Inspiratory muscle training (IMT) has been studied as a rehabilitation tool and ergogenic aid in clinical, athletic, and healthy populations. This technique aims to improve respiratory muscle strength and endurance, which has been seen to enhance respiratory pressure generation, respiratory muscle weakness, exercise capacity, and quality of life. However, the effects of IMT have been discrepant between populations, with some studies showing improvements with IMT and others not. This may be due to the use of standardized IMT protocols which are uniformly applied to all study participants without considering individual characteristics and training needs. As such, we suggest that research on IMT veer away from a standardized, one-size-fits-all intervention, and instead utilize specific IMT training protocols. In particular, a more personalized approach to an individual’s training prescription based upon goals, needs, and desired outcomes of the patient or athlete. In order for the coach or practitioner to adjust and personalize a given IMT prescription for an individual, factors, such as frequency, duration, and modality will be influenced, thus inevitably affecting overall training load and adaptations for a projected outcome. Therefore, by integrating specific methods based on optimization, periodization, and personalization, further studies may overcome previous discrepancies within IMT research.

Attention-deficit/hyperactivity disorder (ADHD) is characterized by evident and persistent inattention, hyperactivity, impulsivity, and social difficulties and is the most common childhood neuropsychiatric disorder, and which may persist into adulthood. Seventy to 80% of children and adults with ADHD are treated with stimulant medication, with positive response rates occurring for both populations. Medicated ADHD individuals generally show sustained and improved attention, inhibition control, cognitive flexibility, on-task behavior, and cognitive performance. The ethics of ADHD medication use in athletics has been a debated topic in sport performance for a long time. Stimulants are banned from competition in accordance with World Anti-Doping Association and National Collegiate Athletic Association regulations, due to their ability to not only enhance cognitive performance but also exercise performance. Limited research has been conducted looking at the differences in exercise performance variables in unmedicated ADHD verses medicated ADHD. Not all ADHD athletes choose stimulant medication in their treatment plan due to personal, financial, or other reasons. Non-stimulant treatment options include non-stimulant medication and behavioral therapy. However, the use of caffeinated compounds and exercise has both independently been shown to be effective in the management of ADHD symptoms in human studies and animal models. This mini review will discuss the effect of exercise and caffeine on neurobehavioral, cognitive, and neurophysiological factors, and exercise performance in ADHD athletes, and whether exercise and caffeine should be considered in the treatment plan for an individual with ADHD.

TO THE EDITOR: Podlogar et al. ( 1) have nicely discussed current methods for classifying athletes in applied physiology studies attending to their training or performance level. We agree with them that relying on a single physiological marker such as maximum oxygen uptake is not without limitations and endorse the use of more performance-based indicators. However, before proposing critical power/speed (CP/ CS) as the primary indicator of an athlete's training status, the robustness of these variables and the best method for their determination remains to be confirmed. Differences in mathematical models or test durations can indeed have a remarkable impact on an individual's CP/CS (e.g., up to $1 km/ h for CS in top-level runners) (2).More research is needed to provide reference or "normative" values of CP/CS allowing classification of athletes into different performance/fitness categories. An alternative, at least in cycling, might be classifying athletes attending to the highest power output that they can achieve for a given duration-the so-called "mean maximum power" (MMP) (3). This approach does not require the use of mathematical calculations or additional laboratory testing and is sensitive enough to allow discerning actual performance even between the two highest category levels-Union Cycliste Internationale [UCI] ProTeam versus UCI WorldTour-in professional cyclists (4). We have recently reported normative MMP values for male (n = 144) (4) and female professional cyclists (n = 44) (5). If a similar approach was used in cyclists of a lower training/competition level, scientists and coaches could accurately classify participants in cycling physiology studies.

Listening to music while exercising can alter afferent feedback from breathing sounds; however, it is currently unknown whether auditory distraction with music mitigates exertional dyspnea in healthy individuals. Purpose: This study aimed to determine whether listening to music through headphones (a) affects the sensory (breathing intensity [BI]) and/or affective (breathing unpleasantness [BU]) components of dyspnea during exercise at different intensities and (b) affects exercise performance. Methods: Twenty-two recreationally active individuals (24 ± 3 yr, 10 women) performed two 5-min constant loads (10% below/above gas exchange threshold [GET]) and an 8-km cycling time trial with ambient laboratory noise or self-selected music in a randomized crossover design. BI, BU, and ventilation ( VE ) were measured at each minute of the constant loads and every 2 km of the time trial. Ratios of BU/ VE and BI/ VE were used to examine the gain in dyspnea during the time trial. Results: In the 10% below GET trial, BU was reduced in the first (P = 0.03) and final (P = 0.04) minutes. In the 10% above GET trial, BU and BI were reduced with music (P < 0.05). During the time trial with music, BU/ VE was significantly attenuated by 9%-13% (P < 0.05) despite a greater heart rate and self-selected power output (P < 0.05). Conclusions: Music through headphones mitigated the sensation of dyspnea and changed the accretion of dyspnea per unit increase in VE leading to a higher self-selected workload during self-paced exercise. The dyspnea-reducing intervention of self-selected music may improve exercise tolerance and performance and promote adherence to regular aerobic exercise.