Influence of inspiratory resistive loading on expiratory muscle fatigue in healthy humans

Expiratory resistive loading elicits inspiratory as well as expiratory muscle fatigue, suggesting parallel co-activation of the inspiratory muscles during expiration. It is unknown whether the expiratorymuscles are similarly co-activated to the point of fatigue during inspiratory resistive loading (IRL).The purpose of this study was to determine whether IRL elicits expiratory as well as inspiratory muscle fatigue. Healthy male subjects (n=9) underwent isocapnic IRL (60% maximal inspiratory pressure, 15 breaths∙min-1, 0.7 inspiratory duty cycle) to task failure. Abdominal and diaphragm contractile function was assessed at baseline and at 3, 15 and 30 min post-IRL by measuring gastric twitch pressure (Pga,tw) and transdiaphragmatic twitch pressure (Pdi,tw) in response to potentiated magnetic stimulation of the thoracic and phrenic nerves, respectively. Fatigue was defined as a significant reduction from baseline in Pga,tw or Pdi,tw. Throughout IRL, there was a time-dependent increase in cardiac frequency and mean arterial blood pressure, suggesting activation of the respiratory muscle metaboreflex. Pdi,tw was significantly lower than baseline (34.3 9.6 cmH2O) at 3min (23.2 5.7 cmH2O, P<0.001), 15 min (24.2 5.1 cmH2O, P<0.001) and 30 min post-IRL (26.3 6.0 cmH2O, P<0.001). Pga,tw was not significantly different from baseline (37.6 17.1 cmH2O) at 3min (36.5 14.6 cmH2O), 15 min (33.7 12.4 cmH2O) and 30 min post-IRL (32.9 11.3 cmH2O). IRL elicits objective evidence of diaphragm, but not abdominal, muscle fatigue. Agonist-antagonist interactions for the respiratory muscles appear to be more important during expiratory versus inspiratory loading.The Natural Sciences and Engineering Research Council (NSERC) of Canada supported this study. C.M. Peters, P.B. Dominelli, and Y. Molgat-Seon were supported by NSERC postgraduate scholarships. J.F Welch was supported by a University of British Columbia graduate fellowship

Effects of Age and Sex on Inspiratory Muscle Activation Patterns During Exercise

Purpose: Characterize the effects of age, sex, and their interaction on inspiratory muscle activation patterns during exercise. Methods: Twenty younger (20-30y, n=10 women) and twenty older (60-80y, n=10 women) subjects performed an incremental cycle exercise test. Electromyography of the scalene (EMGsca) and sternocleidomastoid (EMGscm) muscles were measured using skin surface electrodes, while diaphragm electromyography (EMGdi) and esophageal and transdiaphragmatic pressures were measured using an esophageal catheter. Electromyography data were transformed into root-mean-square with a 100ms time constant. Esophageal (PTPes) and diaphragmatic (PTPdi) pressure-time products were used as indices of total inspiratory muscle pressure production and diaphragmatic pressure production, respectively. Results: At absolute minute ventilations (V E), women and older subjects had greater EMGdi than men and younger subjects, respectively (all p<0.05), but no differences were noted when V E was expressed in relative terms (all p>0.05). Women had greater EMGsca activity than men at absolute and relative levels of V E (all p<0.05). Older subjects had greater EMGsca than younger subjects when V E was expressed relative (all p<0.05) but not absolute terms (all p>0.05). At absolute and relative levels of V E, women and older subjects had greater EMGscm than men and younger subjects, respectively (all p<0.05). Women and older subjects had a greater PTPdi/PTPes at a V E of 70 l·min-1 than men and younger subjects, respectively (both p<0.05), but no differences were noted when V E was expressed in relative terms (all p>0.05). No significant interactions between age and sex were noted (all p>0.05). Conclusion: Age and sex significantly affect inspiratory muscle activation patterns during exercise; however, the extent of the effects depends on whether comparisons are made at a solute or relative V E.This study was supported by the British Columbia Lung Association (BCLA). YMS, PBD, and AHR were supported by graduate scholarships from the Natural Sciences and Engineering Research Council of Canada (NSERC). PBD and MRS were supported by fellowships from the University of British Columbia and BCLA. JAG was supported by a Scholar Award from the Michael Smith Foundation for Health Research, a New Investigator Award from the Providence Health Care Research Institute and St. Paul’s Hospital Foundation, and a Canadian Institutes of Health Research Clinical Rehabilitation New Investigator Award

Manipulation of mechanical ventilatory constraint during moderate intensity exercise does not influence dyspnoea in healthy older men and women

© 2018 The Authors. The Journal of Physiology © 2018 The Physiological Society. KEY POINT SUMMARY:The perceived intensity of exertional breathlessness (i.e. dyspnoea) is higher in older women than in older men, possibly due to sex-difference respiratory system morphology. During exercise at a given absolute intensity or minute ventilation, older women have a greater degree of mechanical ventilatory constraint (i.e. work of breathing and expiratory flow limitation) than their male counterparts, which may lead to a greater perceived intensity of dyspnoea. Using a single-blind randomized study design, we experimentally manipulated the magnitude of mechanical ventilatory constraint during moderate-intensity exercise at ventilatory threshold in healthy older men and women. We found that changes in the magnitude of mechanical ventilatory constraint within the physiological range had no effect on dyspnoea in healthy older adults. When older men and women perform submaximal exercise at a moderate intensity, mechanical ventilatory constraint does not contribute significantly to the sensation of dyspnoea. We sought to determine the effect of manipulating mechanical ventilatory constraint during submaximal exercise on dyspnoea in older men and women. METHODS:Eighteen healthy subjects (60-80 y; 9 men, 9 women) completed two days of testing. On Day 1, subjects performed pulmonary function testing and a maximal incremental cycle exercise test. On Day 2, subjects performed three 6-min bouts of cycling at ventilatory threshold, in a single-blind randomized manner, while breathing: i) normoxic helium-oxygen (HEL) to reduce the work of breathing (Wb ) and alleviate expiratory flow limitation (EFL); ii) through an inspiratory resistance (RES) of ∼5 cmH2 O·l-1 ·s-1 to increase Wb ; and iii) ambient air as a control (CON). Oesophageal pressure, diaphragm electromyography, and sensory responses (using the category-ratio 10 Borg scale) were monitored throughout exercise. RESULTS:During the HEL condition, there was a significant decrease in Wb (men: -21 ± 6%, women: -17 ± 10%) relative to CON (both p < 0.01). Moreover, if EFL was present during CON (4 men, 5 women), it was alleviated during HEL. Conversely, during the RES condition, Wb (men: 42 ± 19%, women: 50 ± 16%) significantly increased relative to CON (both p < 0.01). There was no main effect of sex on Wb (p = 0.59). Across conditions, women reported significantly higher dyspnoea intensity than men (2.9 ± 0.9 vs. 1.9 ± 0.8 Borg scale units, p < 0.05). Despite significant differences in the degree of mechanical ventilatory constraint between conditions, dyspnoea intensity was unaffected, independent of sex (p = 0.46). CONCLUSION:When older men and women perform submaximal exercise at a moderate intensity, mechanical ventilatory constraint does not contribute significantly to the sensation of dyspnoea. This article is protected by copyright. All rights reserved.Natural Science and Engineering Research Council of Canada (NSERC) British Columbia Lung Association (BCLA

Effects of inspiratory muscle training on respiratory muscle electromyography and dyspnea during exercise in healthy men

Inspiratory muscle training (IMT) has consistently been shown to reduce exertional dyspnea in health and disease; however, the physiological mechanisms remain poorly understood. A growing body of literature suggests that dyspnea intensity can largely be explained by an awareness of increased neural respiratory drive, as indirectly measured using diaphragmatic electromyography (EMGdi). Accordingly, we sought to determine if improvements in dyspnea following IMT can be explained by decreases in inspiratory muscle EMG activity. Twenty-five young, healthy recreationally-active men completed a detailed familiarization visit followed by two maximal incremental cycle exercise tests separated by 5 weeks of randomly assigned pressure threshold IMT or sham control training (SC). The IMT group (n=12) performed 30 inspiratory efforts twice daily against a 30-repetition maximum intensity. The SC group (n=13) performed a daily bout of 60 inspiratory efforts against 10% maximal inspiratory pressure (MIP), with no weekly adjustments. Dyspnea intensity was measured throughout exercise using the modified 0-10 Borg scale. Sternocleidomastoid and scalene EMG were measured using surface electrodes whereas EMGdi was measured using a multi-pair esophageal electrode catheter. IMT significantly improved MIP (pre:-138±45 vs. post:-160±43cmH2O, p<0.01) whereas the SC intervention did not. Dyspnea was significantly reduced at the highest equivalent work rate (pre:7.6±2.5 vs. post:6.8±2.9Borg units, p<0.05), but not in the SC group, with no between-group interaction effects. There were no significant differences in respiratory muscle EMG during exercise in either group. 66 Improvements in dyspnea intensity ratings following IMT in healthy humans cannot be explained by 67 changes in the electrical activity of the inspiratory muscles.This research was supported by a Discovery Grant from the Natural Sciences and Engineering Research Council (NSERC) of Canada and an Infrastructure Grant from the Canada Foundation for Innovation. AHR was supported by the University of British Columbia 4 Year Fellowship (4YF). YMS was supported by a 4YF and a Post Graduate Scholarship from the NSERC. MRS was supported by a 4YF and a fellowship from the British Columbia Lung Association. PGC was supported by a Scholar Award from the Michael Smith Foundation for Health Research (MSFHR). JAG was supported by a Scholar Award from the MSFHR, a Canadian Institutes of Health Research Clinical Rehabilitation New Investigator Award, and a New Investigator Award from the Providence Health Care Research Institute and St. Paul’s Hospital Foundation