Friday 12 August 2011

Clearing the air - Some myths about breathing training research


You can obtain more information about breathing training at www.breathestrong.com, where you can also find out about my comprehensive guide to breathing and exercise “Breathe Strong, Perform Better” (published by Human Kinetics Inc.).

Let’s start by defining what we mean by “breathing training”. In my definition, breathing training is the application of established principles of training science to the muscles of respiration, i.e., the breathing pump muscles. These muscles are of two types, inspiratory and expiratory.. I use the term “breathing training” as an overarching term as I would if I were referring to, say interval training. However, the term “inspiratory muscle training” (IMT), has a specific definition, i.e., resistance training of the inspiratory muscles. Similarly, EMT refers to resistance training of the expiratory muscles. The majority of research has been undertaken on IMT, and in a later Blog I’ll summarise the evidence relating to each type of training, and explain why the focus has been on IMT.

Although most people take the scientific evidence relating to IMT at face value, there are still a few misinformed “IMT deniers” whose scepticism does a huge disservice to a legitimate, evidence-based training method. In fact, IMT has more scientific credibility than most other products that are vying for the attention of enthusiastic sports people.

For this reason, I wanted to start my Blog on the front foot by exploding some common myths about breathing training research, as well as setting the record straight about my involvement in it. That way, we can begin with a clean slate, and readers can put behind them all of the misinformation that has been propagated by people who don’t know as much about sport science as they believe they do. Over the years, I’ve seen some pretty outlandish comments about breathing training on Blogs and forums (e.g., “it’s a scam”) from people with just enough knowledge to be dangerous, and too little to provide an accurate, insightful opinion on the scientific facts. Lots of people believe they know about the role of breathing in exercise limitation, but the truth is, they only know half of the story, and that’s why their opinions fall short of being useful (see my next Blog for an explanation of why).

As well as misinformation about the science, there’s also been some [reasonable] scepticism about IMT created by my involvement in the commercialisation of the POWERbreathe® inspiratory muscle trainer (www.powerbreathe.com). As a leading scientist in the area, I’ve played a pivotal role in the development of research on breathing training, but I also have a commercial interest in its results, and this creates an obvious potential conflict – the old, “well she would say that wouldn’t she” scenario. It has even been suggested that an entire area of scientific research has been fabricated in order to create a market for POWERbreathe®. What an extraordinary feat that would have been; to have hoodwinked so many reputable scientists into replicating my “made up” research. The truth is, it’s simply not possible to do this, and I have always been open and honest about my connection with POWERbreathe®. This being the case, it’s up to the readers of my research to draw their own conclusions about the veracity of the data and its interpretation.

In addition, it’s worth pointing out that I never set out to develop a breathing training product - POWERbreathe® came into being some 20 years ago because I needed a ‘tool’ to test a research hypothesis. The hypothesis was simple – does training the inspiratory muscles influence breathlessness and exercise tolerance in older people? Why older people? Because they are more breathless, have lower exercise tolerance, and weaker inspiratory muscles than younger people. The hypothesis seemed logical and worthy of exploration, but I needed to create a training device to test it, i.e., I need to create a ‘dumbbell’ to overload the inspiratory muscles, thereby training them. The resulting device was a little “Heath Robinson”, but it imposed a reliable inspiratory resistance, and became the precursor to the POWERbreathe®.  To cut a long story short (an entire PhD in fact), the research showed that making the inspiratory muscles of older people stronger, reduced their breathlessness and improved exercise tolerance. However, what I was to discovered next surprised even me. The results in older people led me to wonder what effect the training might have upon exercise tolerance in young, physically active people. To satisfy my curiosity, I suggested the question as a final year dissertation project for a BSc student. The results were, to say the least, surprising – performance also improved in people with perfectly normal inspiratory muscles. Why did this surprise me? Because everything I’d been taught as an exercise scientist led me to believe that breathing did not limit exercise performance. So the study was run again, but this time as part of a PhD research programme - the results were the same. So the study was run again, as part of a different PhD research programme – again, the same results. We found repeatedly that athletes got faster by doing nothing more than strength training their inspiratory muscles. Convinced the finding was real, the next step was to dig deeper to find out how this was happening….but that’s another Blog.

My first studies of inspiratory muscle training (IMT) took place in the early 1990s, and their results propelled me on a quest that I have pursued ever since. As for the commercialisation of POWERbreathe®, the finding that we could make people less breathless and improve their exercise performance by doing something as simple and quick (five minutes per day) as IMT got me thinking that I might have created something of some medical and sporting significance. After fruitless efforts to interest existing commercial companies in exploiting the POWERbreathe® patent, I came to the conclusion that the only way my innovation would see the commercial light of day was to take it to market myself. I might add that this was also the only way that the research could be perpetuated and proliferated; creating a commercial product, also created the opportunity for other scientists to undertake their own studies, which they have done in their hundreds.

I’ve spent the past 20 years of my professional life seeking an understanding of how breathing limits exercise performance, as well as figuring out how to overcome those limitations through training. Along the way, I have worked with a number of PhD students, all of whom were independent thinkers, and some of whom even started their research with the firm belief that IMT “did not work”. The result of our research speaks for itself – IMT does work. Furthermore, our findings have been replicated by completely independent scientists, many of whom were also “IMT sceptics” before they undertook their own studies. In common with all high quality published research, our research papers have been peer-reviewed by world-class, independent scientists whose role it is to ensure that only the best research is published. As mentioned above, in seeking publication for my research, I have always been meticulous about declaring my commercial interest in a breathing training product, because the potential conflict of interest that this creates is something readers of the research have a right to know. Despite all these ‘hurdles’, my research has been published in the top international scientific journals, and has also been highly cited by other scientists. That’s why it rankles me when I read comments suggesting that my research “is a scam”.

The purpose of this first Blog was to clear the air for what is to come. In doing so, I hope I have created an atmosphere of open mindedness in which to explore the fascinating, unfolding story of breathing training, and of breathing-related research. In the next instalment of my Blog I’ll address how IMT improves performance, and why, as is commonly assumed, it has nothing to do with maximal oxygen uptake (VO2max).

If you found my first Blog interesting, please come back for further articles and news, as well as my musings on all things breathing and sport related. Also, don’t forget that you can obtain more information about breathing training at www.breathestrong.com, where you can also find out about my comprehensive guide to breathing and exercise “Breathe Strong, Perform Better” (published by Human Kinetics Inc.).

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