Acute effects of inspiratory pressure threshold loading upon airway resistance in people with asthma

This is the post-print version of the final paper published in Respiratory Physiology & Neurobiology. The published article is available from the link below. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. Copyright @ 2009 Elsevier B.V.Large inspiratory pressures may impart stretch to airway smooth muscle and modify the response to deep inspiration (DI) in asthmatics. Respiratory system resistance (Rrs) was assessed in response to 5 inspiratory manoeuvres using the forced oscillation technique: (a) single unloaded DI; (b) single DI at 25 cmH2O; (c) single DI at 50% maximum inspiratory mouth pressure [MIP]; (d) 30 DIs at 50% MIP; and (e) 30 DIs at 50% MIP with maintenance of normocapnia. Rrs increased after the unloaded DI and the DI at 25 cmH2O but not after a DI at 50% MIP (3.6 ± 1.6 hPa L s−1 vs. 3.6 ± 1.5 hPa L s−1; p = 0.95), 30 DIs at 50% MIP (3.9 ± 1.5 hPa L s−1 vs. 4.2 ± 2.0 hPa L s−1; p = 0.16) or 30 DIs at 50% MIP under normocapnic conditions (3.9 ± 1.5 hPa L s−1 vs. 3.9 ± 1.5 hPa L s−1; p = 0.55). Increases in Rrs in response to DI were attenuated after single and multiple loaded breaths at 50% MIP

Correspondence: British Thoracic Society guideline on pulmonary rehabilitation in adults: Does objectivity have a sliding scale?

This article is made available through the Brunel Open Access Publishing Fund. Copyright © 2014 BMJ Publishing Group Ltd & British Thoracic Society. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is noncommercial. See: http://creativecommons.org/licenses/ by-nc/3.0/No abstract available (Letter

Invited Paper RESPIRATORY MUSCLE TRAINING AS AN ERGOGENIC AID

Most sport scientists still do not consider breathing to be a limiting factor for exercise performance. However, the past decade has seen evidence emerge showing unequivocally that breathing not only limits exercise performance, but that removal of this limitation improves performance. This review will describe the mechanisms by which respiratory muscle work limits exercise performance, as well as the evidence that specific training of the respiratory pump muscles improves performance in the context of both endurance and repeated sprint sports. Finally, the mechanisms underlying this ergogenic effect will be considered, as well as their implications for the practical application of respiratory muscle training. [ J Exerc Sci Fit • Vol 7 • No 2 (Suppl) • S18- S27 • 2009

Acute cardiorespiratory responses to inspiratory pressure threshold loading

This is a non-final version of an article (under the working title "Acute cardiovascular and ventilatory responses to inspiratory pressure threshold loading") published in final form in Medicine & Science in Sports & Exercise, 42(9), 1696-1703, 2010 .Purpose: We tested the acute responses to differing pressure threshold inspiratory loading intensities in well-trained rowers. The purpose of this study was to evaluate 1) how the magnitude of inspiratory pressure threshold loading influences repetition maximum (RM), tidal volume (VT), and external work undertaken by the inspiratory muscle; and 2) whether the inspiratory muscle metaboreflex is activated during acute inspiratory pressure threshold loading. Methods: Eight males participated in seven trials. Baseline measurements of maximal inspiratory pressure (PImax), resting tidal volume (VT), and forced vital capacity (FVC) were made. During the remaining sessions, participants undertook a series of resistive inspiratory breathing tasks at loads corresponding to 50%, 60%, 70%, 80%, and 90% of PImax using a pressure threshold inspiratory muscle trainer. The number of repetitions completed at each load, VT, heart rate (fc), and measures of arterial blood pressure was assessed continuously during each trial. Results: A standardized cutoff of 10% FVC was used to define the RM, which decreased as loading intensity increased (P < 0.05). This response was nonlinear, with an abrupt decrease in RM occurring at loads ≥70% of PImax. The most commonly used inspiratory muscle training regimen of 30RM corresponded to 62.5% ± 4.6% of PImax and also resulted in the highest external work output. Tidal volume (VT) decreased significantly over time at 60%, 70%, and 80% of PImax (P < 0.05), as did the amount of external work completed (P<0.05). Conclusions: Although all loads elicited a sustained increase in fc, only the 60% load elicited a sustained rise in mean arterial blood pressure (P = 0.016), diastolic blood pressure (P = 0.015), and systolic blood pressure (P = 0.002), providing evidence for a metaboreflex response at this load

'Functional' inspiratory and core muscle training enhances running performance and economy.

We compared the effects of two 6-week high-intensity interval training interventions. Under the control condition (CON), only interval training was undertaken, whilst under the intervention condition (ICT), interval training sessions were followed immediately by core training, which was combined with simultaneous inspiratory muscle training - 'functional' IMT. Sixteen recreational runners were allocated to either ICT or CON groups. Prior to the intervention phase, both groups undertook a 4-week programme of 'foundation' IMT to control for the known ergogenic effect of IMT [30 inspiratory efforts at 50% maximal static inspiratory pressure (P0) per set, 2 sets.d, 6 d.wk]. The subsequent 6-week interval running training phase, consisted of 3-4 sessions.wk. In addition, the ICT group undertook four inspiratory-loaded core exercises [10 repetitions.set, 2 sets.d, inspiratory load set at 50% post-IMT P0] immediately after each interval training session. The CON group received neither core training nor functional IMT. Following the intervention phase, global inspiratory and core muscle functions increased in both groups (P<0.05), as evidenced by P0 and a sport-specific endurance plank test performance (SEPT), respectively. Compared to CON, the ICT group showed larger improvements in SEPT, running economy at the speed of the OBLA, and 1-hr running performance (3.04% vs 1.57%, P<0.05). The changes in these variables were inter-individually correlated (r≥0.57, n=16, P<0.05). Such findings suggest that the addition of inspiratory-loaded core conditioning into a high-intensity interval training program augments the influence of the interval program upon endurance running performance, and that this may be underpinned by an improvement in running economy

Inspiratory muscle training improves breathing pattern during exercise in COPD patients (letter).

The addition of IMT to a PR programme for selected COPD patients changes breathing pattern during exercise

Implementation of sit-stand desks as a workplace health initiative: stakeholder views"

Purpose Prolonged workplace sitting can harm employee health. Sit-stand desks are a potential workplace health initiative that might reduce and break up the time office-based employees spend sitting in the workplace. However, little is known about the feasibility and acceptability of providing sit-stand desks. The paper aims to discuss this issue. Design/methodology/approach The present study sought stakeholder employee views surrounding sit-stand desk implementation within two UK-based non-profit organisations with open-plan offices. This paper draws on qualitative semi-structured interviews with 26 stakeholder employees and 65 days of participant observations. Data were analysed using thematic analysis, and organisational cultural theory framed the study. Findings Stakeholders employees’ positioning of sit-stand desks as a workplace health initiative reflected their perceptions of the relationship between sit-stand desk provision, employee health and organisational effectiveness. Perceptions were shaped by the nature and context of the organisation and by occupation-specific processes. Relatively fixed (e.g. organisational structure) and modifiable (e.g. selecting products compatible with the environment) factors were found to restrict and facilitate the perceived feasibility of implementing sit-stand desks. Practical implications The findings offer several recommendations for workplaces to improve stakeholder employee attitudes towards sit-stand desk provision and to increase the ease and efficiency of implementation. Originality/value Whilst extant literature has tended to examine hypothetical views related to sit-stand desk provision, this study consulted relevant stakeholders following, and regarding, the sit-stand desk implementation process

Inspiratory muscle training affects proprioceptive use and low back pain.

We have shown that individuals with recurrent nonspecific low back pain (LBP) and healthy individuals breathing against an inspiratory load decrease their reliance on back proprioceptive signals in upright standing. Because individuals with LBP show greater susceptibility to diaphragm fatigue, it is reasonable to hypothesize that LBP, diaphragm dysfunction, and proprioceptive use may be interrelated. The purpose of this study was to investigate whether inspiratory muscle training (IMT) affects proprioceptive use during postural control in individuals with LBP

Greater diaphragm fatigability in individuals with recurrent low back pain.

The diaphragm plays an important role in spinal control. Increased respiratory demand compromises spinal control, especially in individuals with low back pain (LBP). The objective was to determine whether individuals with LBP exhibit greater diaphragm fatigability compared to healthy controls. Transdiaphragmatic twitch pressures (TwPdi) were recorded in 10 LBP patients and 10 controls, before and 20 and 45 min after inspiratory muscle loading (IML). Individuals with LBP showed a significantly decreased potentiated TwPdi, 20 min (-20%) (p=0.002) and 45 min (-17%) (p=0.006) after IML. No significant decline was observed in healthy individuals, 20 min (-9%) (p=0.662) and 45 min (-5%) (p=0.972) after IML. Diaphragm fatigue (TwPdi fall ≥ 10%) was present in 80% (20 min after IML) and 70% (45 min after IML) of the LBP patients compared to 40% (p=0.010) and 30% (p=0.005) of the controls, respectively. Individuals with LBP exhibit propensity for diaphragm fatigue, which was not observed in controls. An association with reduced spinal control warrants further study

Postural strategy and back muscle oxygenation during inspiratory muscle loading.

Most healthy individuals show a multisegmental control strategy during challenging standing conditions, whereas others show a rigid ankle-steered strategy, which is assumed as suboptimal. Respiratory-demanding tasks exert a perturbing effect on balance, although the underlying mechanisms remain poorly understood. The purpose of this study was to investigate whether inspiratory resistive loading (IRL) affects postural strategy, back muscle oxygenation, and blood volume during postural control