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Like other forms of heart failure, low cardiac output and raised central venous pressure is what characterises the Fontan Circulation. However unlike other forms of heart failure, in Fontan circulation patients the primary limitation is absence of a subpulmonary ventricle.
Affects of Fontan circulation
Patients will experience reduced exercise capacity and respiratory muscle strength. Fortunately Inspiratory Muscle Training (IMT) improves exercise capacity and quality of life in adults with heart failure. This is evident from previous studies.
Purpose and method of study
The purpose of this study is to assess whether a home-based IMT program improves inspiratory muscle strength and the ventilatory efficiency of exercise in adolescent patients with a Fontan circulation.
To assess this, Fontan circulation patients underwent 30 minutes of IMT daily for six weeks. Exercise capacity (cardiopulmonary exercise testing), lung function and respiratory muscle strength (maximal inspiratory pressure and expiratory pressure) are all assessed.
Findings from the study show that IMT is a simple and beneficial addition to the management of Fontan patients. It shows that IMT potentially reduces exercise intolerance and long-term morbidity and mortality.
The study shows that six weeks of IMT is associated with improving inspiratory muscle strength, ventilatory efficiency of exercise, and resting cardiac output in young Fontan patients.
“Respiratory activity of the diaphragm and other respiratory muscles is normally co-ordinated with their other functions, such as for postural control of the trunk when the limbs move. The integration may occur by summation of two inputs at the respiratory motoneurons. The present study investigated whether postural activity of the diaphragm changed when respiratory drive increased with hypercapnoea.” Conclusion: “The findings of the present study have implications for the organisation of postural and respiratory activities of ‘respiratory’ trunk muscles and suggest that stability of the spine may be compromised in situations in which respiratory demand is increased, such as exercise and respiratory disease. Although investigation of spinal mechanics is required to confirm the extent to which spinal control is compromised by the increase in respiratory demand, it is hypothesised that such a compromise may lead to increased potential for injury to spinal structures and reduced postural control. During strenuous exercise, when the physical stresses to the spine are greater, the physiological vulnerability of the spine to injury is likely to be increased.” Postural activity of the diaphragm is reduced in humans when respiratory demand increases >
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A new POWERbreathe website has launched in Australia, developed and designed by our Australian POWERbreathe friends and distributor, for their community of sports people with an interest in improving their performance.
Australian Kayaker Jordan Wood, Kayaker/Surf Lifesaver Alyce Burnett and Ironwoman Harriet Brown are already Ambassadors and advocates of POWERbreathe, and the new website should help others understand the benefits of inspiratory muscle training and help them take the first step towards improving their breathing strength and stamina, and ultimately their performance.
“Aside from strengthening respiratory muscles to be able to hold a greater VO2 max I believe it [POWERbreathe] also allows the airways to be less reactive to EIA stimuli. Quite simply there is no reasonable difference in training the muscles that push the pedals to those that pump the air”, said professional cyclist Rachel Neylan.
The Commonwealth Scientific and Industrial Research Organisation (CSIRO) collaborated with the Australian Sports Commission to identify six megatrends likely to shape the Australian sports sector over the next 30 years, with individualised sport and fitness activities on the rise and at the top. This means that people are fitting sport into their increasingly busy and time-limited lifestyles to achieve personal health objectives, and this is where POWERbreathe can help, with its time-efficient training of just 30 breaths twice a day, taking about 5-minutes!