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Respiratory muscle training is an effective way to improve physical performance and enhance exercise tolerance. It involves training the inspiratory and expiratory muscles to increase their strength and endurance, which can lead to a reduction in breathlessness and an increase in physical exercise ability. Respiratory muscle training can be particularly beneficial for individuals with respiratory, cardiac, or neuromuscular conditions, as well as those recovering from surgery or experiencing the effects of ageing. The training uses techniques such as voluntary isocapnic hyperventilation and inspiratory muscle training (IMT) to improve respiratory muscle function and overall endurance performance.
| Characteristics | Values |
|---|---|
| Training principles | Overload, specificity, reversibility |
| Overload | Alter duration, intensity, or frequency |
| Accepted levels of duration, intensity, and frequency | Intensity = 50-70% (yields failure within 30 breaths or 2-3 mins) |
| Specificity | High-intensity, short-duration strength training; low-intensity, long-duration endurance training |
| Endurance training technique | Voluntary isocapnic hyperventilation (VIH) |
| Training devices | PowerBreathe, Pflex device, HealthScan Inc, Respirex 2 incentive spirometer, Respirex, PowerLung |
| Training protocol | 30 breaths, twice daily for 4-12 weeks |
| Training results | Increased strength and endurance of respiratory muscles, reduced blood lactate concentration, improved exercise performance |
| Training applications | Respiratory, cardiac and neuromuscular conditions, surgery, ageing, COPD |
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What You'll Learn
Inspiratory muscle training (IMT) devices
There are two main methods for generating resistance to breathing: inspiratory resistance training and flow-resistance inspiratory muscle training. Inspiratory resistance training uses a method similar to weight-lifting for exercising the inspiratory muscles. A resistance 'load' is applied to your inspired breath. This is the most basic and simplest of inspiratory training techniques, similar to breathing in through different-sized straws. There is no calibration of load, as there is with Pressure Threshold Resistance. Basic breathing trainers that use this flow resistive loading usually consist of holes of varying sizes.
Flow-resistance inspiratory muscle training, on the other hand, always allows you to breathe through the device because the holes are always open. Most of the research into the benefits of IMT traditionally uses Threshold Resistance breathing devices. However, more recent studies are beginning to use the POWERbreathe K-Series Electronic Tapered Resistance. All POWERbreathe K-Series breathing devices use this method of resistance. This type of training uses a computer-controlled valve to automatically match the resistance to your declining muscle strength as you progress through the breath.
There are various IMT devices available on the market, such as the POWERbreathe K3, the Bigbreathe IMT Middle, and the Oumua Smart Breathing Trainer. The POWERbreathe K3 is a drug-free breathing device that measures your maximum breathing capability during the first two breaths of each training session. Training load is then gradually introduced during breaths three and four until full loading is achieved for breath five and onwards. The Bigbreathe IMT Middle is a compact inspiratory muscle trainer that provides adjustable resistance for athletes, fitness enthusiasts, and respiratory health. The Oumua Smart Breathing Trainer is an AI-powered lung exerciser device with 30+ training protocols.
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Resistance training
RMT can be further broken down into inspiratory muscle training (IMT) and expiratory muscle training (EMT). IMT is the more common of the two, with a plethora of data showing its effectiveness in improving muscle strength and endurance. EMT, on the other hand, has fewer clinical and physiological studies to support its effectiveness.
A simple protocol for IMT involves 30 breaths, twice a day for four to twelve weeks, followed by a maintenance period where training is reduced by two-thirds. The intensity of the training should be between 50-70%, typically yielding failure within 30 breaths or 2-3 minutes.
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Pressure threshold loading
During pressure threshold loading, individuals breathe against a resistance, which can be adjusted to provide an appropriate challenge for the person's respiratory muscles. This form of training aims to increase the strength and endurance of the inspiratory muscles, improving their ability to handle higher ventilatory demands.
To perform pressure threshold loading, individuals typically use a device that provides resistance to load the inspiratory muscles when breathing. These devices can be purchased at a relatively low cost, making them an accessible option for those looking to improve their respiratory muscle function. The user breathes through their mouth with their nose clipped shut and is encouraged to exhale all the air content from their lungs.
The pressure threshold loading technique can be further enhanced by focusing on breathing rhythm regulation, increasing expiratory time, boosting diaphragmatic and nasal breathing, and slowing the respiratory flow. It is important to start with a modest breathing frequency to avoid hyperventilation and gradually increase the resistance as the individual's respiratory muscles adapt and strengthen.
Research has shown that pressure threshold loading can be particularly beneficial for individuals with asthma, as it improves their physical capacity and quality of life. Additionally, for individuals with COPD, pressure threshold loading has been found to increase inspiratory muscle strength and reduce breathlessness.
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Endurance training
Respiratory Muscle Training (RMT) is a technique that aims to improve the function of respiratory muscles through specific exercises. RMT can be particularly beneficial for athletes, musicians, and actors, as well as individuals with breathing conditions such as asthma, bronchitis, emphysema, and COPD.
RMT exercises are designed to enhance the endurance of respiratory muscles, such as the diaphragm and intercostal muscles. These exercises can be tailored to an individual's needs and medical condition, with the frequency of training, number of repetitions, and resistance adjusted accordingly.
One technique used in RMT for endurance training is voluntary isocapnic hyperventilation (VIH). VIH requires individuals to maintain high levels of respiration for up to 40 minutes. This method employs a partial re-breathing circuit to prevent hypocapnia.
Additionally, RMT can be combined with traditional communication and swallowing therapies to provide comprehensive care for conditions that affect both respiratory and swallowing functions. Evaluations of speech, swallowing, and breathing functions can help determine if RMT is the right treatment option.
The benefits of RMT for endurance include improved respiratory efficiency, reduced respiratory fatigue, and enhanced physical performance, especially in conditions of hypoxia. RMT has also been shown to positively impact blood redistribution to limb locomotor muscles during heavy exercise, which is crucial for endurance activities.
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High-intensity intervals
High-intensity interval training (HIIT) is a form of exercise that involves short bursts of intense activity followed by brief periods of rest or low-intensity activity. It has been shown to have positive effects on improving respiratory muscle strength and endurance, particularly for those with respiratory conditions or muscle weakness.
During HIIT, the workload on the respiratory muscles increases, which in turn increases ventilation and the demand for blood flow. This can lead to premature respiratory muscle fatigue as the muscles demand more oxygen and blood flow from the active muscles. However, the body adapts to these changes, leading to improved pulmonary function.
HIIT can be performed using various exercises such as cycling or running on a treadmill. For example, a HIIT program may include six repetitions of 4 minutes of exercise at 90-95% of maximum heart rate for 4 weeks. It is important to note that the frequency, duration, and intensity of HIIT should be carefully considered to avoid potential muscle fatigue. A suggested training regimen includes a frequency of 1-2 times per day for a total of 30 minutes, 3-5 days per week, for a duration of 5-6 weeks.
HIIT has been shown to induce physiological adaptations, improving respiratory and cardiovascular adjustments before, during, and after high-intensity exercise. This leads to enhanced exercise performance, as the body can rapidly adapt to the energy requirements of the exercise, reducing oxygen deficit. Additionally, HIIT has been found to be at least as effective as moderate-intensity aerobic exercise in improving pulmonary function in individuals with respiratory conditions such as COPD.
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Frequently asked questions
Training respiratory muscles can improve strength and endurance, reduce blood lactate concentration and RPE, and improve exercise performance.
IMT devices provide resistance to load the inspiratory muscles when breathing. As strength increases, the load can be increased proportionally.
Examples of IMT devices include the Pflex device, Respirex 2 incentive spirometer, and PowerLung products.
A simple and effective protocol is 30 breaths, twice daily for four to 12 weeks, followed by a maintenance period where training is reduced by two-thirds.
The three main types of RMT are resistive training, pressure threshold loading, and normocapnic hyperpnea.
