% (-27.1 cmH2O) and endurance time by 31s, with no observable changes in any submaximal or peak cardiorespiratory variables during exercise. The intensity and unpleasantness of dyspnea increased by 2 and 3 Borg 0-10 units, respectively, at the highest equivalent submaximal exercise time achieved on both tests. Despite having undergone a significant reduction in lung volume post-EPP, the participant achieved a relatively normal peak incremental WR, which may reflect a high level of physical conditioning. This case report also demonstrates that IMT can effectively increase respiratory muscle strength several years following EPP.


2016 ◽  
Vol 30 (12) ◽  
pp. 1165-1174 ◽  
Author(s):  
Melih Zeren ◽  
Rengin Demir ◽  
Zerrin Yigit ◽  
Hulya N Gurses

Objective: To investigate the effects of inspiratory muscle training on pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation. Design: Prospective randomized controlled single-blind study. Setting: Cardiology department of a university hospital. Subjects: A total of 38 patients with permanent atrial fibrillation were randomly allocated to either a treatment group ( n = 19; age 66.2 years (8.8)) or a control group ( n = 19; age 67.1 years (6.4)). Methods: The training group received inspiratory muscle training at 30% of maximal inspiratory pressure for 15 minutes twice a day, 7 days a week, for 12 weeks alongside the standard medical treatment. The control group received standard medical treatment only. Spirometry, maximal inspiratory and expiratory pressures and 6-minute walking distance was measured at the beginning and end of the study. Results: There was a significant increase in maximal inspiratory pressure (27.94 cmH2O (8.90)), maximal expiratory pressure (24.53 cmH2O (10.34)), forced vital capacity (10.29% (8.18) predicted), forced expiratory volume in one second (13.88% (13.42) predicted), forced expiratory flow 25%–75% (14.82% (12.44) predicted), peak expiratory flow (19.82% (15.62) predicted) and 6-minute walking distance (55.53 m (14.13)) in the training group ( p < 0.01). No significant changes occurred in the control group ( p > 0.05). Conclusion: Inspiratory muscle training can improve pulmonary function, respiratory muscle strength and functional capacity in patients with atrial fibrillation.


Sign in / Sign up

Export Citation Format

Share Document