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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 35224

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Special Issue Editors

Prof. Dr. Jesús Gustavo Ponce González

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Guest Editor

1. ExPhy Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cadiz, 11519 Cadiz, Spain
2. Unidad de Investigación, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Hospital Universitario Puerta del Mar, 11009 Cadiz, Spain
Interests: exercise training; HIIT; sports; physical fitness; performance; exercise physiology; health; obesity and comorbidities; type 2 diabetes; metabolism; nutrition; appetite and endocrine system
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Prof. Dr. Cristina Casals

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Guest Editor

1. MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
2. Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Cádiz, Spain
Interests: sport and exercise physiology; physical exercise; combat sports; cardiorespiratory fitness; athlete performance; nutritional assessment; gut microbiota for health and performance
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

A Special Issue on respiratory muscle training (RMT) is being organized in the International Journal of Environmental Research and Public Health. For detailed information on the journal, please see https://www.mdpi.com/journal/ijerph.

RMT has been considered to be an effective method to improve performance in a wide range of exercise modalities, including running, cycling, swimming, and rowing. RMT may also improve exercise capacity, dyspnea, and quality of life of patients with chronic heart disease or respiratory disease, such as COPD and asthma. However, new research in the field is emerging in order to optimize health and performance by applying novel RMT devices, which can be used while performing physical exercise.

This Special Issue offers an opportunity to publish high-quality multidisciplinary research and reviews focused on the development of intervention strategies related to RMT to increase performance, physical capacity, and quality of life in both healthy and illness conditions.

Investigators who have conducted research on these topics are invited to submit manuscripts for consideration for this Special Issue in IJERPH.

Prof. Dr. Jesús Gustavo Ponce-González
Prof. Dr. Cristina Casals
Guest Editors

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

Inspiratory muscle training
Breathing pattern
Ventilation
Exercise
Dyspnea
Respiratory fatigue

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Published Papers (7 papers)

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Research

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14 pages, 3455 KiB

Open AccessArticle

Effects of a Rehabilitation Programme Using a Nasal Inspiratory Restriction Device in COPD

by Jose L. Gonzalez-Montesinos, Jorge R. Fernandez-Santos, Carmen Vaz-Pardal, Jesus G. Ponce-Gonzalez, Alberto Marin-Galindo and Aurelio Arnedillo

Int. J. Environ. Res. Public Health 2021, 18(8), 4207; https://doi.org/10.3390/ijerph18084207 - 15 Apr 2021

Cited by 2 | Viewed by 2666

Abstract

Chronic obstructive pulmonary disease (COPD) patients are characterised for presenting dyspnea, which reduces their physical capacity and tolerance to physical exercise. The aim of this study was to analyse the effects of adding a Feel-Breathe (FB) device for inspiratory muscle training (IMT) to an 8-week pulmonary rehabilitation programme. Twenty patients were randomised into three groups: breathing with FB (FBG), oronasal breathing without FB (ONBG) and control group (CG). FBG and ONBG carried out the same training programme with resistance, strength and respiratory exercises for 8 weeks. CG did not perform any pulmonary rehabilitation programme. Regarding intra group differences in the value obtained in the post-training test at the time when the maximum value in the pre-training test was obtained (Post_PRE), FBG obtained lower values in oxygen consumption (VO₂, mean = −435.6 mL/min, Bayes Factor (BF₁₀) > 100), minute ventilation (VE, −8.5 L/min, BF₁₀ = 25), respiratory rate (RR, −3.3 breaths/min, BF₁₀ = 2), heart rate (HR, −13.7 beats/min, BF₁₀ > 100) and carbon dioxide production (VCO₂, −183.0 L/min, BF₁₀ = 50), and a greater value in expiratory time (Tex, 0.22 s, BF₁₀ = 12.5). At the maximum value recorded in the post-training test (Post_FINAL), FBG showed higher values in the total time of the test (T_t, 4.3 min, BF₁₀ = 50) and respiratory exchange rate (RER, 0.05, BF₁₀ = 1.3). Regarding inter group differences at Pre_POST, FBG obtained a greater negative increment than ONBG in the ventilatory equivalent of CO₂ (EqCO₂, −3.8 L/min, BF₁₀ = 1.1) and compared to CG in VE (−8.3 L/min, BF₁₀ = 3.6), VCO₂ (−215.9 L/min, BF₁₀ = 3.0), EqCO2 (−3.7 L/min, BF₁₀ = 1.1) and HR (−12.9 beats/min, BF₁₀ = 3.4). FBG also showed a greater Pre_POST positive increment in Tex (0.21 s, BF₁₀ = 1.4) with respect to CG. At Pre_FINAL, FBG presented a greater positive increment compared to CG in T_t (4.4 min, BF₁₀ = 3.2) and negative in VE/VCO₂ intercept (−4.7, BF₁₀ = 1.1). The use of FB added to a pulmonary rehabilitation programme in COPD patients could improve tolerance in the incremental exercise test and energy efficiency. However, there is only a statically significant difference between FBG and ONBG in EqCO₂. Therefore, more studies are necessary to reach a definitive conclusion about including FB in a pulmonary rehabilitation programme. Full article

(This article belongs to the Special Issue Respiratory Muscle Training for Health and Performance)

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8 pages, 316 KiB

Open AccessArticle

Cardiorespiratory Fitness in Volleyball Athletes Following a COVID-19 Infection: A Cross-Sectional Study

by Aleksandra Milovancev, Jovana Avakumovic, Nemanja Lakicevic, Valdemar Stajer, Darinka Korovljev, Nikola Todorovic, Antonino Bianco, Nebojsa Maksimovic, Sergej Ostojic and Patrik Drid

Int. J. Environ. Res. Public Health 2021, 18(8), 4059; https://doi.org/10.3390/ijerph18084059 - 12 Apr 2021

Cited by 28 | Viewed by 5361

Abstract

Athletes’ lifestyles have been dramatically affected by the coronavirus disease 2019 (COVID-19) pandemic. Since COVID-19 primarily affects the respiratory system and to a lesser degree the cardiovascular system, the goal of this study was to examine the effects of COVID-19-caused detraining on cardiorespiratory fitness (CRF) of recently recovered volleyball athletes. Sixteen experienced volleyball athletes (age 24 ± 4.5 years) who were recently diagnosed and recovered from a COVID-19 infection volunteered to participate in this study and were tested for CRF and spirometry. Given that participants had only mild symptoms of infection, the primary focus of this study was on the effects of detraining on CRF. On average, the time to exhaustion was 9.4 ± 1.4 min. VE, VCO₂, RER and oxygen pulse increased, heart rate exceeded 90% of predicted values, and peak VO₂ values were typical for this level of athlete (44.1 ± 3.4 mL/kg). Pulmonary function reflected in FVC, FEV1/FVC and MVV values were well above 80% of predicted values for each of the participants while electrocardiography revealed no ischemia, arrythmias or conduction and repolarization abnormalities were found in the tested subjects. Therefore, it can be concluded that participants experienced typical consequences of detraining. Due to a lack of CRF data prior to COVID-19 infection, we were unable to estimate the magnitude detraining had on CRF. Complete CRF assessment after COVID-19 infection in athletes can be useful for screening of residual myocardial and/or respiratory system damage for safe return-to-play decisions. Full article

(This article belongs to the Special Issue Respiratory Muscle Training for Health and Performance)

15 pages, 1924 KiB

Open AccessArticle

12-Week Inspiratory Muscle Training Improves Respiratory Muscle Strength in Adult Patients with Stable Asthma: A Randomized Controlled Trial

by Yi Chung, Ting-Yu Huang, Yi-Hung Liao and Yu-Chi Kuo

Int. J. Environ. Res. Public Health 2021, 18(6), 3267; https://doi.org/10.3390/ijerph18063267 - 22 Mar 2021

Cited by 23 | Viewed by 11062

Abstract

This study aims to investigate and compare the effects of conventional breathing exercises and an inspiratory muscle training intervention on clinical symptoms in asthma patients. Sixty asthma patients (40–65 years old) were randomly assigned to either the conventional breathing exercises (BTE) or inspiratory muscle training (IMT) group for a 12-week intervention period. Outcome measurements were performed before and after the intervention, including the spirometry data, maximal inspiratory and expiratory pressures (PImax and PEmax), asthma control test, asthma control questionnaire, six-minute walk test, and three-day physical activity log, were recorded. PImax expressed as % of predicted value controlled for age and gender in healthy subjects (% predicted) increased by 16.92% (82.45% to 99.38%, p < 0.05) in the BTE group and by 29.84% (71.19% to 101.03%, p < 0.05) in the IMT group. Except for forced vital capacity, which was reduced in the BTE group, all other measured variables improved in both groups, and no statistically significant between-group differences were found. IMT appears to be more effective than breathing exercise intervention in promoting improvements in respiratory muscle strength. IMT may act as an alternative to conventional breathing exercises for middle-aged and elderly asthma patients. Full article

(This article belongs to the Special Issue Respiratory Muscle Training for Health and Performance)

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13 pages, 981 KiB

Open AccessArticle

Chronic Effects of a Training Program Using a Nasal Inspiratory Restriction Device on Elite Cyclists

by Jose L. Gonzalez-Montesinos, Jorge R. Fernandez-Santos, Carmen Vaz-Pardal, Ruben Aragon-Martin, Aurelio Arnedillo-Muñoz, Jose Reina-Novo, Eva Orantes-Gonzalez, Jose Heredia-Jimenez and Jesus G. Ponce-Gonzalez

Int. J. Environ. Res. Public Health 2021, 18(2), 777; https://doi.org/10.3390/ijerph18020777 - 18 Jan 2021

Cited by 1 | Viewed by 3161

Abstract

This study compared the response of a 9-week cycling training on ventilatory efficiency under two conditions: (i) Combined with respiratory muscle training (RMT) using a new nasal restriction device (FeelBreathe) (FB group) and (ii) without RMT (Control group). Eighteen healthy elite cyclists were randomly separated into the FB group (n = 10) or Control group (n = 8). Gas exchange was measured breath by breath to measure ventilatory efficiency during an incremental test on a cycloergometer before (Pre) and after (Post) the nine weeks of training. The FB group showed higher peak power (Δ (95%HDI) (0.82 W/kg (0.49, 1.17)), VO₂max (5.27 mL/kg/min (0.69, 10.83)) and VT₁ (29.3 W (1.8, 56.7)) compared to Control at Post_FINAL. The FB group showed lower values from Pre to Post_PRE in minute ventilation (VE) (−21.0 L/min (−29.7, −11.5)), Breathing frequency (BF) (−5.1 breaths/min (−9.4, −0.9)), carbon dioxide output (VCO₂) (−0.5 L/min (−0.7, −0.2)), respiratory equivalents for oxygen (EqO₂) (−0.8 L/min (−2.4, 0.8)), heart rate (HR) (−5.9 beats/min (−9.2, −2.5)), respiratory exchange ratio (RER) (−0.1 (−0.1, −0.0) and a higher value in inspiratory time (Tin) (0.05 s (0.00, 0.10)), expiratory time (Tex) (0.11 s (0.05, 0.17)) and end-tidal partial pressure of CO₂ (PETCO₂) (0.3 mmHg (0.1, 0.6)). In conclusion, RMT using FB seems to be a new and easy alternative ergogenic tool which can be used at the same time as day-to-day training for performance enhancement. Full article

(This article belongs to the Special Issue Respiratory Muscle Training for Health and Performance)

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15 pages, 2977 KiB

Open AccessArticle

A New Nasal Restriction Device Called FeelBreathe^® Improves Breathing Patterns in Chronic Obstructive Pulmonary Disease Patients during Exercise

by José L. Gonzalez-Montesinos, Aurelio Arnedillo, Jorge R. Fernandez-Santos, Carmen Vaz-Pardal, Pelayo A. García, José Castro-Piñero and Jesús G. Ponce-González

Int. J. Environ. Res. Public Health 2020, 17(13), 4876; https://doi.org/10.3390/ijerph17134876 - 6 Jul 2020

Cited by 3 | Viewed by 3677

Abstract

A device called FeelBreathe (FB)^® was designed, developed, and patented for inspiratory muscle training. The main aim was to determine the acute responses on lung ventilation, gas exchange, and heart rate during exercise in patients with chronic obstructive pulmonary disease (COPD) with and without the use of FB. In this study, a randomized cross-over trial was performed with 18 men diagnosed with COPD (FEV₁ between 30% and 70% of its predicted value). Each participant randomly conducted two trials with 30 min of rest between them with the same protocol on a treadmill for 10 min at a constant rate of 50% of VO_2peak. Each test was performed randomly and in a crossover randomized design in two different conditions: (1) oronasal breathing; and (2) nasal breathing with FB (nasal ventilatory flow restriction device). It was observed that FB had positive effects on dynamic hyperinflation, breathing pattern, and breathing efficiency, with higher expiratory and inspiratory time. Despite these differences, blood oxygen saturation percentage, oxygen uptake, and heart rate showed a similar response for both conditions during exercise. The results suggest that exercise performed with FB improved ventilatory responses compared to the oronasal mode in COPD patients. This new tool could be used during most daily tasks and exercise programs. Full article

(This article belongs to the Special Issue Respiratory Muscle Training for Health and Performance)

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13 pages, 1735 KiB

Open AccessArticle

Effects of a Rehabilitation Programme with a Nasal Inspiratory Restriction Device on Exercise Capacity and Quality of Life in COPD

by Aurelio Arnedillo, Jose L. Gonzalez-Montesinos, Jorge R. Fernandez-Santos, Carmen Vaz-Pardal, Carolina España-Domínguez, Jesús G. Ponce-González and Magdalena Cuenca-García

Int. J. Environ. Res. Public Health 2020, 17(10), 3669; https://doi.org/10.3390/ijerph17103669 - 22 May 2020

Cited by 10 | Viewed by 3091

Abstract

Objective: The objective was to assess the effects of a nasal restriction device for inspiratory muscle training, called Feelbreathe^®, added to a rehabilitation program (RP) on exercise capacity, quality of life, dyspnea and inspiratory muscle strength in patients with stable COPD. Methods: Patients were randomized into three groups, one performed a supervised RP using the Feelbreathe^® device (FB group), the second group developed the same RP with oronasal breathing without FB (ONB group) and the third was the control group (CG). We evaluated inspiratory muscle strength (PImax), dyspnea (mMRC), quality of life (CAT) and exercise capacity (6MWT) before and after 8-week of RP. Results: A total of 16 patients completed the study, seven in FB group, five in ONB group and four in the CG. After the RP, the FB group showed a significant increase in PImax (93.3 ± 19.1 vs. 123.0 ± 15.8 mmHg) and in the 6MWT distance (462.9 ± 71.8 m vs. 529.1 ± 50.1 m) and a decrease in the CAT score (9.7 ± 6.5 vs. 5.9 ± 6.0) and in the mMRC dyspnea score. FB provides greater improvement in PImax, dyspnea, quality of life and 6MWT than ONB. Conclusions: The Feelbreathe^® device provides greater improvements in quality of life, dyspnea, exercise capacity and inspiratory muscle strength compared to patients that did not use it. Full article

(This article belongs to the Special Issue Respiratory Muscle Training for Health and Performance)

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Review

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17 pages, 807 KiB

Open AccessReview

Inspiratory Muscle Training in Intermittent Sports Modalities: A Systematic Review

by Juan Lorca-Santiago, Sergio L. Jiménez, Helios Pareja-Galeano and Alberto Lorenzo

Int. J. Environ. Res. Public Health 2020, 17(12), 4448; https://doi.org/10.3390/ijerph17124448 - 21 Jun 2020

Cited by 20 | Viewed by 5129

Abstract

The fatigue of the respiratory muscles causes the so-called metabolic reflex or metaboreflex, resulting in vasoconstriction of the blood vessels in the peripheral muscles, which leads to a decrease in respiratory performance. Training the respiratory muscles is a possible solution to avoid this type of impairment in intermittent sports. The objective of this systematic review was to evaluate the results obtained with inspiratory muscle training (IMT) in intermittent sports modalities, intending to determine whether its implementation would be adequate and useful in intermittent sports. A search in the Web of Science (WOS) and Scopus databases was conducted, following the Preferred Reporting Elements for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The methodological quality of the articles was assessed using the PEDro (Physiotherapy Evidence Database) scale. In conclusion, the introduction of specific devices of IMT seems to be a suitable method to improve performance in intermittent sports, mainly due to a reduction of the metaboreflex, fatigue sensation, and dyspnea. The ideal protocol would consist of a combination of acute and chronic treatment, and, even if IMT is done daily, the duration will not exceed one hour per week. Full article

(This article belongs to the Special Issue Respiratory Muscle Training for Health and Performance)

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