Effects of Respiratory Resistance Training With a Concurrent Flow Device on Wheelchair Athletes

Abstract

Background/Objective: To determine the effect of respiratory resistance training (RRT) with a concurrent flow respiratory (CFR) device on respiratory function and aerobic power in wheelchair athletes. Methods: Ten male wheelchair athletes (8 with spinal cord injuries, 1 with a neurological disorder, and 1 with postpolio syndrome), were matched by lesion level and/or track rating before random assignment to either a RRT group (n ¼ 5) or a control group (CON, n ¼ 5). The RRT group performed 1 set of breathing exercises using Expand-a-Lung, a CFR device, 2 to 3 times daily for 10 weeks. Pre/posttesting included measurement of maximum voluntary ventilation (MVV), maximum inspiratory pressure (MIP), and peak oxygen consumption (V O 2 peak). Results: Repeated measures ANOVA revealed a significant group difference in change for MIP from pre-to posttest (P , 0.05). The RRT group improved by 33.0 cm H 2 O, while the CON group improved by 0.6 cm H 2 O. Although not significant, the MVV increased for the RRT group and decreased for the CON group. There was no significant group difference betweenV O 2 peak for pre/posttesting. Due to small sample sizes in both groups and violations of some parametric statistical assumptions, nonparametric tests were also conducted as a crosscheck of the findings. The results of the nonparametric tests concurred with the parametric results. Conclusions: These data demonstrate that 10 weeks of RRT training with a CFR device can effectively improve MIP in wheelchair athletes. Further research and a larger sample size are warranted to further characterize the impact of Expand-a-Lung on performance and other cardiorespiratory variables in wheelchair athletes.

A systematic review and meta-analysis of the effects of respiratory muscle training on pulmonary function in tetraplegia

“…Some studies included participants with thoracic-level injuries 7,16 and nontraumatic SCI. 15,19 Testing position was not consistent across the studies. Six studies tested participants in a seated position, [6][7][8]15,16,19 whereas two studies used a supine testing position.…”

“…15,19 Testing position was not consistent across the studies. Six studies tested participants in a seated position, [6][7][8]15,16,19 whereas two studies used a supine testing position. 14,18 Two studies tested in both positions 13,17 and one study did not report the testing position.…”

“…One study 13 had a cross-over design, and in the remaining 10 studies there were four comparisons between RMT and an alternative intervention, 6,8,14,15 and seven comparisons against a control condition (three vs a sham treatment 6,7,16 and four vs 'usual care'). [17][18][19][20] Sample sizes for the included studies ranged from 9 to 40 participants, and injury level ranged from C4 to C8. Some studies included participants with thoracic-level injuries 7,16 and nontraumatic SCI.…”

“…[6][7][8]16 In addition, six studies failed to report outcome data for participants who did not complete the trial. 6,[14][15][16]18,19 Two of the included studies 6 . Eight studies used resistive muscle training devices targeting either inspiratory (n ¼ 5) 6,13,14,18,20 or expiratory (n ¼ 3) 13,16,17 muscle resistance.…”

“…Five studies simultaneously targeted both inspiratory and expiratory muscle function. [6][7][8]15,19 The different interventions ranged in intensity from 10 to 60 min per day, 3 to 7 days per week, and total length of training ranged from 4 to 12 weeks (mean 8 weeks).…”