I have recently attempt to regain my overall fitness, particularly in running. I have tried to implement some new training strategies to maximize my performance. I have already included barefoot training, altitude training, and some new core re-education exercises. Now, I am interested in exploring the benefits of respiratory muscle training. Research and my clinical experience definitely indicate its positive impact on many special populations.^1,2 For this post, I will focus more on respiratory muscle training in healthy and athletic populations.

Before adding any new exercise program, it makes sense to evaluate any available research. Luckily, a review article available to me examines the effects of respiratory muscle training.³ Using this research, we will be better able to understand and possibly integrate respiratory muscle training in fitness programs. Both inspiratory and combined (inspiratory and expiratory) programs were evaluated. Also, exercises that targeted respiratory strength versus respiratory endurance were compared.

In healthy populations, a review of respiratory muscle training programs found significant improvements in exercise testing including constant load testing and time trials. At first look, the studies examined seemed to demonstrate conflicting results. However, most studies which did not find a positive effect of respiratory muscle training used incremental exercise testing to assess subject response. While incremental exercise testing (like VO2 Max testing) does not change, other tests of fitness do. These gains were found in different sports including running, swimming, and rowing. In trained individuals, similar effects were seen as above. The magnitude of these changes were not as drastic in lesser trained individuals. At higher levels of competition, even small gains can have dramatic benefits, where less separates the competition.

It was difficult to determine whether inspiratory strength, inspiratory and expiratory strength, or inspiratory and expiratory endurance was most effective. Inspiratory strength and inspiratory and expiratory endurance performed similar while inspiratory and expiratory strength yielded the greatest results. These results should be cautiously considered, due to the relative paucity of studies researching combined inspiratory and expiratory strength and the relatively low fitness levels of the subjects in these studies. Due to limited available information, objective analysis of intensity and protocol specifics was not possible.

Despite some of these limitations, the research indicates respiratory muscle training likely has a place in fitness and athletics. Still more questions remain. What is the ideal training regimen? What other populations and individuals could benefit? Unfortunately, the mechanism underlying findings is unclear. Although not perfect, these findings further encourage me to investigate and experiment with this intervention. Considering fitness levels, past medical history, and this research; respiratory muscle training could be adapted to an individual as an adjunct to a potentially wide variety of training programs.

Hope this helps,

Steve

References:

1. Tonella RM, Ratti LDSR, Delazari LEB, Junior CF, Da Silva PL, Herran ARDS, Dos Santos Faez DC, Saad IAB, De Figueiredo LC, Moreno R, Dragosvac D, Falcao ALE. Inspiratory Muscle Training in the Intensive Care Unit: A New Perspective. J Clin Med Res. 2017;9(11):929-934.
2. Menezes KK, Nascimento LR, Ada L, Polese JC, Avelino PR, Teixeira-Salmela LF. Respiratory muscle training increases respiratory muscle strength and reduces respiratory complications after stroke: a systematic review. J Physiother. 2016;62(3):138-44.
3. Illi SK, Held U, Frank I, Spengler CM. Effect of respiratory muscle training on exercise performance in healthy individuals: a systematic review and meta-analysis. Sports Med. 2012;42(8):707-24.