Abdominal muscle fatigue following exercise in chronic obstructive pulmonary disease

<p>Abstract</p> <p>Background</p> <p>In patients with chronic obstructive pulmonary disease, a restriction on maximum ventilatory capacity contributes to exercise limitation. It has been demonstrated that the diaphragm in COPD is relatively protected from fatigue during exercise. Because of expiratory flow limitation the abdominal muscles are activated early during exercise in COPD. This adds significantly to the work of breathing and may therefore contribute to exercise limitation. In healthy subjects, prior expiratory muscle fatigue has been shown itself to contribute to the development of quadriceps fatigue. It is not known whether fatigue of the abdominal muscles occurs during exercise in COPD.</p> <p>Methods</p> <p>Twitch gastric pressure (TwT10Pga), elicited by magnetic stimulation over the 10^ththoracic vertebra and twitch transdiaphragmatic pressure (TwPdi), elicited by bilateral anterolateral magnetic phrenic nerve stimulation were measured before and after symptom-limited, incremental cycle ergometry in patients with COPD.</p> <p>Results</p> <p>Twenty-three COPD patients, with a mean (SD) FEV₁40.8(23.1)% predicted, achieved a mean peak workload of 53.5(15.9) W. Following exercise, TwT₁₀Pga fell from 51.3(27.1) cmH₂O to 47.4(25.2) cmH₂O (p = 0.011). TwPdi did not change significantly; pre 17.0(6.4) cmH₂O post 17.5(5.9) cmH₂O (p = 0.7). Fatiguers, defined as having a fall TwT10Pga ≥ 10% had significantly worse lung gas transfer, but did not differ in other exercise parameters.</p> <p>Conclusions</p> <p>In patients with COPD, abdominal muscle but not diaphragm fatigue develops following symptom limited incremental cycle ergometry. Further work is needed to establish whether abdominal muscle fatigue is relevant to exercise limitation in COPD, perhaps indirectly through an effect on quadriceps fatigability.</p

The Influence of Inspiratory and Expiratory Muscle Training Upon Rowing Performance

We investigated the effect of 4 week of inspiratory (IMT) or expiratory muscle training (EMT), as well as the effect of a subsequent 6 week period of combined IMT/EMT on rowing performance in club-level oarsmen. Seventeen male rowers were allocated to either an IMT (n = 10) or EMT (n = 7) group. The groups underwent a 4 week IMT or EMT program; after interim testing, both groups subsequently performed a 6 week program of combined IMT/EMT. Exercise performance and physiological responses to exercise were measured at 4 and 10 week during an incremental rowing ergometer ‘step-test’ and a 6 min all-out (6MAO) effort. Pressure threshold respiratory muscle training was undertaken at the 30 repetition maximum load (~50% of the peak inspiratory and expiratory mouth pressure, PImax or PEmax,respectively). PImax increased during the IMT phase of the training in the IMT group (26%, P < 0.001) and was accompanied by an improvement in mean power during the 6MAO (2.7%, P = 0.015). Despite an increase in PEmax by the end of the intervention (31%, P = 0.03), the EMT group showed no significant changes in any performance parameters during either the ‘step-test’ or 6MAO. There were no significant changes in breathing pattern or the metabolic response to the 6MAO test in either group, but the IMT group showed a small decrease in HR (2–5%, P = 0.001). We conclude that there were no significant additional changes following combined IMT/EMT. IMT improved rowing performance, but EMT and subsequent combined IMT/EMT did not

Expiratory muscle fatigue impairs exercise performance

High-intensity, exhaustive exercise may lead to inspiratory as well as expiratory muscle fatigue (EMF). Induction of inspiratory muscle fatigue (IMF) before exercise has been shown to impair subsequent exercise performance. The purpose of the present study was to determine whether induction of EMF also affects subsequent exercise performance. Twelve healthy young men performed five 12-min running tests on a 400-m track on separate days: a preliminary trial, two trials after induction of EMF, and two trials without prior muscle fatigue. Tests with and without prior EMF were performed in an alternate order, randomly starting with either type. EMF was defined as a >or=20% drop in maximal expiratory mouth pressure achieved during expiratory resistive breathing against 50% maximal expiratory mouth pressure. The average distance covered in 12 min was significantly smaller during exercise with prior EMF compared to control exercise (2872+/-256 vs. 2957+/-325 m; P=0.002). Running speed was consistently lower (0.13 m s(-1)) throughout the entire 12 min of exercise with prior EMF. A significant correlation was observed between the level of EMF (decrement in maximal expiratory mouth pressure after resistive breathing) and the reduction in running distance (r2=0.528, P=0.007). Perceived respiratory exertion was higher during the first 800 m and heart rate was lower throughout the entire test of running with prior EMF compared to control exercise (5.3+/-1.6 vs. 4.5+/-1.7 points, P=0.002; 173+/-10 vs. 178+/-7 beats min(-1), P=0.005). We conclude that EMF impairs exercise performance as previously reported for IMF