This study is a randomized controlled trial. Firstly it will look at the efficacy of inspiratory muscle training using POWERbreathe. Furthermore it will asses the swimming performance, airway dysfunction and perceived breathlessness in the elite swimmers recruited for the trial. Finally the trial will recruit participants from the elite competitive Futebol Clube do Porto swimming team.
Intervention used in swimming trial
ClinicalTrials.gov identifier: NCT03062735
Protocol for a Randomized Controlled Trial Evaluating the Efficacy of Inspiratory Muscle Training on Swimming Performance, Airway Dysfunction and Perceived Breathlessness in Elite Swimmers >
There is a study that aims to assess athletes’ ability to warm and humidify inspired air. This study is published in Medicine and Science in Sports and Exercise. It is called, Athletes do not condition inspired air more effectively than non-athletes during hyperpnea.
Endurance athletes’ inspired air
Airway disease is more prevalent in endurance athletes. This is possible because they need to adapt their breathing to cope with large volumes of inspired air. And they need to inspire large volumes of air because of the intense exercise they perform. But the environment they train in may also be relevant.
The study measures the difference between each athlete’s inhaled and exhaled air temperature. It did this during and after a Eucapnic Voluntary Hyperpnea test (EVH). This is the test that is used to diagnose exercise-induced asthma or exercise-induced bronchospasm. It is a 6 minute test during which the athlete breathes a cold, dry gas at very high ventilation rates.
All 23 athletes in the study attend a laboratory on three occasions. Two of these occasions are for baseline measurements and information. The third is to perform a modified EVH test. This is to measure their inspired and expired air temperatures.
No evidence of improved capacity to condition inspired air
The test results show no evidence of improved capacity to condition inspired air. And by ‘conditioned’ air the study means the athlete’s ability to warm and humidify inspired air. If the study did find evidence, this could suggest an increased bronchial blood flow or another adaptive mechanism. Bronchial blood flow supplies nutrients and oxygen to the cells that constitute the lungs, as well as carrying waste products away from them. Therefore the absence of an adaptive mechanism could contribute to airway damage observed in endurance athletes. This may be that colder but mainly dryer air is penetrating deeper in the lung.
Strategies to reduce impact on airway injury
A pre-exercise warm-up is well known to reduce the severity of exercise-induced bronchospasm and exercise-induced asthma. It is thought the reason for this is because of an increase in bronchial blood flow. A warm-up involves performing the athlete’s activity at a slower pace and reduced intensity. It gradually raises the body temperature. Furthermore it increases blood flow to the muscles.
An inspiratory warm-up
It is also beneficial to warm-up the breathing muscles. A scientifically proven way of doing this is with Inspiratory Muscle Training (IMT). POWERbreathe is an IMT device that is quick and easy to use. POWERbreathe IMT is performed as part of an athlete’s daily training. But research and trials have also shown it to be beneficial for an inspiratory warm-up. This means simply reducing the breathing load on the POWERbreathe IMT device to a lower setting. Better still the POWERbreathe K3, K4 and K5 with Breathe-Link Live Feedback Software feature an automatic warm-up mode. This automatically sets the optimal resistance for an inspiratory muscle warm-up.
This BASES Expert Statement looks into exercise respiratory symptoms, such as wheezing, tight chest, difficulty breathing, shortness of breath and coughing which are commonly reported by athletes.
These non-specific symptoms need to be assessed in order to confirm or eliminate the presence of cardio-pulmonary causes.
There is a high prevalence – 70% – of asthma and exercise induced bronchoconstriction (EIB) in sports with high breathing requirements, and it has been assumed that exercise-induced respiratory symptoms in these athletes is due to asthma or exercise-induced-asthma (EIA).
Symptoms however are misleading and this Expert Statement looks at these differential causes of exercise respiratory symptoms: Exercise-Induced Laryngeal Obstruction (EILO) and Dysfunctional Breathing.
Interventions are then discussed which include breathing pattern retraining and inspiratory muscle training and finally conclusions are made.
You can read the full Expert Statement here, Assessment and Management of Non-asthma Related Breathing Problems in Athletes.
A recent article in Triathlete Europe offered advice on how to avoid side stitch, citing diaphragm spasm as one of the most common causes, with spasm of the accessory muscles of breathing, the obliques, another cause.
Canadian Running also featured an article about side stitch explaining that as you take in air (while running) your diaphragm contracts, allowing your lungs to expand, and this, like any other muscle, can become overloaded during a run, straining it and causing it to spasm.
While there appears to be no definitive consensus on the causes of side stitch, many medical and sports professionals do believe it to be associated with the diaphragm, your main breathing muscle, and surrounding muscles.
An easy way to help prevent your diaphragm from feeling fatigued is to train your inspiratory muscles (mainly your diaphragm and intercostals) with POWERbreathe to become stronger. This will help improve your breathing stamina and enable you to run or swim for longer with less effort.
A pain in the side – why a stitch can turn a sporting demigod into a ‘DNF’ is a really informative article written by Sports Performance Bulletin which looks at strategies for coping with stitch and training techniques for its prevention, including POWERbreathe Inspiratory Muscle Training.
Allan do Carmo, a Brazilian swimmer who specialises in open water marathons, has secured his spot at the 2016 Summer Olympic Games and is one of the first 20 swimmers to qualify for Rio.
Since January Allan has been training his inspiratory muscles to become stronger and more resistant to fatigue with POWERbreathe, improving his stamina for swimming.
Physiotherapist Mateus Esquivel initially assessed Allan’s breathing parameters using the POWERbreathe K5 with Breathe-Link Live Feedback Software before establishing a specific training regimen and will be monitoring Allan’s performance throughout his training.
As an open water marathon swimmer Allan’s breathing faces the ultimate challenge of inhaling as much as possible, as quickly as possible so that his body can return to its optimal position for propelling himself forwards in the water. POWERbreathe teaches Allan to do this as the breathing technique needed to use POWERbreathe in order to elicit the benefits, is to breathe in as deeply as possible, and quickly/sharply.
In addition to training himself to breathe in this way, Allan will be breathing in against a resistance, exercising his breathing muscles (mainly his diaphragm and intercostals) so that they become progressively stronger and less prone to fatigue. This is very beneficial as research has shown that fatigue of the breathing muscles reduces blood flow to other working muscles, and in the case of swimmer Allan, his arms and legs, which will slow him down by reducing the flow of oxygen to those muscles.
Allan has been taking full advantage of his POWERbreathe and been using it to warm-up his inspiratory muscles too before training, but on a reduced load setting. Warming up the inspiratory muscles is just as beneficial as warming up other muscles at the start of exercise, and research has shown that a standard pre-workout exercise warm-up fails to prepare the inspiratory muscles for the exercise ahead.
Equally a POWERbreathe cool-down will help Allan to speed lactate clearance more effectively than a standard active recovery.
You can see a few photos of Allan do Carmo using his POWERbreathe in this Facebook post.
Your primary breathing muscle is your diaphragm; a dome shaped thin sheet of muscle separating your rib cage from your abdomen.
When you inhale this dome shape flattens out as your diaphragm contracts, pushing down on the contents of your abdomen (your gut) and increasing the space in your chest cavity.
Because your gut has to go somewhere as your diaphragm descends, it forces it down and out and your tummy expands. Because of this, this natural, healthy and proper way of breathing is often referred to as abdominal breathing or diaphragmatic breathing.
If you do already have a good breathing technique it can often go awry when you start exercising as you demand more air and your breathing increases to compensate. This is when your breathing technique can change from good diaphragmatic breathing to reverse breathing i.e. pulling in your tummy as you breathe in and letting your tummy go as you breathe out.
Because your diaphragm is a muscle, you can train it like any other muscle to become stronger and helping you retain that good diaphragmatic breathing even when pushed to your limit. POWERbreathe targets your inspiratory muscles – not only your diaphragm but also your intercostal muscles, the tiny muscles in between your ribs, which are recruited during a slightly forced respiration.
You’ll notice when training with POWERbreathe that you have to work harder to breathe in. This is the effect of resistance training acting on your inspiratory muscles. When breathing out, POWERbreathe offers no resistance because when you exhale normally, your diaphragm and intercostals naturally relax and move back up, pushing the air from your lungs.
The Spring 2015 edition of the University of Kent’s School of Sport and Exercise Sciences’ newsletter contains an interesting article by Dr John Dickinson who’s research found that 70% of top swimmers from the British Swimming squad suffer from some form of respiratory condition, especially exercise-induced asthma #EIA (page 9), and also a Research Spotlight (page 8) into a 12-week support programme aimed at assessing and improving a student’s sporting performance.
Discussions with the student revealed that he needed to improve his breathing efficiency during swimming. The article reveals that “To achieve this we implemented a twice-daily breathing training regime” – this was using POWERbreathe!
The student returned to the lab after 3-months to perform fitness tests which found that he had markedly improved his swimming performance, demonstrating a 4-second improvement over 100m and a 5-second improvement over both 200m and 400m distances.
Read Inside Sport and Exercise Sciences Spring Newsletter >
Read more about how to improve swimming performance with POWERbreathe >
EliteVelo Kalas Sportswear Cycling Race Team using POWERbreathe Plus IMT (above)
PHOTO: Richard Fox Photography
Effects of Inspiratory Muscle Training on Resistance to Fatigue of Respiratory Muscles During Exhaustive Exercise
M. O. Segizbaeva, N. N. Timofeev, Zh. A. Donina, E. N. Kur’yanovich, N. P. Aleksandrova
This study, published in Body Metabolism and Exercise – Advances in Experimental Medicine and Biology (Volume 840, 2015, pp 35-43) concluded that IMT elicits resistance to the development of inspiratory muscles fatigue during high-intensity exercise.
To assess the effect of inspiratory muscle training (IMT) on resistance to fatigue of the diaphragm, parasternal, sternocleidomastoid and scalene muscles in healthy humans during exhaustive exercise.
The sternocleidomastoid muscle flexes the neck and helps with the oblique rotation of the head. Also, the muscle helps in forced inspiration while breathing, and it raises the sternum. As for forced inspiration, the muscle also works in concert with the scalene muscles in the neck. The scalene muscles are lateral vertebral muscles that begin at the first and second ribs and pass up into the sides of the neck. There are three of these muscles. (SOURCE: Healthline.com)
“The study found that in healthy subjects, IMT results in significant increase in MIP (+18 %), a delay of inspiratory muscle fatigue during exhaustive exercise, and a significant improvement in maximal work performance. We conclude that the IMT elicits resistance to the development of inspiratory muscles fatigue during high-intensity exercise.”
Read Effects of Inspiratory Muscle Training on Resistance to Fatigue of Respiratory Muscles During Exhaustive Exercise
Check out more Inspiratory Muscle Training Research here >
Discover POWERbreathe used in Research here >
The reason why asthma symptoms may be brought on during exercise has not been completely established but it is thought that because breathing becomes heavy and we breathe faster when we exercise, the linings of our airways narrow and dry out. Also weather conditions and allergies, such as an allergy to pollen, can also trigger asthma-like symptoms when exercising.
Recognising exericse-induced asthma (EIA)
Diagnosis is often made after symptoms, such as wheezing and a tight chest, are experienced during exercise, but this can result in either over-diagnosis, where athletes report symptoms but DO NOT have narrowing of the airways, or under-diagnosis where athletes who’re asymptomatic (showing no symptoms) DO have narrowing of the airways which affects their performance.
The scenarios above are supported in studies where elite athletes have been screened and shown to have EIA, such as reported by British Olympic Teams in the 2012 Olympics where it found that 25% of Team GB suffers from exercise-induced asthma. And at the 1996 Olympic games 20% of athletes reported asthma upon exercising.
Why screen for EIA?
The main reason is because exercise-induced asthma may be detrimental to an athlete’s performance, as it’s already been shown to reduce exercise capacity and running speed in colder environments which will not only affect an athlete during training but also during competition.
Treatment of EIA
Both pharmacological and non pharmacological therapies are currently successfully used to treat EIA, and studies have also highlighted the benefits of adjunctive intervention. POWERbreathe Inspiratory Muscle Training can be used as an adjunctive intervention, not only for daily training, but also as a respiratory warm-up prior to exercise.
Read more about Respiratory Disorders in endurance athletes in our blog.
And here’s an interesting article that looks at Pollen and Exercise Induced Asthma >
Deep breathing reaches the deepest depths of your lungs, and by practicing POWERbreathe inspiratory muscle training you’ll be training your respiratory muscles to breathe deeply into your diaphragm, taking in as much air as possible, breathing more in per breath.
As you’re breathing in more air per breath, you’re receiving more oxygen into your body, giving you more energy.
Senior consultant at the National heart Institute, India, and Founder, SAANS Foundation in India, Partha Pratim Bose offers a good example of this,
“By deep breathing exercises you breathe more per breath. If you breathe more per breath you expand your lungs more, you receive more oxygen. You will feel more energetic and also save your breaths. For example, if you breathe 250 ml per breath and your requirement is 5 litres then you need 20 breaths per minute. If you breathe more breath say double i.e. 500ml then you will require only ten breaths. So by breathing deep you breathe less and you feel better and conserve energy.”
Thankfully you can train your breathing muscles to breathe deep, as your respiratory muscles respond in the same way as skeletal muscles do to a training stimuli as they undergo adaptations to their structure and function. POWERbreathe is one such training stimuli, using the principles of resistance training to strengthen the inspiratory muscles. Its pressure loaded inspiratory valve offers the resistance on the inhale, while an unloaded expiratory valve allows for normal, passive exhalation.
How POWERbreathe Works >
You can read about other benefits of deep conscious breathing in Bose’s article ‘Wellness: Breathe like a tortoise, live like a king’ and here in POWERbreathe Benefits.