Acclimatisation to High Altitude – POWERbreathe IMT is Beneficial

There is a new Review Article in Frontiers in Physiology (January 2019) that looks into using respiratory/inspiratory muscle training for acclimatisation to altitude.

Respiratory muscle training

Respiratory muscle training, or RMT, is a programme of exercises that aim to improve the function of the respiratory muscles. Otherwise known as the ‘breathing pump’ muscles, the expiratory muscles and the inspiratory muscles make up the respiratory muscles. It’s the inspiratory muscles that we use when we breathe in. The main inspiratory muscle is the diaphragm, but to a lesser extent, the intercostal muscles also help with inhalation. To help improve the strength and stamina of these inspiratory muscles, respiratory muscle training will include Inspiratory Muscle Training (IMT).

Inspiratory Muscle Training

Inspiratory muscle training, such as with POWERbreathe, uses resistance to provide the training effect. When breathing in against the resistance, the breathing muscles have to work harder. As a result, they get stronger. Consequently, breathing stamina improves resulting in a reduction in breathing fatigue. There is numerous research validating this form of breathing training and, as a result, it is the most commonly used.

The review

For the review, researchers perform a comprehensive search, analysing seven appropriate studies. Three of these studies refer to using respiratory muscle endurance training (RME with isocapnic hyperpnea). However, the remaining four studies use respiratory muscle strength training (RMS with POWERbreathe IMT).

Acclimatisation to altitude

Studies suggest that respiratory muscle training with IMT is a useful preparatory method for enhancing respiratory muscle efficiency 4-6 weeks before being exposed to hypoxia/altitude.

It is evident that breathing during exercise in hypoxia is associated with increased energy costs (20–30%) when compared to normoxia. Therefore, it is more likely to cause respiratory muscle fatigue. However, inspiratory muscle training will help to combat this. This is because IMT trains the inspiratory muscles to become stronger, increasing stamina. Consequently, breathing muscle fatigue reduces.

It, therefore, seems apparent that breathing muscle training has the potential to minimise at least some of the limiting respiratory factors that occur during training and competition in hypoxia/at altitude.

Benefits of acclimatisation to altitude using IMT

The Review suggests that both elite athletes and non-elite individuals may benefit from RMT, including:

  1. A delay in the onset of premature fatigue.
  2. A delay in respiratory muscle metaboreflex onset/activation.
  3. An improvement in clearance and tolerance to anaerobic metabolite products.
  4. A decrease in the perception of dyspnea (‘air hunger’).
  5. An increase in oxygen saturation values.
  6. A more favourable blood redistribution to the locomotor muscles.

Finally, evidence from this review finds that respiratory muscle training is an effective stimulus for improving the strength and endurance of the respiratory muscles. In fact, it’s these adaptive responses that contribute to the improvement of ventilatory function and efficiency. In translation, this means that respiratory muscle training is very likely to improve exercise performance in normoxia and particularly in hypoxia/altitude.

Lower Blood Pressure with POWERbreathe IMT

The University of Colorado Boulder is using the POWERbreathe K-Series in their independent research. They are investigating the effects of just 30 breaths of inspiratory muscle strength training (IMST). Specifically, they are looking to see if it could lower blood pressure and reduce heart attack risk. They are also investigating whether it could help you think more clearly and boost sports performance.

Lower blood pressure

One of the key findings of the research so far is that 30 breaths of IMST (about five minutes) will lower blood pressure. Crucially, with about half the tests completed, researchers report significant drops in blood pressure and improvements in large-artery function. In fact, their findings show that about 5-minutes of IMST lowers blood pressure as much as aerobic exercise and more than some medications.

Other preliminary findings

The research findings also suggest that just 5-minutes of IMST may also boost cognitive function. Furthermore, their findings show that it may also improve fitness and increase sports performance. In fact, these improvements are already proven in previous research studies. However, this study reiterates such findings.

With the help of the university’s new National Institute on Ageing grant, researchers are launching a clinical trial.

The research

Research subjects will either be a part of a sham group (using low/no IMST) or the IMST group. The IMST group will perform 30 breaths of inspiratory muscle strength training (taking approximately 5-minutes). IMST is strength training for the muscles you use to inhale. Both groups will be performing their version of IMST over a period of 6 weeks. Researchers are hoping that by doing this for 5 minutes a day in the comfort of their own home, people will get health benefits they otherwise might not get.

The tests

Researchers will be performing tests to evaluate:

  • Vascular function – how healthy the blood vessels are
  • Cerebral vascular function – how healthy the blood vessels in the brain are
  • Cognitive function
  • Physical performance – VO2 max testing assesses this
  • Motor function

Results so far are showing that the IMST group, compared to sham subjects, are lowering their blood pressure and improving blood vessel health. Also, the IMST group is performing better on certain cognitive and memory tests. In addition, the IMST group are able to keep their heart rate and oxygen consumption lower during exercise. Consequently, subjects are also showing an increase in exercise tolerance time too.

Positive outcomes

With all this evidence, researchers hope that by using IMST, people may be able to get their blood pressure under control, decrease their risk of chronic conditions and live healthier lives.

Pilates Plus IMT Improves Lung Function

Researchers from Brazil are looking at the effects of combining Inspiratory Muscle Training (IMT) with Pilates on lung function in elderly women. The reason for this is because ageing affects the respiratory system. In fact, it can change the composition of the lung’s connective tissue.

Ageing and the lungs

Ageing will ultimately affect bones and muscles. Moreover, natural ageing also affects the bones and muscles of the chest. Consequently, it may affect the shape of the ribcage. As a result, the ribcage may no longer expand or contract as well as it once did, during breathing. Additionally, the main breathing muscle, the diaphragm, becomes weaker too. This will affect how much air a person is able to breathe in and out.

Furthermore, ageing affects lung tissue and the airways may lose their ability to stay open. Additionally, the air sacs begin to lose their shape. Consequently, air may become trapped in the lungs. This affects how well you’re able to breathe.

Why inspiratory muscle training?

Inspiratory Muscle Training (IMT) is a form of resistance training that exercises the inspiratory muscles. The main inspiratory muscles are the diaphragm and intercostals. It’s these muscles that are responsible for drawing air into the lungs. Furthermore, it’s these muscles that will be affected by ageing. Therefore, exercising these muscles with IMT will limit the effects of ageing. IMT will help them to become stronger and less prone to fatigue.

The IMT device that participants use in this trial is the POWERbreathe K5.

Participants breathe in through the K5 for 30 breaths. They perform this twice, with a one-minute interval between each set. After two weeks’ training, they must increase the training resistance by 10%. Researchers then assess an individual’s results following Pilates exercise.

Why Pilates?

Pilates is an exercise programme, developed in the 20th Century by Joseph Pilates. The exercises focus on improving core strength and muscular imbalance. Furthermore, Pilates improves flexibility, overall muscle strength and is low-impact, making it ideal for the age group in this study.

As we age, we become less active and more sedentary. Consequently, sitting for long periods limits movement and affects the body. In fact, age affects the entire musculoskeletal system: joints, muscles and bones. As a result, posture is affected and we also start to lose muscle tone, balance and joint mobility. Pilates can help to minimise these age-related changes.

For this study, participants use the Cadillac, Combo Chair and Reformer devices for the Pilates method. The researchers recommend nine exercises per session. Participants perform up to three sets of 12 repetitions of each exercise. They do this for a maximum of 45-minutes.

Study results

To establish if IMT positively effects breathing muscle strength, each participant’s maximum inspiratory pressure (MIP) is measured. MIP is an index of diaphragm strength and an independent predictor of all-cause mortality (longevity). Study findings show that MIP significantly evolved in the elderly. Additionally, the study highlights:

“the use of the POWERbreathe K5 device, which further favoured the gain in this variable.”

Findings also show:

“that all the variables were significantly better in the intervention groups than in the Control Group, thus strengthening the importance of the association between IMT and Pilates.”

In conclusion

“In conclusion, physiotherapy is an excellent ally in the prevention, promotion, and maintenance of health, quality of life and functional capacity in the gerontological population. The use of the Pilates Studio method, associated with technological equipment that allows more detailed analysis and treatment of pulmonary conditions, strength, function and mobility, was shown to be beneficial for this type of application.”

The influence of inspiratory muscle training combined with the Pilates method on lung function in elderly women: A randomized controlled trial >

Rugby & the Beneficial Effects of Inspiratory Muscle Training

The nature of the game of rugby involves high and low-intensity action. Also, the physical demands of the game are specific to each player’s positional role. However, despite the player’s position, all need to be aerobically fit. Each must also have a high lactate tolerance and be strong and powerful.

Challenges facing rugby players

Most of the game of rugby is sub-maximal. This means that the intensity at which the player performs increases at a steady rate. Furthermore, this sub-maximal exercise will only work the player up to 85% of their maximum heart rate.

However, integral to the game are intermittent sprints, tackling, scrums, rucks and mauls. These are supra-maximal. And it’s this part of the game that pushes players beyond their maximum limit. Consequently, breathing effort will be a challenge.

The pattern of exertion rugby has on players places extreme demands upon their breathing. This is because these activities are anaerobic and generate high levels of lactic acid. Furthermore, the lactic acid stimulates their breathing to increase. In addition, a unique feature of rugby is the involvement of high-intensity upper body activity. This can induce conflicting demands upon the breathing muscles, which as well as bringing about breathing, are also essential in activities that involve the upper body.

This 2018 study from Brazil reiterates the fact that the respiratory muscles need adequate work to maintain sustained effective breathing in the sport of rugby.

The scientific study

This scientific study set about analysing the effects of high-intensity inspiratory muscle training (IMT) in 20 amateur rugby players. These players are from the city of Uberaba, Minas Gerais, Brazil.

For the trial, the amateur players undergo a pulmonary function test, respiratory muscle strength and physical capacity assessment. Researchers then split them into two groups: the IMT group and the control group, each consisting of 10 players. The study has approval from the Research Ethics Committee of the Federal University of Triângulo Mineiro under protocol no. 2398.

Rugby training & conditioning for the trial

During the trial, players begin training with a warm-up by jogging for 5-minutes. They then perform dynamic stretching of the major muscle groups. Following this, the researchers have the players simulate specific moves applied to the game of rugby to improve its fundamentals. These include such moves as passing, blocking, feinting and collective strategic moves. Ultimately, the training session ends with stretching.

Players in the Inspiratory Muscle Training group perform three weekly sessions of an inspiratory muscle training programme, using the POWERbreathe Plus, for 12 consecutive weeks. These sessions are supervised by a physiotherapist and a physical education professional.

The IMT group protocol

This group protocol consists of:

  • 10 minutes’ stretching of the trunk muscles, upper and lower limbs
  • 10-minute inspiratory warm-up by performing a full and vigorous inspiration through the POWERbreathe Plus IMT device
  • A series of 30 repetitions using 80% of maximal inspiratory pressure using the POWERbreathe Plus IMT device. After the fourth training session, the level is increased.

The control group protocol

This group of 10 players perform the same protocol as above, except they do not perform the 30 repetitions of inspiratory muscle training using the POWERbreathe Plus.

Effects of high-intensity IMT in Rugby Players

Results show that the 12-week course of high-intensity POWERbreathe IMT provides significant increases in maximal voluntary ventilation (22%), maximum inspiratory pressure (38%), PEmax (32%), and distance travelled (13%) in the YoYo Test.

Also worthy of note is how physical capacity will be compromised if the respiratory system does not provide sufficient oxygen supply to satisfy the demands. Researchers explain that when the arrival of blood to the respiratory muscles decrease, it experiences fatigue and leads to lactic acid buildup. Consequently, this situation causes a decrease in the strength and resistance of the respiratory muscles.

Results of this trial suggest therefore that the POWERbreathe IMT training protocol provides beneficial, positive effects for rugby players.

The study

Effects of high-intensity Inspiratory Muscle Training in Rugby Players >

Metaboreflex & Performance in Elite Female Soccer

ECSS is the European College of Sport Science (ECSS). Part of its purpose is to promote junior scientists and foster state-of-the-art research. And in order to do this, ECSS have created the Young Investigators Award (YIA). This award-winning research, presented in the video, is for Metaboreflex and Performance in Elite Female Soccer: Effects of Inspiratory Muscle Training.

Video presentation of ECSS YIA winning research

Metaboreflex & Performance in Elite Female Soccer

This research aims to determine the effects of Inspiratory Muscle Training (IMT) on respiratory and peripheral muscles oxygenation. It examines this during a maximal exercise tolerance test and on repeated-sprint ability (RSA) performance in professional women football players.

Inspiratory Muscle Training

All participants in the study perform 6-weeks of IMT. The device they use for IMT is the POWERbreathe K5 with Breathe-Link Live Feedback software.

At the end of their 6 weeks’ training, all participants are reevaluated.

Research Findings

The findings show that,

“…only the IMT group present lower deoxyhaemoglobin and total haemoglobin blood concentrations on intercostal muscles concomitantly to an increased oxyhemoglobin and total haemoglobin blood concentrations on vastus lateralis muscle during time-to-exhaustion”

Research Conclusions

Results suggest the potential role of IMT to attenuate inspiratory muscles metaboreflex. Consequently, oxygen and blood supply to limb muscles during high-intensity exercise improves. Furthermore, there is also a potential impact on inspiratory muscle strength, exercise tolerance and sprints performance in professional women football players.

ECSS YIA Award

ECSS presents scientists with the opportunity of entering this prestigious competition for scientific excellence, every year. And it’s at the ECSS annual congress where young scientists present their scientific work, as they compete to win the YIA Award.

Following presentations, members of the ECSS Scientific Board and ECSS Scientific Committee, grant the awards. They base this decision upon an oral and mini-oral presentation for the top ten presentations respectively.

Bruno Archiza is the winner of this 2016 YIA award, and his presentation took place at the 21st annual congress of the ECSS in Vienna.

Tennis Players’ Endurance Improves after POWERbreathe IMT

New research shows tennis players’ endurance and strength improves after Inspiratory Muscle Training (IMT). The research from Pune, India, is in the International Journal of Current Research (February 2018).

What affects tennis performance

The main characteristics of this game are intense bouts of running, such as sprinting to reach a ball. Consequently, breathing is driven to its highest levels. And this induces extreme breathlessness. This affects performance.

In order to continue to play effectively while maintaining a high level of skill performance, breathing mustn’t hinder performance.

Breathing effort in tennis

Playing tennis involves using your breathing muscles in your torso to brace and twist during a racket stroke. Also, experienced players use their inflated lungs to brace the impact of the ball and racket. This helps them to control the release of air from their lungs and optimise the transmission of force. However, breathing muscle fatigue impairs this control. Thankfully though, breathing muscle strengthening training will improve this. Using a device that specifically trains the breathing muscles, the inspiratory muscles, is the easiest way of doing this. These are called Inspiratory Muscle Training (IMT) devices, such as POWERbreathe IMT. And training your breathing muscles to become stronger can help with a player’s postural control and movement too.

Research into players’ endurance

The research from Pune highlights the fact that tennis matches feature high-intensity, short- duration bouts of extreme activity with a short rest time. And it’s the competition of blood flow between the arms and legs and the breathing muscles which ultimately increases breathing fatigue.

For this study, researchers use the POWERbreathe KH1 Inspiratory Muscle Training (IMT) device to strengthen participants’ breathing muscles. Furthermore, each participant performed a prescribed protocol for using the device for five days over four weeks. Researchers were aiming to assess the effect of IMT on cardiovascular endurance in lawn tennis players.

Research findings

The findings of this latest research show there to be,

“significant improvement in cardiovascular endurance and strength in lawn tennis players after progressive inspiratory muscle training.”

How to improve tennis performance

POWERbreathe IMT specifically targets the breathing muscles, strengthening them by around 30-50%, significantly improving performance and helping to eliminate breathing fatigue. And these findings are a result of studies with tennis players who, after IMT, took less time to recover and were ready sprint maximally again more quickly.

 

 

Hospitalised Patients Benefit from POWERbreathe IMT

A new clinical trial in Brazil has found that POWERbreathe IMT improves inspiratory muscle strength and shortens the length of stay in hospitalised patients.

Objective

The aim of this double-blind randomised controlled trial is to assess the impact of IMT on hospitalised patients. IMT stands for Inspiratory Muscle Training. It trains the inspiratory muscles (the ones we use to breathe in) to become stronger and more resistant to fatigue. IMT is undertaken using the POWERbreathe Plus IMT device.

Proposed Outcomes for Hospitalised Patients

Hospitalised patients, with no existing respiratory issues, may encounter inpatient complications.

The clinical trial believes that, if implemented early, POWERbreathe IMT could prevent in-hospital adverse outcomes. These may, or may not, be directly associated with the loss of respiratory muscle mass inherent to a prolonged hospital stay.

Trial Method

Subjects are randomly assigned to either an IMT intervention group or an IMT sham group. Both groups were also to undergo conventional physiotherapy interventions.

The IMT intervention group performs IMT using the POWERbreathe Plus. Each patient trains against a load equivalent to 50% of their maximum inspiratory pressure. Maximum inspiratory pressure, or MIP, is a marker of respiratory muscle function and strength. All they need to do is breathe in through the device for 30 breaths. And they do this twice a day for 4 weeks.

Trial Results

Results show that patients in the IMT intervention group had a significantly shorter length of stay in hospital. They also show a lower risk of endotracheal intubation, muscle weakness and mortality.

Findings

The trial’s findings demonstrate that POWERbreathe IMT is a safe addition to physiotherapy. Results also show that it improves inspiratory muscle strength and functional status, as well as a shortened length of hospital stay.

Conclusion

This clinical trial shows that early implementation of POWERbreathe IMT is effective at preventing complications due to prolonged hospitalisation. It is also effective at reducing associated in-hospital mortality rates. Its therapeutic use is safe and well-tolerated in the hospital environment, providing respiratory gain and improving functional capacity.

Full details of this clinical trial are freely available for all to read on the internet. Safety and efficacy of inspiratory muscle training for preventing adverse outcomes in patients at risk of prolonged hospitalisation.

New Trial into Effects of IMT in COPD Patients

A new clinical trial will be looking at the effects of inspiratory muscle training (IMT) on shortness of breath (dyspnea) and postural control in patients with COPD.

Shortness of breath in patients with COPD

Patients with chronic obstructive pulmonary disorder (COPD) experience shortness of breath, or dyspnea, during physical activity. It is related to weakness of their respiratory muscles. There is much evidence of IMT improving breathing muscle function and reducing the intensity of dyspnea.

Balance impairment in patients with COPD

Patients with COPD and pronounced respiratory muscle weakness also show impaired postural balance. But improvements in respiratory muscle function might improve balance control in patients.

Purpose of the controlled trial

The trial will consider whether eight week’s of controlled IMT will reduce the intensity and feeling of dyspnea. It will also investigate if it improves postural control. And finally it will look to see if IMT improves blood flow and oxygen delivery to a patient’s limb muscles too.

Inspiratory muscle training intervention

The trial will use the POWERbreathe KHP2 Inspiratory Muscle Training device for monitoring breathing parameters. And patients will each use a POWERbreathe Medic Plus twice a day, mostly in their home and without supervision. However they will perform one training session each week under supervision, during which the training load will be increased. A sham group will perform three daily sessions of 30 breaths and will train at a constant inspiratory load of no more than 10% of their initial Pi,max.

The Principal Investigator is Rik Gosselink, PT, PhD. The trial is open to all sexes ageing from 40 to 90 years of age. It will take place at the University Hospital Leuven, Belgium. And the estimated completion date for the trial is January 31st 2018.

Influence of IMT on Cycling Performance at altitude

This study, Influence of IMT on Ventilatory Efficiency & Cycling Performance in Normoxia and Hypoxia, is published in Frontiers in Physiology. The aim of the study is to analyse the influence of inspiratory muscle training (IMT) on ventilatory efficiency in normoxia and hypoxia. It also investigates the relationship between ventilatory efficiency and cycling performance.

The point of the study

The premise of the study is that IMT improves ventilatory efficiency in normoxia and hypoxia. It also reduces the metabolic demands of the respiratory muscles in both conditions. The study also hypothesizes that improvements in submaximal cycling performance can be linked to improvements in ventilatory efficiency in normoxia and hypoxia.

Study method

The study assigns participants, at random, to either a control group or an inspiratory muscle training (IMT) group. The IMT group were to complete 30 inhalations twice a day using the POWERbreathe K3. They were to do this 5 days a week for 6 weeks. Researchers set the POWERbreathe K3 to 50% of each participant’s Pimax (maximal inspiratory mouth pressure). By contrast, the control group did not perform any IMT.

To determine Pimax participants had to inspire through the K3 as quickly as possible. And in order to achieve a stable measurement they were perform this a few times.

Conclusions for training at altitude

The study suggests a possible positive effect of IMT on cycling time trial performance in both normoxic and hypoxic conditions. It also shows that hypoxia has a negative effect on ventilatory efficiency. It furthermore shows that IMT may reduce this effect.

Additionally the authors report that these findings may have relevance for athletes planning to train at a high altitude, or compete at high altitude.

Finally, the study suggests that Inspiratory Muscle Training before a competition at altitude might be a successful method to improve performance.

Efficacy of Inspiratory Muscle Training on Elite Swimmers (PEAK)

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

    • POWERbreathe IMT

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 >