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Jonkman AH, Warnaar RSP, Baccinelli W, Carbon NM, D'Cruz RF, Doorduin J, van Doorn JLM, Elshof J, Estrada-Petrocelli L, Graßhoff J, Heunks LMA, Koopman AA, Langer D, Moore CM, Nunez Silveira JM, Petersen E, Poddighe D, Ramsay M, Rodrigues A, Roesthuis LH, Rossel A, Torres A, Duiverman ML, Oppersma E. Analysis and applications of respiratory surface EMG: report of a round table meeting. Crit Care 2024; 28:2. [PMID: 38166968 PMCID: PMC10759550 DOI: 10.1186/s13054-023-04779-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
Surface electromyography (sEMG) can be used to measure the electrical activity of the respiratory muscles. The possible applications of sEMG span from patients suffering from acute respiratory failure to patients receiving chronic home mechanical ventilation, to evaluate muscle function, titrate ventilatory support and guide treatment. However, sEMG is mainly used as a monitoring tool for research and its use in clinical practice is still limited-in part due to a lack of standardization and transparent reporting. During this round table meeting, recommendations on data acquisition, processing, interpretation, and potential clinical applications of respiratory sEMG were discussed. This paper informs the clinical researcher interested in respiratory muscle monitoring about the current state of the art on sEMG, knowledge gaps and potential future applications for patients with respiratory failure.
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Affiliation(s)
- A H Jonkman
- Department of Intensive Care Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - R S P Warnaar
- Cardiovascular and Respiratory Physiology, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - W Baccinelli
- Netherlands eScience Center, Amsterdam, The Netherlands
| | - N M Carbon
- Department of Anesthesiology, Friedrich Alexander-Universität Erlangen-Nürnberg, Uniklinikum Erlangen, Erlangen, Germany
| | - R F D'Cruz
- Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - J Doorduin
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J L M van Doorn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Elshof
- Department of Pulmonary Diseases/Home Mechanical Ventilation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - L Estrada-Petrocelli
- Facultad de Ingeniería and Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT) - Sistema Nacional de Investigación (SNI), Universidad Latina de Panamá (ULATINA), Panama, Panama
| | - J Graßhoff
- Fraunhofer Research Institution for Individualized and Cell-Based Medical Engineering, Lübeck, Germany
| | - L M A Heunks
- Department of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A A Koopman
- Division of Paediatric Critical Care Medicine, Department of Paediatrics, Beatrix Children's Hospital, University Medical Center Groningen, Groningen, The Netherlands
| | - D Langer
- Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium
| | - C M Moore
- Netherlands eScience Center, Amsterdam, The Netherlands
| | - J M Nunez Silveira
- Hospital Italiano de Buenos Aires, Unidad de Terapia Intensiva, Ciudad de Buenos Aires, Argentina
| | - E Petersen
- Technical University of Denmark (DTU), DTU Compute, 2800, Kgs. Lyngby, Denmark
| | - D Poddighe
- Research Group for Rehabilitation in Internal Disorders, Department of Rehabilitation Sciences, KU Leuven, 3000, Leuven, Belgium
| | - M Ramsay
- Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Rodrigues
- Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - L H Roesthuis
- Department of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Rossel
- Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - A Torres
- Institut de Bioenginyeria de Catalunya (IBEC), Barcelona Institute of Science and Technology (BIST) and Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universitat Politècnica de Catalunya BarcelonaTech (UPC), Barcelona, Spain
| | - M L Duiverman
- Department of Pulmonary Diseases/Home Mechanical Ventilation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - E Oppersma
- Cardiovascular and Respiratory Physiology, TechMed Centre, University of Twente, Enschede, The Netherlands.
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Sato S, Ishida K, Tanaka NI, Katayama K. Impact of high-intensity interval hyperpnea on aerobic energy release and inspiratory muscle fatigue. Respir Physiol Neurobiol 2024; 319:104170. [PMID: 37838229 DOI: 10.1016/j.resp.2023.104170] [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: 07/22/2023] [Revised: 09/27/2023] [Accepted: 10/06/2023] [Indexed: 10/16/2023]
Abstract
Respiratory muscle endurance training reportedly has beneficial effects on whole-body endurance performance. We produced a novel high-intensity interval (HII) protocol and characterized the associated physiological responses and respiratory muscle fatigue. Peak oxygen uptake of respiratory muscle (V̇O2peakRM) was estimated during the respiratory incremental test. The HII session consisted of five 3-minute hyperpnea periods at 100%V̇O2peakRM interspersed with 2-minute periods at 40%V̇O2peakRM (25 min total). The high-intensity continuous (HIC) session involved a single time-to-end bout of hyperpnea at 100%V̇O2peakRM. The moderate-intensity continuous (MIC) session involved 25 min of hyperpnea at 60% of maximal voluntary ventilation. V̇O2RM was recorded continuously, and maximal inspiratory pressure (PImax) was assessed before and after the sessions. HII session: V̇O2RM gradually increased as the sets proceeded, whereas PImax decreased significantly. HIC session: V̇O2RM increased progressively, and the time to end was 6.5 ± 0.5 min. PImax decreased significantly. MIC session: V̇O2RM did not change for 25 min, and PImax remained unchanged. The duration of V̇O2RM at near- and supra-maximal levels in the HII session (10 ± 1 min) was longer than that in the HIC session (4 ± 1 min). The decrease in PImax was larger in the HII session (-12 ± 3 %) than MIC session (-4 ± 3 %). The HII protocol is characterized by a longer time to maximally stimulate the aerobic energy system of respiratory muscle than the HIC protocol and greater inspiratory muscle fatigue than the traditional MIC protocol. These results suggest that the HII protocol could enhance the efficacy of respiratory muscle training programs.
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Affiliation(s)
- Suzuna Sato
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan
| | - Koji Ishida
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan; Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Noriko I Tanaka
- Graduate School of Education and Human Development, Nagoya University, Nagoya, Japan; Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan
| | - Keisho Katayama
- Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya, Japan; Graduate School of Medicine, Nagoya University, Nagoya, Japan.
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Notter DA, Verges S, Renggli AS, Beltrami FG, Spengler CM. Similar effects on exercise performance following different respiratory muscle training programs in healthy young men. Sci Rep 2023; 13:16135. [PMID: 37752180 PMCID: PMC10522679 DOI: 10.1038/s41598-023-41580-w] [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: 04/11/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023] Open
Abstract
Both respiratory muscle endurance training (RMET) and inspiratory resistive training (IMT) seem to increase whole-body exercise performance, but direct comparisons between the two are scarce. We hypothesized that the similarity of RMET to exercise-induced ventilation would induce larger improvements compared to IMT. Twenty-six moderately-trained men performed either 4 weeks of RMET, IMT or SHAM training. Before and after the interventions, respiratory muscle endurance, 3-km running time-trial performance and leg muscle fatigue after intense constant-load cycling (assessed with femoral nerve magnetic stimulation) were measured. Both RMET (+ 59%) and IMT (+ 38%) increased respiratory muscle endurance (both p < 0.01 vs. SHAM) but only IMT increased inspiratory strength (+ 32%, p < 0.001 vs. SHAM). 3-km time improved showing a main effect of training (p = 0.026), however with no differences between groups. Leg fatigue after cycling was not attenuated with training (p = 0.088 for group-training interaction). All groups showed a significant (~ 0.3 l) increase in average tidal volume during cycling exercise combined with a concomitant reduction in respiratory exertion. While RMET and IMT improved specific aspects of respiratory muscles performance, no benefits beyond SHAM were seen during whole-body exercise. Changes in respiratory sensations might be a result of altered breathing pattern.
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Affiliation(s)
- Dominic A Notter
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Gloriastrasse 37/39, 8092, Zurich, Switzerland
| | - Samuel Verges
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Gloriastrasse 37/39, 8092, Zurich, Switzerland
| | - Andrea S Renggli
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Gloriastrasse 37/39, 8092, Zurich, Switzerland
| | - Fernando G Beltrami
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Gloriastrasse 37/39, 8092, Zurich, Switzerland
| | - Christina M Spengler
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Gloriastrasse 37/39, 8092, Zurich, Switzerland.
- Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland.
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Schaer CE, Erne D, Tageldin D, Wüthrich TU, Beltrami FG, Spengler CM. Effects of Sprint Interval and Endurance Respiratory Muscle Training on Postcycling Inspiratory and Quadriceps Fatigue. Med Sci Sports Exerc 2023; 55:1683-1694. [PMID: 37076980 DOI: 10.1249/mss.0000000000003192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
PURPOSE We investigated whether a 4-wk period of respiratory muscle endurance training (RMET) or respiratory muscle sprint interval training (RMSIT) would lead to an attenuation of inspiratory muscle and quadriceps fatigue after a bout of high-intensity cycling compared with a placebo intervention (PLAT), as predicted by the respiratory metaboreflex model. METHODS Thirty-three active, young healthy adults performed RMET, RMSIT, or PLAT. Changes in inspiratory muscle and quadriceps twitches in response to a cycling test at 90% of peak work capacity were assessed before and after training. EMG activity and deoxyhemoglobin (HHb, via near-infrared spectroscopy) of the quadriceps and inspiratory muscles were also monitored during the cycling test, along with cardiorespiratory and perceptual variables. RESULTS At pretraining, cycling reduced the twitch force of the inspiratory muscles (86% ± 11% baseline) and quadriceps (66% ± 16% baseline). Training did not attenuate the drop in twitch force of the inspiratory muscles (PLAT, -3.5 ± 4.9 percent-points [p.p.]; RMET, 2.7 ± 11.3 p.p.; RMSIT, 4.1 ± 8.5 p.p.; group-training interaction, P = 0.394) or quadriceps (PLAT, 3.8 ± 18.6 p.p.; RMET, -2.6 ± 14.0 p.p.; RMSIT, 5.2 ± 9.8 p.p.; group-training interaction P = 0.432). EMG activity and HHb levels during cycling did not change after training for either group. Only RMSIT showed a within-group decrease in the perception of respiratory exertion with training. CONCLUSIONS Four weeks of RMET or RMSIT did not attenuate the development of exercise-induced inspiratory or quadriceps fatigue. The ergogenic effects of respiratory muscle training during whole-body exercise might be related to an attenuation of perceptual responses.
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Affiliation(s)
- Corina E Schaer
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, SWITZERLAND
| | - Desirée Erne
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, SWITZERLAND
| | - Dina Tageldin
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, SWITZERLAND
| | - Thomas U Wüthrich
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, SWITZERLAND
| | - Fernando G Beltrami
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, SWITZERLAND
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Beltrami FG, Schaer CE, Spengler CM. Sex differences in quadriceps and inspiratory muscle fatigability following high-intensity cycling. J Sci Med Sport 2023; 26:208-213. [PMID: 36863893 DOI: 10.1016/j.jsams.2023.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES As females have been hypothesized to have more fatigue resistant inspiratory muscles, this study aimed to compare the development of inspiratory and leg muscle fatigue between males and females following high-intensity cycling. DESIGN Cross-sectional comparison. METHODS 17 healthy young males (27 ± 6 years, V̇O2peak 55 ± 10 ml・min-1・kg-1) and females (25 ± 4 years, V̇O2peak 45 ± 7 ml・min-1・kg-1) cycled until exhaustion at 90% of the peak power output achieved during an incremental test. Changes in quadriceps and inspiratory muscle function were assessed via maximal voluntary contractions (MVC) and assessments of contractility via electrical stimulation of the femoral nerve and cervical magnetic stimulation of the phrenic nerves. RESULTS Time to exhaustion was similar between sexes (p = 0.270, 95% CI -2.4 - 0.7 min). MVC of the quadriceps was lower after cycling for males (83.9 ± 11.5% vs. 94.0 ± 12.0% of baseline for females, p = 0.018). Reductions in twitch forces were not different between sexes for the quadriceps (p = 0.314, 95% CI -5.5 - 16.6 percent-points) or inspiratory muscles (p = 0.312, 95% CI -4.0 - 2.3 percent-points). Changes in inspiratory muscle twitches were unrelated to the different measures of quadriceps fatigue. CONCLUSION Females incur similar peripheral fatigue in the quadriceps and inspiratory muscles compared with men following high-intensity cycling, despite smaller reduction in voluntary force. This small difference alone does not seem sufficient to warrant different training strategies to be recommended for women.
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Affiliation(s)
- Fernando G Beltrami
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Corina E Schaer
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Christina M Spengler
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland; Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland.
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Salvadego D, Tringali G, De Micheli R, Sartorio A. Respiratory Muscle Interval Training Improves Exercise Capacity in Obese Adolescents during a 3-Week In-Hospital Multidisciplinary Body Weight Reduction Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:487. [PMID: 36612808 PMCID: PMC9819313 DOI: 10.3390/ijerph20010487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
The purpose of this study was to determine whether a novel approach of interval training targeted to the respiratory muscles (RMIT; normocapnic hyperpnea with resistance) in addition to a multidisciplinary in-hospital body weight reduction program (BWRP) was able to improve the integrative response to exercise in young patients with obesity. Nine male patients (17.9 ± 4.9 (x ± SD) years; 113.8 ± 16.3 kg) underwent 12 sessions of RMIT and eight age-and sex-matched patients underwent 12 sessions of a sham protocol (CTRL) during the same 3-week BWRP. Before and after the interventions the patients performed an incremental and a heavy-intensity constant work-rate (CWR>GET) cycling exercise to voluntary exhaustion. Body mass decreased by ~4.0 kg after both RMIT (p = 0.0001) and CTRL (p = 0.0002). Peak pulmonary O2 uptake (V˙O2) increased after RMIT (p = 0.02) and CTRL (p = 0.0007). During CWR>GET at ISO-time, V˙O2 (p = 0.0007), pulmonary ventilation (p = 0.01), heart rate (p = 0.02), perceived respiratory discomfort (RPER; p = 0.03) and leg effort (p = 0.0003) decreased after RMIT; only RPER (p = 0.03) decreased after CTRL. Time to exhaustion increased after RMIT (p = 0.0003) but not after CTRL. In young patients with obesity, RMIT inserted in a 3-week BWRP reduced the cardiorespiratory burden, the metabolic cost, the perceived effort, and improved exercise tolerance during heavy-intensity cycling.
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Stutz J, Casutt S, Spengler CM. Respiratory muscle endurance training improves exercise performance but does not affect resting blood pressure and sleep in healthy active elderly. Eur J Appl Physiol 2022; 122:2515-2531. [PMID: 36018510 PMCID: PMC9613745 DOI: 10.1007/s00421-022-05024-z] [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: 01/14/2022] [Accepted: 08/04/2022] [Indexed: 11/29/2022]
Abstract
Purpose Ageing is associated with increased blood pressure (BP), reduced sleep, decreased pulmonary function and exercise capacity. The main purpose of this study was to test whether respiratory muscle endurance training (RMET) improves these parameters. Methods Twenty-four active normotensive and prehypertensive participants (age: 65.8 years) were randomized and balanced to receive either RMET (N = 12) or placebo (PLA, N = 12). RMET consisted of 30 min of volitional normocapnic hyperpnea at 60% of maximal voluntary ventilation while PLA consisted of 1 inhalation day−1 of a lactose powder. Both interventions were performed on 4–5 days week−1 for 4–5 weeks. Before and after the intervention, resting BP, pulmonary function, time to exhaustion in an incremental respiratory muscle test (incRMET), an incremental treadmill test (IT) and in a constant-load treadmill test (CLT) at 80% of peak oxygen consumption, balance, sleep at home, and body composition were assessed. Data was analyzed with 2 × 2 mixed ANOVAs. Results Compared to PLA, there was no change in resting BP (independent of initial resting BP), pulmonary function, IT performance, sleep, body composition or balance (all p > 0.05). Performance significantly increased in the incRMET (+ 6.3 min) and the CLT (+ 3.2 min), resulting in significant interaction effects (p < 0.05). Conclusion In the elderly population, RMET might be used to improve respiratory and whole body endurance performance either as an adjunct to physical exercise training or as a replacement thereof for people not being able to intensively exercise even if no change in BP or sleep may be expected.
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Affiliation(s)
- Jan Stutz
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Selina Casutt
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Christina M Spengler
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland. .,Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland.
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Harbour E, Stöggl T, Schwameder H, Finkenzeller T. Breath Tools: A Synthesis of Evidence-Based Breathing Strategies to Enhance Human Running. Front Physiol 2022; 13:813243. [PMID: 35370762 PMCID: PMC8967998 DOI: 10.3389/fphys.2022.813243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/28/2022] [Indexed: 01/23/2023] Open
Abstract
Running is among the most popular sporting hobbies and often chosen specifically for intrinsic psychological benefits. However, up to 40% of runners may experience exercise-induced dyspnoea as a result of cascading physiological phenomena, possibly causing negative psychological states or barriers to participation. Breathing techniques such as slow, deep breathing have proven benefits at rest, but it is unclear if they can be used during exercise to address respiratory limitations or improve performance. While direct experimental evidence is limited, diverse findings from exercise physiology and sports science combined with anecdotal knowledge from Yoga, meditation, and breathwork suggest that many aspects of breathing could be improved via purposeful strategies. Hence, we sought to synthesize these disparate sources to create a new theoretical framework called “Breath Tools” proposing breathing strategies for use during running to improve tolerance, performance, and lower barriers to long-term enjoyment.
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Affiliation(s)
- Eric Harbour
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
- *Correspondence: Eric Harbour,
| | - Thomas Stöggl
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
- Red Bull Athlete Performance Center, Salzburg, Austria
| | - Hermann Schwameder
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
| | - Thomas Finkenzeller
- Department of Sport and Exercise Science, University of Salzburg, Salzburg, Austria
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OUP accepted manuscript. Eur J Prev Cardiol 2022; 29:1707-1709. [DOI: 10.1093/eurjpc/zwac064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/16/2022] [Accepted: 03/20/2022] [Indexed: 11/13/2022]
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Beltrami FG, Mzee D, Spengler CM. No Evidence That Hyperpnea-Based Respiratory Muscle Training Affects Indexes of Cardiovascular Health in Young Healthy Adults. Front Physiol 2020; 11:530218. [PMID: 33391004 PMCID: PMC7773763 DOI: 10.3389/fphys.2020.530218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 11/20/2020] [Indexed: 01/05/2023] Open
Abstract
Introduction The chronic effects of respiratory muscle training (RMT) on the cardiovascular system remain unclear. This investigation tested to which degree a single sessions of RMT with or without added vibration, which could enhance peripheral blood flow and vascular response, or a 4-week RMT program could result in changes in pulse wave velocity (PWV), blood pressure (systolic, SBP; diastolic, DBP) and other markers of cardiovascular health. Methods Sixteen young and healthy participants (8 m/8f) performed 15 min of either continuous normocapnic hyperpnea (RMET), sprint-interval-type hyperpnea (RMSIT) or a control session (quiet sitting). Sessions were performed once with and once without passive vibration of the lower limbs. To assess training-induced adaptations, thirty-four young and healthy participants (17 m/17f) were measured before and after 4 weeks (three weekly sessions) of RMET (n = 13, 30-min sessions of normocapnic hyperpnea), RMSIT [n = 11, 6 × 1 min (1 min break) normocapnic hyperpnea with added resistance] or placebo (n = 10). Results SBP was elevated from baseline at 5 min after each RMT session, but returned to baseline levels after 15 min, whereas DBP was unchanged from baseline following RMT. Carotid-femoral PWV (PWVCF) was elevated at 5 and 15 min after RMT compared to baseline (main effect of time, P = 0.001), whereas no changes were seen for carotid-radial PWV (PWVCR) or the PWVCF/PWVCR ratio. Vibration had no effects in any of the interventions. Following the 4-week training period, no differences from the placebo group were seen for SBP (P = 0.686), DBP (P = 0.233), PWVCF (P = 0.844), PWVCR (P = 0.815) or the PWVCF/PWVCR ratio (P = 0.389). Discussion/Conclusion Although 15 min of RMT sessions elicited transient increases in PWVCF and SBP, no changes were detected following 4 weeks of either RMET or RMSIT. Adding passive vibration of the lower limbs during RMT sessions did not provide additional value to the session with regards to vascular responses.
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Affiliation(s)
- Fernando G Beltrami
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - David Mzee
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Christina M Spengler
- Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
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Bellar A, Welch N, Dasarathy S. Exercise and physical activity in cirrhosis: opportunities or perils. J Appl Physiol (1985) 2020; 128:1547-1567. [PMID: 32240017 DOI: 10.1152/japplphysiol.00798.2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Reduced exercise capacity and impaired physical performance are observed in nearly all patients with liver cirrhosis. Physical activity and exercise are physiological anabolic stimuli that can reverse dysregulated protein homeostasis or proteostasis and potentially increase muscle mass and contractile function in healthy subjects. Cirrhosis is a state of anabolic resistance, and unlike the beneficial responses to exercise reported in physiological states, there are few systematic studies evaluating the response to exercise in cirrhosis. Hyperammonemia is a mediator of the liver-muscle axis with net skeletal muscle ammonia uptake in cirrhosis causing signaling perturbations, mitochondrial dysfunction with decreased ATP content, modifications of contractile proteins, and impaired ribosomal function, all of which contribute to anabolic resistance in cirrhosis and have the potential to impair the beneficial responses to exercise. English language-publications in peer-reviewed journals that specifically evaluated the impact of exercise in cirrhosis were reviewed. Most studies evaluated responses to endurance exercise, and readouts included peak or maximum oxygen utilization, grip strength, and functional capacity. Endurance exercise for up to 12 wk is clinically tolerated in well-compensated cirrhosis. Data on the safety of resistance exercise are conflicting. Nutritional supplements enhance the benefits of exercise in healthy subjects but have not been evaluated in cirrhosis. Whether the beneficial physiological responses with endurance exercise and increase in muscle mass with resistance exercise that occur in healthy subjects also occur in cirrhotics is not known. Specific organ-system responses, changes in body composition, or improved long-term clinical outcomes with exercise in cirrhosis need evaluation.
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Affiliation(s)
- Annette Bellar
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Nicole Welch
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Gastroenterology, Hepatology Cleveland Clinic, Cleveland, Ohio
| | - Srinivasan Dasarathy
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Gastroenterology, Hepatology Cleveland Clinic, Cleveland, Ohio
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