‘Train To Win’

The benefits of training the breathing muscles have been well researched and validated. During the development of the RespiBelt, Progressive Sports Technologies (Progressive) ran its own series of trials and laboratory tests to prove the concept.

Building on the extensive research supporting the use of pressure threshold inspiratory muscle training devices such as Powerbreathe, studies were  instigated to explore whether similar results could be achieved using RespiBelt. Preliminary studies have been incredibly positive and whilst further work is clearly desirable, the basic principle of thoracic-elastic loading delivered via a RespiBelt garment has been proven beyond doubt.

11 Week British Triathlon Trials

The first trial of early prototypes was performed with the support of British Triathlon and four of their TASS athletes over an 11 week period. The results of the training intervention proved very interesting. The participants significantly enhanced running economy measures, along with reduced sub-maximal oxygen utilisation and minute ventilation which was considered by British Triathlon scientists as being atypical of results expected due to habitual training adaptations. This prompted further investigation into the RespiBelt using a larger sample size with the addition of a control group.

4 Week Running Trials

The second trial was performed with 12 competitive athletes over only a 4 week period. Additional measures were taken in addition to the measures previously investigated. All the measures showed positive changes compared to the control group who undertook the same training regime. Breathing endurance improved as did, sub-maximal oxygen consumption, % VO2max, sub-maximal minute ventilation and heart rate. Further improvements in running economy, respiratory frequency and minute ventilation were also present.

Warm-up Trials

A third study was performed to assess the effectiveness of using RespiBelt to improve warm-up prior to exercise. The study suggested that inspiratory muscle strength was enhanced using RespiBelt during short duration, low intensity whole body exercise. In addition, this was more effective than using a control garment. Use of RespiBelt can facilitate optimal warm-up preparations by providing a respiratory warm-up effect similar to the one present in locomotive muscles. It also seems that self reported asthmatics responded most to this intervention.

Effect on Breathing Dynamics

The final study investigated whether the use of RespiBelt during training would alter the breathing dynamics of the athlete. Using 3D motion video capture to monitor the changes to the chest volume and measuring all cardiac and ventilatory measures, no differences were observed. As expected, increase levels of perceived exertion were reported when using the RespiBelt due to the training load imparted by the device during exercise.

A. 11-week RTD Training Intervention

Leeder, J., Pearce, M., Gray, A.R. (2007) Garment-based inspiratory muscle training enhances physiological responses to sub-maximal exercise: a pilot study (unpublished).

Methodology

Four male Talented Athlete Scholarship Scheme (TASS) triathletes took part in an 11-week RTD intervention, measures were taken as part of the standard monitoring procedures in place by British Triathlon sport science support staff. Participants incorporated RTD into the majority of their cycling and running training sessions (~10 hours per week).

Pre and post intervention, an indirect measure of inspiratory muscle strength; maximal inspiratory pressure (MIP) at residual volume, was obtained using an MIP device (Chest Scientific, UK). Lung function (flow-volume loops) values were obtained using static spirometry (Super spiro, Micro Medical, UK).

Physiological responses to sub-maximal exercise were assessed pre-and post-intervention. The test began with the first stage being 1 km.h-1 faster than the warm up speed. Each stage lasted 4-min and continued in an incremental manner with increases of 1 km.h-1 per stage. In the final minute of each stage oxygen consumption (VO2), carbon dioxide production (VCO2), minute ventilation (VE), respiratory frequency (fR), tidal volume (VT) and respiratory exchange ratio (RER) were assessed via an automated online gas analysis system (Jaeger Oxycon Pro, Manheim, Germany). In this final minute, heart rate and rating of perceived exertion (RPE; Borg, 1982) were recorded.

There was a 1-min rest period in between stages in which a blood sample was taken for blood lactate analysis. The sub-maximal test consisted of at least 4 stages and was terminated once the participant had experienced a sudden and sustained increase in blood lactate concentration, defined as the steep part of the exponential increase in blood lactate concentration (Kindermann, Simon & Keul, 1979).

Results

The participants significantly enhanced (from pre to post intervention):

Running Economy (ml.kg-1km-1) -6.1 ± 3.3% (P < 0.00001)
Sub-maximal oxygen consumption (ml.min-1) -4.3 ± 3.8% (P < 0.001)
Sub-maximal minute ventilation (l.min-1) -4.5 ± 3.7% (P < 0.001)
Sub-maximal heart rate (beat.min-1) -4.8 ± 2.2% (P < 0.05)

Discussion

The significant enhancement of running economy along with reduced sub-maximal oxygen utilisation and minute ventilation was deemed by support staff as being atypical of results expected due to habitual training adaptations. This prompted further investigation into the RTD using a larger sample size with the addition of a control group.

B. 4-week RTD Training Intervention

Leeder, J., Gleeson, M., Gray, A.R. (2007) Garment-based inspiratory muscle training enhances respiratory endurance and physiological responses to sub-maximal exercise, with no effect on 3-km time trial in competitive male runners. MSc Thesis, Loughborough University (unpublished).

Methodology

Twelve competitive male runners (24 ± 3 yrs) participated in 4 week inspiratory muscle training (IMT) intervention.  Participants were randomly assigned into a RTD group (n=6) and a control group (n=6).  Each participant completed 5h of steady running per week (~70% VO2 peak  / ~80% maximal heart rate).

Pre and post intervention, lung function, inspiratory muscle strength, and physiological responses to sub-maximal exercise were recorded (as in British Triathlon Study 1).  The sub-maximal test now included a rating of perceived dyspnoea (RPD).  The RPD scale was a modification of the Borg (1982) scale in which participants selected a score of 1-10 that was a reflection of the effort required to breathe, rather than the effort of the exercise.

A second additional measure was breathing endurance time.  The endurance capacity of both inspiratory and expiratory muscles was assessed by the use of a respiratory muscle analyser (Micro Medical Ltd, Kent, UK).  While seated, participants breathed into the flow resistive device at their natural resting breathing frequency.  Once the breathing rate had stabilised, a load of 70% MIP was added to both inspiratory and expiratory breathing cycles.  Participants were instructed to maintain their natural breathing frequency that was visible on a monitor.  The aid of a metronome ensured this breathing rate was adhered to and helped the participants to stay in a rhythmical cycle.

The test was terminated when participants deviated within ± 5 breaths.min-1 or when they could no longer continue.  Breathing endurance time was recorded to the nearest second.
A performance measure was also included pre and post intervention using a 3-km running TT on an outdoor athletics track with participants performing individually.

Results

Breathing endurance improvement was significantly greater (P < 0.05) in the RTD group (mean ± SD; 150.5 ± 99.2%) than control group (35.5 ± 27.5%).

The RTD group significantly decreased (pre to post intervention):

Sub-maximal oxygen consumption (l.min-1) -3.8 ± 2.4% (P < 0.05)
% VO2 peak (%) -4.5 ± 2.1% (P < 0.05)
Sub-maximal minute ventilation (VE) -7.3 ± 3.5% (P < 0.01)
Heart rate (b.min-1) -4.8 ± 2.2% (P < 0.05)

No significant changes in these measures were seen in the control group.
There were significantly different % changes in respiratory frequency (fR, P < 0.05) and minute ventilation (VE, P < 0.01) between groups. There was also a trend towards enhanced running economy (-4.2 ± 4.7%) in the RTD group. Significant improvements in 3-km TT times were seen in both the RTD and control group, however there was no significant difference between groups.

Discussion

The present data indicate that garment-based IMT is effective in increasing breathing endurance, attenuates sub-maximal VE and reduces the oxygen cost of running but has no effect on 3-km TT performance.

It is anticipated that performance benefits may become elucidated during a longer distance TT as it is unlikely that inspiratory muscle fatigue occurred during the relatively short duration of exercise required for the 3-km TT. It is also worth noting the relatively short term intervention (4 weeks) used, and consequently the opportunity for extensive adaptation is likely to have been limited.

C. RTD warm-up response (Study 3)

Gray, A.R., Waller, T.M., Caine, M.P. (2008) The acute response to a garment-based elastic thoracic load, applied during exercise on inspiratory muscle strength and pulmonary function. Proceedings of the 7th International Conference on the Engineering of Sport, Biarritz, France.

Methodology

Twelve recreationally active males (24 ± 3 yrs, 81.3 ± 7.1 kg) took part in a randomised cross over study. Wearing RTD or control garment, participants exercised at 100 W for 10 minutes on a rowing ergometer (Concept II, USA). For the final 5 minutes, 6 x 5 s high-intensity sprints were performed separated by 1 minute 100 W recovery bouts.

Pre and post exercise, an indirect measure of inspiratory muscle strength, maximal inspiratory pressure (MIP) at Residual Volume, was obtained using an MIP device (Chest Scientific, UK). Lung function (flow-volume loops) values were obtained using static spirometry (Super spiro, Micro Medical, UK). Heart rate was monitored throughout the exercise protocol.

Results

Wearing the RTD significantly enhanced (from baseline):

Inspiratory muscle strength (cmH2O) 8.1 ± 2.0 % (P < 0.01)

Wearing the control garment reduced (from baseline):

Inspiratory muscle strength (cmH2O) -2.0 ± 2.6 %

Pre-exercise, FEV1 was found to be significantly higher before using the RTD. No other differences in lung function parameters pre and post exercise were seen between RTD and control.

Discussion

The present study suggests that inspiratory muscle strength can be enhanced using RTD during short duration, low intensity whole body exercise. In addition, this was more effective than using a control garment. RTD may therefore be useful in facilitating optimal warm-up preparations by providing a respiratory warm-up effect similar to the one present in locomotive muscles. It also seems that self reported asthmatics responded most to this intervention (circled).

D. RTD during use effects

Gray, A.R., Smith, P.W., Caine, M.P. (2009) The acute response to garment-based thoracic elastic loading on ventilation. Proceedings of the 4th Asia-Pacific Congress on Sports Technology, Hawaii, USA.

Methodology

Four recreationally active males (24 ± 1 yrs, 70.9 ± 4.2 kg) took part in a cross over study. Wearing RTD or control garment, participants ran at 75% VO2max for 4 x 6 minute bouts, with RTD and control conditions experienced twice by each subject on the same test occasion with order determined by a latin square.

Minute oxygen uptake (VO2), minute ventilation (VE), tidal volume (VT), breathing frequency (fR) and heart rate (HR) were recorded during the final 90 seconds of each bout of running (Medical Graphics Ultima CardiO2, USA). Ratings for dyspnoea, breathing exertion and leg exertion were also obtained. Maximal inspiratory pressure (MIP) was measured pre and post each bout.

Results

No significant differences were in VO2, VE, VT, fR or HR, between conditions.

However ratings of dyspnoea (P < 0.05), breathing exertion (P < 0.01) and leg exertion (P < 0.01) were all found to be significantly higher while wearing RTD compared to control.

MIP was significantly higher after wearing RTD (161 ± 39 cmH2O) than control (156 ± 38 cmH2O) (P < 0.05).

Discussion

These preliminary data suggest that RTD did not significantly affect ventilatory measures, however the loading stimulus around the thorax was deemed to be present evidenced by elevated perceptual indices. In corroboration with Study C, inspiratory muscle strength after the short sub-maximal exercise bout was found to be significantly higher after wearing RTD than control.

Further Reading and References Page

  • Improved lung strength (Griffiths and McConnell, 2007)
  • Reduced feeling of breathlessness (Lisboa, 1997) (Volianitis et al., 2001b)
  • Increased perception of recovery (Romer et al., 2002b)
  • Enhanced development of intercostal muscle fibres (Ramirez-Sarmiento et al., 2002)
  • Reduced minute ventilation (Harms et al., 1998)
  • Enhanced resistance to fatigue in respiratory muscles (Verges et al., 2006)
  • Reduced heart rate (Gething et al., 2004)
  • Attenuation of lactate (Romer et al., 2002b, Dempsey et al., 2006)
  • Relieves the symptoms of asthma resulting in reduction of medication and a fall in hospitalizations (Weiner et al., 1992)
  • Enhanced respiratory endurance (208%) (Leddy et al., 2007)
  • Enhanced exercise capacity and physical activity levels in the elderly (Aznar-Lain et al., 2007)

Specific Performance Adaptions

  • Improvements in time trial performance by as much as 4.6%: rowing, cycling (Volianitis et al., 2001a) (Romer et al., 2002a)
  • Improvements in 80% VO2max treadmill run time to exhaustion using VIH by 50% (Leddy et al., 2007)

References

  • Aznar-Lain S, Webster AL, Canete S, San Juan AF, Lopez Mojares LM, Perez M, Lucia A, Chicharro JL. (2007) Effects of Inspiratory Muscle Training on Exercise Capacity and Spontaneous Physical Activity in Elderly Subjects: a Randomized Controlled Pilot Trial. International Journal of Sports Medicine 29: (ahead of print)
  • Gething AD, Passfield L, Davies B (2004) The effects of different inspiratory muscle training intensities on exercising heart rate and perceived exertion. European Journal of Applied Physiology. 92: 50-55
  • Griffiths LA, McConnell AK (2007) The influence of inspiratory and expiratory muscle training upon rowing performance. European Journal of Applied Physiology 99: 457-466 Harms CA, Babcock MA, McClaran SR, Pegelow DF, Nickele GA, Nelson WB, Hanson P, Dempsey JA (1998) Effects of respiratory muscle work on cardiac output and its distribution during maximal exercise. Journal of Applied Physiology. 85: 609-618
  • Leddy JJ, Limprasertkul A, Patel S, Modlich F, Buyea C, Pendergast DR, Lundgren CEG (2007) Iscocapnic hyperpnea training improves performance in competitive male runners. European Journal of Applied Physiology. 99: 665-676
  • Lisboa C, Villafranca C, Leiva A, Cruz E, Pertuzé J, Borzone G (1997) Inspiratory muscles training in chronic airflow limitation: effect on exercise performance. European Respiratory Journal 3: 537-542
  • Ramirez-Sarmiento A, Orozco-Levi M, Guell R, Barreiro E, Hernandez N, Mota S, Sangenis M, Broquetas JM, Casan P, Gea J (2002) Inspiratory muscle training in patients with chronic obstructive pulmonary disease: structural adaptation and physiologic outcomes. American Journal of Respiratory Critical Care Medicine 166: 1491-1497
  • Romer LM, McConnell AK, Jones DA (2002a) Effects of inspiratory muscle training upon time trial performance in trained cyclists. Journal of Sports Science. 20: 547-562 Romer LM, McConnell AK, Jones DA (2002b) Effects of inspiratory muscle training upon recovery time during high intensity exercise, repeated sprint activity. International Journal of Sports Medicine. 23: 353-360
  • Verges S, LenHerr O, Haner A, Schulz C, Spengler C (2006) Increased fatigue resistance of respiratory muscles during exercise after respiratory muscle endurance training. American Journal of Physiology - Regulatory Integrative Comparative Physiology. (in press)
  • Volianitis S, McConnell AK, Koutedakis Y, McNaughton L, Backx K, Jones DA (2001) Inspiratory muscle training improves rowing performance. Medicine and Science in Sports and Exercise. 33: 803-809
  • Weiner P, Azqad Y, Ganam R, Weiner M (1992) Inspiratory muscle training in patients with bronchial asthma. Chest. 102(5): 1357-1361
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