Effects of High-Intensity IMT Following a Near-Fatal Gunshot Wound


Effects of High-Intensity Inspiratory Muscle Training Following a Near-Fatal Gunshot Wound


A man who sustained a gunshot wound (via the left axilla which exited from the right side of the abdomen) during armed combat left him with severe thoracic and abdominal injuries. After five months he still reported severe dyspnoea on exertion and so a program of high-intensity, interval-based threshold inspiratory muscle training (IMT) was undertaken.

Discussion points and observations:

The subject tolerated well the high-intensity IMT. “It was associated with improvements in maximum forced inspiratory flow and changed the locus of symptom limitation during high-intensity exercise from dyspnea to leg fatigue.”

The purpose of this case study was to ensure every effort is made to optimise physical function following such injuries, so that individuals may continue in active service.

Use POWERbreathe To Help Alleviate Side Stitch

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.

Effects of IMT on Resistance to Fatigue of Respiratory Muscles in Exercise

EliteVelo Kalas Sportswear Cycling Race Team by Richard Fox Photography

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 >

Royal Marine passes fitness test with help from POWERbreathe

At the Triathlon Show we recently attended in London (February 2015), we were delighted when a visitor to the stand shared a very personal and positive story with us.

In 1998 / 1999 the gentleman in question had applied to take the Royal Marines fitness test but unfortunately didn’t pass on that occasion.

Determined to pass the fitness test, he went away to assess how he could become fit enough to take it again and came across POWERbreathe which he immediately incorporated into his training regimen.

After about 3-months’ training with his POWERbreathe, he re-took the test and as he says in this short video, “aced the test”.


The Potential Royal Marines Course (PRMC) and Potential Officers Course (POC) are among the toughest initial trainings of any elite force in the world. But before recruits make it through to these courses they need to pass the Royal Marines Pre Joining Fitness Test which involves two runs of 1.5 miles (2.4 km) each with the treadmill set at a 2% incline. To pass they need to do the first run in under 12 minutes 30 seconds and then complete the second 2.4km run immediately afterwards in less than 10 minutes (regardless of age). So you can see how tough it is to pass the test!

Energy and stamina are required if recruits are to get through, and this is where POWERbreathe can help. Because a recruit will be asking more from their muscles, their body will demand more oxygen to provide more energy to their muscles. To cope with this extra demand, their breathing will increase and their circulation will speed up as it needs to take the oxygen as quickly as possible to their fiercely working muscles. This will naturally leave a recruit out of breath and potentially feeling fatigued early, hindering their chance of finishing the test in the time allowed.

POWERbreathe Inspiratory Muscle Training (IMT) trains these breathing muscles to become stronger, enabling recruits to draw in more air, filling the useable area of their lungs to their fullest capacity, giving them the strength and stamina to perform at their best.

Read more about POWERbreathe for Armed Forces here.


Don’t let obesity slow you down at work – POWERbreathe!

In this blog we’re looking at how POWERbreathe could help improve the endurance of heavier people in the workplace.

Published in the Journal of Occupational and Environmental Hygiene (JOEH), a new study revealed workers that are obese “may have significantly shorter endurance times when performing workplace tasks, compared with their non-obese counterparts.”

The study, which focused on industrial environments where tasks are repetitive and controlled, could also be applied to roles that require a certain level of stamina on a daily basis, such as that required in the public or uniformed services (including the fire service, military e.g. RAF, Army, Navy, HM Prisons); nursing; the postal/delivery service; and builders, for instance.

The study was inconclusive as to what caused the lower levels of endurance; whether difficulty moving because of the worker’s heavier weight contributed to less stamina and more fatigue, or whether fatigue contributed to the weight gain.

The report revealed how being overweight can affect the way muscles work i.e. “decreasing blood flow and thus reducing the amount of oxygen and energy that reaches the muscles. When contracting muscles for a sustained period of time, people who are obese can experience muscle fatigue sooner than others.”

During physical activity your breathing can be pushed to its limit, and as you draw more air into your lungs your respiratory system can start to consume as much as 20% of available energy. This results in your breathing muscles, including your diaphragm and intercostal muscles between the ribs, starting to fatigue and steal oxygenated blood from your working limbs in order to support them. This makes physical activity feel harder and induces a feeling of breathlessness.

The good news is that your breathing muscles are just like any other muscle, so just as you’d train your calves or hamstrings to give you better endurance and strength for a particular sport or activity, you can also develop your breathing muscles using POWERbreathe to improve their strength and stamina which in turn reduces fatigue.

Read more about POWERbreathe breathing training for Corporate Fitness, or if you’re already using POWERbreathe, then please leave a comment here or on the POWERbreathe Forum, Facebook or Twitter as we’d love to hear from you. You can also read more about POWERbreathe for health and wellbeing in our Health and Wellbeing Blog.

POWERbreathe training for tri-forces expedition to Makalu

In September of this year, a tri-service team – Makalu 2014 – will attempt to place at least two of its eight members on the summit of Makalu via the most challenging route, the South East Ridge. If they are successful then this expedition will become the first British ascent via this notoriously difficult route.

Makalu is the fifth highest mountain in the world standing at 8,463 metres and is located in the Mahalangur Himalayas on the border between Nepal and China, southeast of Mount Everest.

Not only does scaling the mountain via this particular route present a challenge, but also the height of the mountain means that breathing at altitude will also be difficult.

With breathing an issue at high altitude, the expedition plan on introducing POWERbreathe Inspiratory Muscle Training to the team for their pre-expedition training “as a way of developing their respiratory function”, which is something they have done successfully for previous expeditions.

The Makalu 2014 team, led by Expedition Leader Wing Commander Colin Scott MBE (RAF), comprises members of the British Army, Royal Navy and Royal Air Force and they have already spent a day undergoing a series of physiological tests, including VO2 max, at the Carnegie Research Institute at Leeds Metropolitan University.

Arranged by Dr. John O’Hara, Reader in Sports and Exercise Physiology, the team was subjected to a range of tests designed to enable Expedition Performance Coach, Paul (Chip) Rafferty, to finely tune individual training plans for each member as part of their final preparation.

Included in their training plans for breathing at high altitude will be POWERbreathe Inspiratory Muscle Training (IMT) which targets the breathing muscles, strengthening them by around 30-50%, helping to eliminate breathing fatigue.

As the team ascends Makalu, above 3000m the amount of oxygen in the air decreases by 30%. At around 1km they’ll begin to experience breathlessness and at 4km they’ll even feel breathless at rest. This is because at high altitude the body becomes limited by the ability to pump air in and out of the lungs. Just to put this into perspective whilst resting at sea level, you breathe about 12 litres of air in and out of your lungs every minute. At the summit of Mt. Everest (8848m) it requires almost maximal levels of breathing (in excess of 150 litres per minute) just to put one foot in front of the other. This level of breathing can be sustained for only a couple of minutes at a time. And if the respiratory muscles are working very hard at breathing, they can then also ‘steal’ blood from the legs to meet their own requirement for oxygen, thus impairing leg performance during climbing. Basically, all this respiratory work can lead to chronic fatigue of the breathing muscles, increasing breathlessness and impairing climbing performance.

Inspiratory Muscle Training:

  • Reduces oxygen requirement of exercise in simulated altitude by 8-12%*
  • Reduces cardiac output requirement of exercise in simulated altitude by 14%*
  • Reduces breathing requirement of exercise in simulated altitude by 25%*
  • Increases arterial oxygen saturation by 4%*
  • Increases lung diffusing capacity by 4%*
  • Reduces perceived exertion*
  • Reduces breathlessness*

*Effects of inspiratory muscle training on exercise responses in normoxia and hypoxia

So as part of their pre-expedition training, each team member will be given a POWERbreathe Plus to use as part of their daily training (POWERbreathe Plus Level 2 MR and POWERbreathe Plus Level 3 HR). They will also have the use of a POWERbreathe K5 with Breathe-Link Software for lab quality measurement of four main training indices: training load; inspiratory power; inspiratory flow; energy expenditure.

You can check on the team’s progress by visiting their website www.makalu2014.com but we’ll also be offering updates here on the POWERbreathe website, where you can also find research papers and review articles that look at Inspiratory Muscle Training for High Altitude Training.

Why you should dig deep and breathe from your diaphragm

We thought we’d write a very quick blog on why it’s important to breathe deeply from your diaphragm, after all that’s why POWERbreathe was developed – to answer a need for training the breathing muscles (primarily the diaphragm) so that we all start to breathe again as nature intended, from the diaphragm and not from the chest.

Your diaphragm is the large muscle that’s located below your lungs. When you take a deep breath in your lungs expand with air and press down on your diaphragm, which in turn causes your abdomen to expand.

This deep diaphragmatic breathing is something we all did when we were babies, but with our busy and often stressful lifestyles we become shallow chest breathers and lose the benefits that deep breathing brings.

Remember how at a particular stressful moment we’re often told to “take a deep breath,” well this is because it helps to calm you down. Research has also shown that deep breathing exercises will help people with breathing problems, as it makes their breathing muscles stronger. Deep breathing exercise with POWERbreathe is also helpful to athletes because inspiratory muscle training exercises these breathing muscles to become stronger and more resistant to fatigue, while also helping them to take in as much oxygen as possible for improved stamina and ultimately performance.

Try this quick test:

1. Place your right hand on your abdomen and your left hand on your chest. As you breathe, see which hand rises more. If your left hand rises more, you are a chest breather. If your right hand rises more, you are an abdomen breather, pulling air into the base of your lungs.

If you’re a chest breather, don’t worry because you can develop your breathing muscles for a better breathing technique with POWERbreathe Inspiratory Muscle Training.

If you’re a belly breather, then the next stage is to make your breathing more efficient with POWERbreathe.

POWERbreathe trains your diaphragm and intercostals (the muscles between your ribs which contract during inspiration) to breathe in a strong, smooth and continuous motion, improving the mechanical efficiency of your ‘bellows’ and making them stronger and more resistant to fatigue.

Training your breathing muscles with POWERbreathe is probably one of the most effective things that you can do for both short and long-term physical health, and now you can see why we say POWERbreathe is for ‘anyone who breaths’.


POWERbreathe for Firefighters with Chronic Respiratory Conditions

A study recently published (February 2014) in the International Archives of Occupational and Environmental Health assessed the prevalence of chronic respiratory conditions in (South Australian) metropolitan fire fighters. It also studied associations between occupational exposure, use of respiratory protection and health-related quality of life (HRQoL) in firefighters with and without chronic respiratory conditions.

Study: Chronic respiratory conditions in a cohort of metropolitan fire-fighters: associations with occupational exposure and quality of life.


Respiratory symptoms, medical conditions, occupational tasks and exposures and consistency of using respiratory protection were inquired by questionnaire. The Health Survey was used to measure physical and mental health-related quality of life.

Fire-fighters were categorised in subgroups: asthma; COPD/emphysema/chronic bronchitis; no chronic respiratory conditions; and as being ‘not involved’ or ‘involved’ in fire-fighting tasks, the latter further categorised as ‘consistent’ or ‘inconsistent’ use of respiratory protection.


Ten percent of metropolitan fire-fighters reported underlying chronic respiratory conditions. Presence of such a condition in combination with suboptimal protection from inhaled exposures may lead to poorer physical health-related quality of life.

Read Abstract: Chronic respiratory conditions in a cohort of metropolitan fire-fighters: associations with occupational exposure and quality of life.

How could POWERbreathe help?

A project conducted at the University of Birmingham Sports Medicine and Human Performance Unit into the respiratory performance in firefighters unearthed some not-so-surprising findings:

  • Lung function is impaired whilst wearing SCBA (Self-Contained Breathing Apparatus)
  • Respiratory muscle strength and lung function are impaired further after physical work in SCBA
  • Firefighters adopt a special breathing strategy to minimise the breathlessness induced by working in SCBA

Looking at data from scientific studies, if firefighters performed POWERbreathe Inspiratory Muscle Training for a minimum of 4-weeks, they could:

  • Increase their inspiratory muscle strength
  • Reduce breathlessness
  • Reduce heart rate (1)
  • Reduce the rate of air use from the cylinder (increasing wear time by around 1.5 min from a 15 min cylinder) (1)
  • Increase time to exhaustion (findings from a standard laboratory treadmill test)

(1) Donovan K, McConnell A. Fire-fighters’ Self-contained Breathing Apparatus (SCBA): The Effects of Inspiratory Muscle Training (IMT) during Fire-Fighting Simulations in the Laboratory. In: Hanson, Lovesey, Robertson, editors. Annual Conference of the Ergonomics Society; 1999: Ergonomics Society; 1999. p. 348-52.

Read more about how POWERbreathe could benefit those in the Fire Service.

Women Police Officers Fail Fitness Test – POWERbreathe Could Help

Nearly 3% of 13,024 police officers have failed to pass their compulsory fitness test, and of those 3% who failed, 70% of them were women (according to a news article published online at BBC News UK which looked at figures provided by 27 forces under the Freedom of Information Act.)

Compulsory police fitness testing for those involved in officer safety training was introduced only last year (2014) in England and Wales for police officers, and what could be missing from their training in preparation for the fitness test, is Inspiratory Muscle Training (IMT).

Biologically women have smaller lungs and airways and weaker respiratory muscles, which makes breathing during exercise much harder work. This could be a contributing factor in fitness levels in women, and why more women than men failed the police fitness test.

The study that discovered women really do get more exhausted during exercise than men, ‘Physiological mechanisms of sex differences in exertional dyspnea: Role of neural respiratory motor drive’ revealed that “because of a woman’s smaller size, when she is exercising, her brain needs to send stronger electrical signals to the respiratory muscles, and specifically the diaphragm, than does a man’s in the same situation.”

This revelation that women are more short of breath than men during exercise because their respiratory muscles are more active does not mean that there’s no hope for women. On the contrary, all is not lost because women – in fact all of us – can influence the strength and stamina of our breathing, by exercising our breathing muscles with POWERbreathe.

By incorporating POWERbreathe respiratory muscle training into fitness training 4 – 6 weeks in advance of the police fitness test, women can start off with an advantage as opposed to feeling disadvantaged because of their physiology. By taking just 30 breaths twice a day through POWERbreathe against the adjustable resistance we can all improve our breathing strength and stamina, and for women preparing for their police fitness test, this would help their performance in the Shuttle Run Test, and ultimately during any prolonged foot chases and foot patrols.

Read more about incorporating POWERbreathe IMT into police fitness training, or if you’re a police officer and are already using POWERbreathe, then please leave a comment here or on the POWERbreathe Forum, Facebook or Twitter pages as we’d appreciate your feedback.

Learning about the Respiratory System for Fitness Instructing & Personal Training





Emma Foden is an Exercise Science Consultant and CYQ Accredited Head of the Training Academy at Dynamic Fitness. Emma is also a published author in the British Journal of Sports Medicine for her research on the ‘Effects of inspiratory muscle training on respiratory function and repetitive sprint performance in wheelchair basketball players’.

Here Emma tells us about the new REPs accredited courses Dynamic Fitness delivers, including one that teaches Fitness Instructors and Personal Trainers the importance of the respiratory system.

“Dynamic Fitness has turned a bit of a corner in recent months. The business used to be about educating an individual, teaching the about their body, how to eat and how to train to get maximum results through Personal Training.

We now deliver REPs accredited courses in Fitness Instructing and Personal Training, teaching students face-to-face or via e-learning over a set period of time. In both the Fitness Instructing and the Personal Training courses students spend time learning about the Respiratory System which helps them to piece together this and the other five systems of the human body.

Within the body, especially during exercise, the effectiveness of the respiratory system and how well it works together with the cardiovascular system can have a definite improvement in exercise performance.

Students learn the transportation of air and then oxygen through the body and the process of diffusion for the gaseous exchange. They understand how the muscles help with inspiration and expiration. It is at this point that we talk about asthma and other respiratory disorders. From there it leads me to demonstrate the way that the intercostal muscles can be trained using improved breathing action.

The final point for student’s learning is to study the respiratory system in different populations; young people, pregnancy, in older people and disabilities.

Students are always fascinated to learn about POWERbreathe and their ability to train the intercostals muscles and I feel really lucky to be able to pass on this information to my students.

If you are interested in e-learning courses to be a Fitness Instructor or Personal Trainer, please get in touch with me, Emma at emma@dynamicfitnessuk.com so we can discuss options and cost of learning.”


Our thanks go to Emma for highlighting the importance of learning about the respiratory system and how it works together with the cardio system to improve exercise performance. Congratulations Emma on delivering these REPS accredited courses. We’d love to hear how everyone gets on. If you have a message for Emma then please leave a comment here.