Gender differences in dimensions of dyspnea in active young adults

RESEARCH:

Sex differences in the intensity and qualitative dimensions of exertional dyspnea in physically active young adults
Julia M. Cory, Michele R. Schaeffer, Sabrina S. Wilkie et al

The purpose of this study was to explore the development of qualitative dimensions of dyspnea in a group of 70 physically active, healthy young adults.

The young participants were asked to record two things throughout each stage of a symptom limited incremental cycle exercise test:

1. Intensity of their breathing discomfort using the Borg 0-10 scale.
2. Select a phrase that best described their breathing from a standardized list (“work/effort”, “unsatisfied inspiration”, “unsatisfied expiration”).

During the study, at peak exercise women were significantly more likely to select the phrases: “my breathing feels shallow”, “I cannot get enough air in”, “I cannot take a deep breath in”, and “my breath does not go in all the way”.

Findings from the study suggested that men and women do not differ in their perceived quality of dyspnea during submaximal exercise, but subjective differences appear at maximal exercise and may be related, perhaps in part, to underlying differences in breathing patterns and operating lung volumes during exercise.

Read the full study here >

POWERbreathe For Older People In Slovenia

POWERbreathe Slovenia, with the kind assistance from Tanja, a physiotherapist at Ljubljana hospital, held two POWERbreathe training sessions for over 100 physiotherapists who’ll be implementing POWERbreathe Inspiratory Muscle Training (IMT) as one of the therapies they’ll be using with the older population within their communities.

Older adults experience a higher intensity of breathlessness than younger people, simply because of advancing years or as a result of illness, but by exercising and strengthening their breathing muscles (their inspiratory muscles) with POWERbreathe, they will learn how to breathe well again.

Research has in fact shown that IMT may be a useful technique for positively influencing exercise capacity and physical activity in elderly individuals.

Why POWERbreathe is ideal for the senior population

  • It’s scientifically proven to reduce breathlessness and restore breathing power
  • Does not involve drugs and has no interactions with other drugs
  • It’s quick and easy to use and effective within 4-weeks
  • It increases breathing muscle strength by 30 – 50%

Other therapies the physio’s will be including is Nordic walking and general exercise to get this more sedentary group moving, with the intention of making savings in the long-term for the health service.

You can view photos taken at the training sessions on POWERbreathe Facebook.

POWERbreathe For Patients With Spinal Cord Injury

Grupo GNAP in Salvador – Bahia offers specialised care in neurological rehabilitation, offering rehabilitation to their spinal cord injury patients that is efficient and motivating.

Respiratory approach to the neurological patient

GNAP believes that the treatment of neurological patients should not be limited to a motor or sensory approach of the limbs and trunk only, but also to their respiratory ability, because in many patient cases a reduction in functional performance limitations is associated with their respiratory ability.

To verify this, using the POWERbreathe K5 with Breathe-Link Live Feedback Software, they assess the patient’s respiratory ability by asking them to perform specific tasks, after which they identify issues and begin a course of POWERbreathe Inspiratory Muscle Training to help them improve not only their respiratory function but in turn their functional performance.

We’d like to thank Mateus Esquivel, Departamento De Fisioterapia Sbc Bahia and Fabio Carvalho, Physical therapist, expert in physical therapy neurofuncionnal and MBA in Business Management (FGV) from GNAP for bringing this important and encouraging work to our attention. Thank you!

 

Effects of Inspiratory Muscle Training in older adults

RESEARCH:

The Effects of Inspiratory Muscle Training in Older Adults
Mills D, Johnson M, Barnett Y, Smith W, Sharpe G

This research, published in Medicine & Science in Sports & Exercise (April 2015 – Volume 47 – Issue 4 – p 691–697) concluded that Inspiratory Muscle Training (IMT) elicits some positive changes in inspiratory muscle function and structure in healthy older adults…

PURPOSE:
“Declining inspiratory muscle function and structure and systemic low-level inflammation and oxidative stress may contribute to morbidity and mortality during normal ageing. Therefore, we examined the effects of inspiratory muscle training (IMT) in older adults on inspiratory muscle function and structure and systemic inflammation and oxidative stress, and reexamined the reported positive effects of IMT on respiratory muscle strength, inspiratory muscle endurance, spirometry, exercise performance, physical activity levels (PAL), and quality of life (QoL).”

CONCLUSION:
“These novel data indicate that in healthy older adults, IMT elicits some positive changes in inspiratory muscle function and structure but neither attenuates systemic inflammation and oxidative stress nor improves exercise performance, PAL, or QoL.”

Read The Effects of Inspiratory Muscle Training in Older Adults

Discover POWERbreathe used in Research here >

The value of breathing retraining

This interesting article, written by osteopath Leon Chaitow, reviews ‘The Value of Breathing Retraining for Better Posture, Balance & Less Pain and Dyskinesis.’

It talks about how problems arising from poor posture, such as back pain for instance, can come about as a result of faulty breathing mechanics.

Chaitow refers to the study, ‘Inspiratory Muscle Training Affects Proprioceptive Use and Low Back Pain’ which supports evidence that breathing training can be successful in rehabilitating function as well as reducing a variety of symptoms.

Participants in the study completed an Inspiratory Muscle Training (IMT) program using the POWERbreathe Medic over a period of 8 weeks, “known as an effective training duration”.

The study concluded: “After 8 wks of high IMT, individuals with LBP (low back pain) showed an increased reliance on back proprioceptive signals during postural control and improved inspiratory muscle strength and severity of LBP, not seen after low IMT. Hence, IMT may facilitate the proprioceptive involvement of the trunk in postural control in individuals with LBP and thus might be a useful rehabilitation tool for these patients.

Read more about the POWERbreathe Medic Classic (used in this study) and the second generation POWERbreathe Medic Plus.

Alleviate screen apnoea by breathing deeply

‘Screen apnoea’ is a new, 21st Century condition. The term is a play on the name for the serious condition, ‘sleep apnoea’. Sufferers with sleep apnoea may stop breathing for short periods of time while they sleep. Surprisingly, a similar thing happens to users of electronic devices. Findings show that people have a tendency to hold their breath while communicating electronically.

About screen apnoea

Screen apnoea is a term now in use by those treating office workers. Findings from a 2009 study leads to this diagnosis. In fact, findings show that while using mobile devices, participants hold their breath and begin to breathe shallowly and rapidly. Additionally, researchers at UCI ICS, (Gloria Mark, Stephen Voida, and Anthony Cardello), formally validate this impact of email, using heart rate variability. Their research shows that our heart rate starts to increase. Furthermore, evidence shows that we tense our muscles while sending and receiving text messages or emails. Although the trial only invited 12 participants, anecdotal evidence is now proving this to be the case.

Have you ever noticed that when you’re really focussed and concentrating hard, you have a tendency to hold your breath? And when concentrating on a small screen, this can result in a tightness in the neck and shoulders. Consequently, this hunching of the body may also cause back pain, thanks to the compromised posture.

Back pain

In a 2006 study of more than 38,000 women, researchers found that back pain was more strongly related to breathing disorders than to obesity or physical activity. This is because the main breathing muscle, the diaphragm, is also one of the core muscles that supports and stabilises the torso. So when the diaphragm’s dual role of breathing and stabilisation is too great, breathing wins out.

Improve your breathing strength

All is not lost though, because the breathing muscles can be exercised to improve their strength and stamina. One of the most effective – and simple – ways of achieving this is through Inspiratory Muscle Training (IMT). IMT uses a resistance that you breathe IN against. It’s this that strengthens your breathing muscles, and in turn, improves your breathing stamina. Furthermore, IMT will help you to breathe deeply into your diaphragm, as opposed to your chest. Finally, IMT is a good teaching practice for your breathing, in an age when we seem to be suffering from screen apnoea.

Breathing Exercises for Asthma

We recently came across this article on Breathe, The Respiratory Professional’s Source for Continuing Medical Education, which summarises the evidence of the role of breathing control approaches in asthma and provides information on the content of evidence-based breathing exercise programmes.

ARTICLE

Breathing Exercises for Asthma

The article initially states the three broad groups of breathing exercises for asthma:

1. Exercises aimed at manipulating the pattern of breathing (breathing retraining)
2. Exercises aimed at increasing the strength and/or endurance of the respiratory muscles (respiratory muscle training) e.g. POWERbreathe
3. Exercises aimed at increasing the flexibility of the thoracic cage and improving posture (musculoskeletal training)

This particular article focuses on breathing retraining techniques, which, after years of neglect, has recently seen a resurgence. A typical first breathing training session they suggest contains teaching the use of the abdomen (as opposed to upper chest breathing) and offers advice on the use of the lower thoracic and abdominal expansion rather than upper chest expansion. Breathing Control they define as “breathing at normal rate and depth initially, but using only lower thoracic and abdominal compartment expansion (also known as diaphragmatic breathing)”. POWERbreathe Inspiratory Muscle Training (IMT) teaches people to use their diaphragm (the main inspiratory muscle) for deep breathing, strengthening it and making it more resistant to fatigue.

The authors go on to suggest that the main components at the core of the breathing training packages that may be modified are, rate of breathing (number of breaths per minute), depth of breathing (volume of air inspired per breath), airflow velocity (flow rate), timing (inspiratory/expiratory phase, duration, ratio and pauses), rhythm of breathing (within-individual variability of rate, volume and timing) and primary region of movement (upper thoracic expansion, lower thoracic expansion, abdominal expansion). The POWERbreathe K2 IMT device offers a Single Breathe Test that measures inspiratory muscle strength, peak inspiratory flow rate and inhaled volume in a single breath.

The article informs us that there’s now “a convincing body of evidence that breathing training for people with asthma is effective in improving patient-reported endpoints, such as symptoms, health status and psychological well-being, and may be effective in reducing rescue bronchodilator medication usage.”

In addition to this, we’re able to show that in randomised controlled trials on mild/moderate asthmatics, POWERbreathe IMT:

  • Increased inspiratory muscle strength by a mean of 11% in just 3 weeks1.
  • Has been shown to relieve the symptoms of asthma by improving lung function, resulting in reduction of medication and a fall in hospitalisations2.

Also, after as little as 3 weeks’ POWERbreathe IMT1, asthma patients experienced a reduction in dyspnoea (difficult or laboured breathing; shortness of breath) as well as improvements in quality of life.

And in laboratory studies and randomised controlled trials, IMT was shown to generate:

  • A reduction in the consumption of asthma medication of up to 79%2
  • A reduction of ß2-agonists consumption by up to 79%2
  • An improvement in asthma symptoms by up to 75% in 3 weeks1

Read more about POWERbreathe for Asthma or have a look at the models most suited to people with asthma (please consult your health care provider before beginning any health related program), in addition to the book from the Bradcliff Breathing Method for managing your asthma, ‘Dynamic Breathing’:  

The article goes on to say that the latest Global Initiative for Asthma (GINA) iteration states that “breathing exercises may be a useful supplement to medications” and that the recently updated non-pharmacological management section of the British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) UK Asthma Guideline gives grade-A recommendation to the statement ‘Breathing exercise programmes (including physiotherapist-taught methods) can be offered to people with asthma as an adjuvant to pharmacological treatment to improve quality of life and to reduce symptoms’, based on evidence graded as 1++. This should now be a standard part of the range of treatments offered to patients.”

REFERENCES:

  1. Inspiratory muscle training improves lung function and reduces exertional dyspnoea in mild/moderate asthmatics
  2. lnspiratory Muscle Training in Patients with Bronchial Asthma

Effects of Inspiratory Muscle Training in Elderly Women

Published in The Journals of Gerontology: Series A (Volume 69, Issue 12Pp. 1545-1553 September 2014)

STUDY

Effects of Inspiratory Muscle Training in Elderly Women on Respiratory Muscle Strength, Diaphragm Thickness and Mobility

Abstract

“Aging results in a decline in the function of the respiratory muscles. Inspiratory muscle training is emerging as a possible intervention to attenuate the decline of respiratory muscles in the elderly. The aim of this study was to evaluate the efficacy of inspiratory muscle training on respiratory strength, diaphragm thickness, and diaphragmatic mobility in elderly women.”

Conclusion

“Inspiratory muscle training of moderate intensity improves respiratory muscle strength, diaphragm thickness, and diaphragm mobility in elderly women and it should be considered to minimize changes associated with senescence.”*

*Oxford Dictionary definition of Senescence: “The condition or process of deterioration with age.”

Only in October did we publish another blog based on a study that revealed how Respiratory Muscle Strength Reduces with Age and how POWERbreathe Inspiratory Muscle Training can help.

Other Research

In other research, Rush University Medical Centre in Chicago revealed how people with stronger breathing muscles showed higher levels of physical activity and a slower rate of activity decline.1 These findings are consistent with those from another research group showing that physically active older people had stronger breathing muscles than less active older people.2

Breathing muscle strength may also be an important determinant of death in older people, according to another study from the Chicago group who found that older people with a weaker respiratory system tended to have poorer lung function, known to be a contributory factor to survival.4

“Overall, our findings suggest that respiratory muscle strength is at the beginning of a causal chain which can lead to reduced pulmonary function and death.” The authors concluded.

How POWERbreathe can help

POWERbreathe is a breathing muscle trainer, scientifically proven to increase breathing muscle strength by 20% in just 6-weeks, with 65% of participants feeling less out of breath when undertaking everyday activities.3 Training your breathing muscles can help you remain active, which consequently can help you maintain mobility. And as POWERbreathe is drug-free, there’s nothing to lose in training with it.

Whether the benefits of inspiratory muscle training contribute to improvements in life expectancy has yet to be determined. However, since it has no side effects, and takes less than 5 minutes per day to undertake, it’s probably worth giving it a go.

If you found this blog interesting, you may also like to read about this pilot trial: Effects of inspiratory muscle training on exercise capacity and spontaneous physical activity in elderly subjects: a randomized controlled pilot trial.

References:

1. Buchman AS, Boyle PA, Wilson RS, Leurgans S, Shah RC, Bennett DA. Respiratory muscle strength predicts decline in mobility in older persons. Neuroepidemiology 2008;31:174-80

2. Summerhill EM, Angov N, Garber C, McCool FD. Respiratory muscle strength in the physically active elderly. Lung 2007;185:315-20

3. Copestake AJ, McConnell AK. Inspiratory muscle training reduces exertional breathlessness in healthy elderly men and women. In: International Conference on Physical Activity and Health in the Elderly; 1995; Stirling, Scotland: University of Sterling; 1995. p. 150)

4. Buchman AS, Boyle PA, Wilson RS, Gu L, Bienias JL, Bennett DA. Pulmonary function,. Mech Ageing Dev 2008

Read more about Inspiratory Muscle Training Research our our blog and read more about POWERbreathe in Research.

Ageing Reduces Breathing Muscle Strength

We came across this recent study (Oct 2014) from the Clinical Interventions in Aging which we felt worth sharing because it’s an area of women’s health (and applicable to men’s health) that we haven’t discussed before.

Single – and multiple – set resistance training improves skeletal and respiratory muscle strength in elderly women

Aging & biological modifications

The study identifies how, with aging, biological modifications take place which, generally speaking, “involves a reduction in physical capacity, in association with functional deficits, such as reduced levels of respiratory muscle strength and muscle strength, reduced cardiorespiratory capacity, and reduced mobility, all of which make completing daily activities more difficult.(1-3) A recent study established a strong association between poor physical fitness and respiratory (breathing) disorders.(3)

This dysfunction of the breathing muscles, it states, “can lead to hyperventilation, reduction in exercise tolerance, and even respiratory insufficiency; also, it is associated with an increase in morbidity and mortality rates.(3,4)

The study refers to how specific breathing muscle training has shown significant effects on the breathing muscle strength and endurance in athletes (5). It continues to remark that resistance training can be used for improving breathing muscle strength and that “the evaluation of respiratory muscle strength is of great clinical importance.”

How to reduce age-related breathing decline

In order to limit the progressive reduction of breathing muscle strength that sedentary ageing elicits, the study results suggested “elderly women who are not in the habit of physical activity may start with single-set resistance training programs as a short-term strategy for the maintenance of health.”

But there is a much more direct method for training the breathing muscles to become stronger, and that is POWERbreathe breathing muscle training. This is not to diminish though the benefits of physical activity for the maintenance of health. However, when combined with physical activity, breathing muscle training will improve breathing strength and stamina more than physical activity alone. And the benefits of this type of training apply equally to ageing men too.

Breathing strength and stamina will improve after just 4-weeks of POWERbreathe training, if the scientifically proven training regimen of 30 breaths twice a day is followed. Furthermore, as breathing stamina and strength improve, everyday tasks that once left you breathless will feel more comfortable. Consequently, daily activities will feel easier to achieve and you’ll find yourself enjoying life more.

See How POWERbreathe Works.

REFERENCES:

1. Westcott WL. Resistance training is medicine: effects of strength training on health. Curr Sports Med Rep. 2012;11(4):209–216. [PubMed]

2. Fiatarone MA, Marks EC, Ryan ND, Meredith CN, Lipsitz LA, Evans WJ. High-intensity strength training in nonagenarians. Effects on skeletal muscle. JAMA. 1990;263(22):3029–3034. [PubMed]

3. Vaz Fragoso CA, Enright PL, McAvay G, Van Ness PH, Gill TM. Frailty and respiratory impairment in older persons. Am J Med. 2012;125(1):79– 86. [PMC free article] [PubMed]

4. Sin DD, Wu L, Man SF. The relationship between reduced lung function and cardiovascular mortality: a population-based study and a systematic review of the literature. Chest. 2005;127(6):1952–1959. [PubMed]

5. HajGhanbari B, Yamabayashi C, Buna TR, et al. Effects of respiratory muscle training on performance in athletes: a systematic review with meta- analyses. J Strength Cond Res. 2013;27(6):1643–1663. [PubMed]

POWERbreathe and The Arthrogryposis Group

In April we were honoured to be asked by Emma Foden, Sport Scientist and Personal Trainer in disability sport, to talk to the charity, The Arthrogryposis Group at one of their summer events. Each event showcases different health, wellbeing and lifestyle opportunities that are available to them under the banner of Moving and Grooving with Otto; Otto being the charity’s mascot. Naturally we were delighted to be asked and agreed to assist at the event.

The Arthrogryposis Group is a UK based charity for those affected by Arthrogryposis Multiplex Congenita which causes curved joints in parts of the body.

The event we attended was the first in their calendar and took place on the 5th April at Uppingham School, Leicester. It was a ‘Swim Big Meet’ where the focus was to encourage people to swim more as a leisure activity as it helps to mobilise joints, activate muscles and improve cardiovascular strength.

During the event POWERbreathe provided a 30 – 45 minute presentation about the benefits of Inspiratory Muscle Training (IMT) as well as a demonstration of how POWERbreathe works. The importance of stronger breathing muscles for people affected by Arthrogryposis was brought home to us when we heard about a lady who’d been affected so much by this condition that she didn’t have enough air in her lungs to be able to speak.Thankfully POWERbreathe was there to offer her hope…

Because the lungs aren’t a muscle, they rely on the muscles surrounding them for their expansion and contraction. It’s this supporting structure that you need to strengthen and condition in order to appreciate proper, full breathing. So, by using POWERbreathe to exercise her breathing muscles, this lady will be strengthening her lungs’ supporting structure and improving her vital capacity, the usable portion of her lungs.

The day started at 10.30am and we were able to chat to members of the AGM about POWERbreathe before our presentation. We set up the presentation in a sports hall where we were also able to demonstrate the POWERbreathe K5 with Breathe-Link Software. Attendees came and tried out the K5 and took a strength-index test to see how their breathing faired. We were given permission by one member of the group, Neil Andrews, to record his first impressions of the POWERbreathe which you can view here:
“This could change my life” – WATCH VIDEO > 

In the afternoon the pool was open for people who wished to have a leisurely swim or take part in a lesson, as well as shooting, trampolining and fencing to have a go at. It proved to be a very positive, enjoyable day for all involved.

Emma already had personal experience of POWERbreathe and its benefits following the work she did for the study published in the BJSM (British Journal of Sports Medicine), Effects of inspiratory muscle training on respiratory function and repetitive sprint performance in wheelchair basketball players.

Thank you to Emma for contacting us in the first instance and allowing us to help people with potential breathing problems; to The Arthrogryposis Group for being so attentive and interested in POWERbreathe and making it such an enjoyable day; and to Uppingham School for making us all feel welcome in such a lovely environment.