The Effect of Inspiratory Muscle Warm-up on Decreased Diffusing Capacity for Carbon Monoxide After Maximal Exercise in Athletes

Not Applicable

Not yet recruiting

• Conditions: Athlete

• Registration Number: NCT06751511
• Lead Sponsor: Emre Karaduman

Brief Summary

This study aims to examine the effects of inspiratory muscle warm-up (IMW) on the gas exchange capacity of the lungs (DLCO) and its potential contribution to recovery and athletic performance in elite athletes from various disciplines. The study hypothesizes that the decline in respiratory muscle capacity following high-intensity exercise, which negatively affects ventilation, diffusion, and oxygen transport, may be ameliorated through specific IMW protocol. A placebo-controlled, randomized, crossover, and double-blind design will be utilized, involving 28 elite male athletes from endurance, power, skill-based, and mixed disciplines.

Participants will complete three warm-up protocols: General Warm-up (GW), General Warm-up combined with IMW at 40% resistance intensity (GW+IMW40%), and a placebo condition (GW+IMWplacebo). Measurements will include respiratory muscle strength, DLCO (assessed at post-2, 30, 60, 90, and 120 minutes), respiratory function, and cardiorespiratory parameters during maximal exercise. This study is unique as it aims to detail the micro-level effects of IMW on pulmonary diffusion mechanisms and performance outcomes, providing novel insights into the ameliorative effects of IMW on respiratory function post-exercise. Additionally, it seeks to expand understanding of the mechanistic basis of IMW's benefits on both pulmonary diffusion capacity and athletic performance.

Detailed Description

STUDY DESIGN This study will employ a placebo-controlled, randomized, crossover, and double-blind research design to evaluate the effects of three warm-up conditions: Control, Placebo 15%, and IMW 40%. Athletes will be randomly assigned to the conditions using a crossover approach, ensuring that all participants will experience each protocol on separate days.

The warm-up protocols will include:

General Warm-up (Control): A standard warm-up without resistance. IMW 40%: A general warm-up combined with inspiratory muscle warm-up at 40% resistance intensity.

Placebo 15%: A general warm-up combined with inspiratory muscle warm-up (placebo) at 15% resistance intensity.

Blinding will be maintained for both participants and researchers. Participants will be informed that the study aims to investigate various warm-up types, while the true purpose will remain concealed. This design will ensure reliability and minimize bias in the data to be collected.

Study Timeline

• Status Verified: 2024-12
• Study First Submitted: 2024-12-20
• Study First Submitted QC: 2024-12-27
• Last Update Submitted: 2024-12-27
• Study First Posted: 2024-12-30
• Last Update Posted: 2024-12-30
• Study Start: 2025-01-15
• Primary Completion: 2025-01-15
• Study Completion: 2025-01-30

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: Male
• Target Recruitment: 28

Inclusion Criteria

• Age between 18-24 years.
• A training history of at least six years.
• Regular training frequency of at least four sessions per week.

Exclusion Criteria

• History of smoking.
• History of physical disability or acute respiratory or cardiovascular disease within the past three months.
• Diagnosis of SARS-CoV-2 within the past three months.
• Pulmonary function measurements outside the normal clinical range (≤ 80%).

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Primary Outcome Measures

Name	Time	Method
Lung Carbon Monoxide Diffusion Capacity (DLCO)	Pre intervention and immediately post intervention	DLCO will be measured using the single breath-hold method with a Quark PFT gas analyzer, following ATS/ERS standards. Each test involves inhalation of a gas mixture (0.3% CO, 0.3% CH4, and dry air), breath-holding for 10±2 seconds, and exhalation. Subjects will undergo DLCO tests at baseline, following the warm-up protocols, and at both the start and conclusion of VO2max testing. Additional measurements will be conducted at 2, 30, 60, 90, and 120 minutes post-VO2max during each laboratory visit.
Pulmonary Function (FVC)	Pre intervention and immediately post intervention	Forced Vital Capacity (FVC) will be assessed using the Quark PFT device according to ATS/ERS guidelines. Subjects will perform the FVC maneuver while seated, with disposable mouthpieces and a nose clip to ensure accurate recordings. The FVC maneuver will involve a maximal inhalation followed by a rapid and forceful exhalation into the spirometer until no more air can be expelled. Subjects will be encouraged to maintain consistent effort throughout the maneuver to ensure reliable and reproducible results.
Pulmonary Function (SVC)	Pre intervention and immediately post intervention	Slow Vital Capacity (SVC) will be assessed using the Quark PFT device according to ATS/ERS guidelines. Subjects will perform the SVC maneuver while seated, with disposable mouthpieces and a nose clip to ensure accurate recordings. The SVC maneuver will start with a full, deep inhalation. This will be followed by a slow and controlled exhalation at a steady pace until the lungs are completely emptied. The maneuver will provide measurements reflecting lung volumes under non-forced conditions.
Pulmonary Functions (MVV)	Pre intervention and immediately post intervention	Maximum Voluntary Ventilation (MVV) will be assessed using the Quark PFT device according to ATS/ERS guidelines. Subjects will perform the MVV maneuver while seated, with disposable mouthpieces and a nose clip to ensure accurate recordings. The MVV maneuver will evaluate the maximum amount of air a subject can inhale and exhale in a specific timeframe, typically 12 seconds. Subjects will be instructed to breathe as quickly and deeply as possible during the maneuver. Proper coaching will be provided to help maintain maximal effort while avoiding hyperventilation-related discomfort.
Respiratory Muscle Strength	Pre intervention and immediately post intervention	Respiratory muscle strength will be measured using the Pony FX MIP/MEP device following ERS guidelines. For maximal respiratory pressures, subjects will exhale maximally, followed by a maximal inspiration against a closed valve (and the opposite maneuver). At least three trials with less than 5% variability will be averaged to determine the final values.
Bicycle ergometer and Maximal Aerobic Capacity (VO2max)	Pre intervention and immediately post intervention	The test will begin at a workload of 50 (Watt) and will progress by increasing the workload by 25 (Watt) every two minutes. Throughout the test, the pedaling speed (rhythm) will be continuously monitored on the bicycle display, and participants will be instructed to maintain a steady pace within an average range of ≥60 (±5) rpm. Despite strong verbal encouragement provided during the test, it will be terminated if a participant spends more than 10 seconds below the 55 rpm pedal rhythm and decides they cannot continue further (voluntary exhaustion). After completing the test, participants will continue pedaling at a workload of 20 (Watt) for approximately 2 minutes for active recovery. Each test will be initiated in accordance with the workload optimization and adjustments to bike fit (saddle, handlebar height, and position) performed during the first visit. Cardiopulmonary data will be obtained using a breath-by-breath Quark CPET metabolic system (Mixing chamber system) (COSMED).