Tuesday 14 May 2013

Inspiratory Muscle Training Symposium A Breathtaking Success!

The level and breadth of interest inspiratory muscle training (IMT) was confirmed by both the number and diversity of attendees at this unique symposium, which was hosted by the Centre for Sports Medicine & Human Performance at Brunel University. As well as sport and exercise physiologists, delegates included clinicians, human factors specialists, commercial companies, end users of IMT, and even an equine vet. They were rewarded with a “feast” of integrative physiology, covering the respiratory, cardiovascular, muscular and neural systems, in both health and disease.

The seminar was opened by Professor Alison McConnell, who provided an introductory overview of the history of IMT, the "state of the art", as well as the rationale for each of three putative mechanisms for the well-established ergogenic effect of IMT. These mechanisms were expanded and developed by the other three speakers. The Centre’s own Dr Lee Romer described the surprisingly high metabolic cost of respiratory muscle work in highly trained individuals, the conditions under which exercise-induced fatigue of the inspiratory and expiratory muscles arises, and its implications for exercise tolerance. Dr Romer then reviewed the evidence that feedback from respiratory muscle afferents can exacerbate locomotor muscle contractile fatigue and impair performance. Dr Romer was followed by the University of Brighton’s Dr Emma Ross, who provided some fascinating insights into another role for muscle afferent feedback, viz., its role in central fatigue. This included consideration of the potential role of respiratory muscle afferents in central fatigue as part of an “ensemble” of feedback that serves to maintain and optimise exercise performance. The final presentation came from King’s College Hospital physician Dr Caroline Jolley who explained the role of respiratory muscle function in the perception of breathing effort, focussing in particular upon patients with chronic obstructive pulmonary disease (COPD). A neurophysiological model of breathlessness was presented in which disordered lung mechanics and diaphragm weakness, lead to an uncoupling of inspiratory pressure generation and ventilation to create a state of “neuromechanical dissociation” and efferent-afferent mismatch. Finally, Dr Jolley considered whether IMT might ameliorate this mismatch. The morning was rounded off by a panel “question and answer” session.

The presenters answer questions and consider the future directions for inspiratory muscle training research. From the left: Dr Lee Romer, Prof Alison McConnell, Dr Emma Ross, Dr Caroline Jolley

The four presentations are available to view on the Centre for Sports Medicine & Human Performance YouTube channel.

For further information about inspiratory muscle training for sport please visit www.breathetsrong.com, and for information about the many clinical applications of respiratory muscle training please visit www.physiobreathe.com.

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