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Inspiratory Muscle Training on The Severity of Exercise-Induced Bronchoconstriction and Time-Trial Performance (IMT_EIB)

Not Applicable
Recruiting
Conditions
Exercise Induced Asthma
Exercise Induced Bronchospasm
Interventions
Device: PrO2Fit Device
Registration Number
NCT06336681
Lead Sponsor
Indiana University
Brief Summary

Due to the lack of studies examining the impact of inspiratory muscle training (IMT) on the severity of exercise-induced bronchoconstriction (EIB) and exercise performance, the specific aim of this study is to assess the efficacy of flow-resistive IMT on EIB severity and symptoms, short-acting beta-2-agonist medication use, operating lung volumes, respiratory and limb locomotor muscle deoxygenation during constant-load cycling exercise, exertional dyspnea, and cycling time-trial performance.

Detailed Description

To the investigators knowledge, no study has been conducted assessing the impact of inspiratory muscle training (IMT) on exercise-induced bronchoconstriction (EIB) severity, exertional dyspnea, and cycling time-trial performance. A review noted that studies examining the impact of IMT on asthma have all demonstrated an increase in inspiratory muscle strength (maximal inspiratory pressure, MIP) and endurance (sustained maximal inspiratory pressure). In addition, it has been observed that the reduction in the perception of dyspnea following and during exercise leads to a reduction in short-acting beta-2-agonist (SABA) use and fewer asthma symptoms. The same review also noted the lack of data available to explain the impacts of IMT on exercise performance and tolerance in athletes with EIB. Due to the lack of studies examining the impact of IMT on the severity of EIB and exercise performance, the specific aim of this study is to assess the efficacy of flow-resistive IMT on EIB severity and symptoms, SABA medication use, operating lung volumes, respiratory and limb locomotor muscle deoxygenation during constant-load cycling exercise, femoral blood flow, exertional dyspnea, and cycling time-trial performance. It is hypothesized that eight weeks of IMT will reduce EIB's severity and symptoms, respiratory and limb locomotor muscle deoxygenation, improve operating lung volumes, and exertional dyspnea and improve cycling time-trial performance.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Male and female, between the ages of 18 to 35 years.
  • Required to be a competitive recreational or college athlete and have at least 1-2 years of cycling or biking experience.
  • Body Mass Index (BMI) of 18.5 to 28 kg/m^2
  • Considered "moderately to highly active" by the International Physical Activity Questionnaire (IPAQ).
  • Have clinically treated mild to moderate persistent asthma and/or exercise-induced bronchoconstriction (EIB), with a resting forced expiratory volume in 1 second (FEV1) > 65% of predicted.
  • A ≥ 10% drop in FEV1 after eucapnic voluntary hyperpnea (EVH).
  • Prescribed short-acting β2-agonists (SABAs) by a physician.
  • Comfortable not taking SABA before experimental visits.
Exclusion Criteria
  • History of smoking or recreational smoking, cardiovascular disease, renal disease, neurological disease, and metabolic disease.
  • Currently taking asthma maintenance medications (e.g., corticosteroids and leukotriene modifiers)
  • Any injuries in the past 6 months.
  • Taking selective serotonin reuptake inhibitors (SSRI)'s (antidepressants and anxiety medication), attention-deficit hyperactivity disorder (ADHD) medication, and chronically consume pain medication (Aleve, Tylenol, cannabidiol (CBD), etc.).
  • Has had or is positive for COVID-19.
  • Resting blood pressure of > 130 mmHg systolic or 90 mmHg diastolic.
  • Resting Pulse rate of > 100 bpm.
  • Regularly consuming fish oil supplements or eating more then one fish meal per week

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Inspiratory Muscle Training (IMT) groupPrO2Fit DeviceThe test protocol requires participants to inhale maximally (maximum inspiratory pressure, MIP) against 2mm diameter leak and sustain inhalation (sustained maximal inspiratory pressure, SMIP) until task failure. Participants will complete 3 SMIP maneuvers with each training session and use the best of the three for that day's training template (corresponding to about 80% SMIP for the IMT group) via the PrO2Fit software. Participants must match or exceed the SMIP template with each increasing level of the work-rest ratio. Work at each level consists of 6 breaths, 36 breaths total. If six breaths are completed, the next level starts. Rest intervals will progressively shorten as training continues from 40-seconds to 5-seconds. The session will be terminated if participants are unable to match at least 90% of the training template for two consecutive breaths or have completed all 36 breaths. Training will be done 3 times a week, and over 8-weeks.
Sham Inspiratory Muscle Training (Sham-IMT) groupPrO2Fit DeviceSimilar to the IMT group protocol, participants will be required to complete 3 SMIP maneuvers with each training session. Participants will use the best of the three for that day's training template (corresponding to about 30% SMIP for the Sham-IMT group) via the PrO2Fit software. Participants must match or exceed the SMIP template with each increasing level of the work-rest ratio. Work at each level consists of 6 breaths, 36 breaths total. If six breaths are completed, the next level starts. Rest intervals will progressively shorten as training continues from 40-seconds to 30-, 20-, 15-, 10-, and 5-seconds. The training session will be terminated if participants are unable to match at least 90% of the training template for two consecutive breaths or have completed all 36 breaths. Training will be done 3 times a week, and over 8-weeks.
Primary Outcome Measures
NameTimeMethod
Maximum Inspiratory Pressure and Sustained Maximum Inspiratory Pressure8 weeks

More specifically, the pre- to post-values of maximum inspiratory pressure (reported as cmH2O) and sustained maximum inspiratory pressure (reported as pressure time units) before and after IMT will be measured.

Exercise-Induced Bronchoconstriction (EIB) Severity8 weeks

More specifically, the pre- and post-values of the percentage drop in forced expiratory volume in 1 second (FEV1) from the eucapnic voluntary hyperpnea (EVH) test before and after IMT will be measured. Percentage drop in forced expiratory volume in 1 second (FEV1) will be reported in percentages.

16-km Cycling Time-Trial Time to Completion8 weeks

More specifically, differences in 16-km cycling time-trial completion time (seconds) before and after IMT.

16-km Cycling Time-Trial Power Output8 weeks

More specifically, differences in 16-km cycling time-trial power output (watts) before and after IMT.

Constant Load Performance8 weeks

More specifically, differences in constant load performance (i.e., power output \[watts\]) before and after IMT.

Secondary Outcome Measures
NameTimeMethod
Femoral blood flow (FBF) of the limb locomotor muscles by ultrasound8 weeks

More specifically, the effects of IMT on femoral blood flow (FBF) of the limb locomotor muscles during constant load cycling

Lung Volumes8 weeks

More specifically, the effects of IMT on operating lung volumes during constant load cycling and a 16-km cycling time-trial.

Perception of Breathing Intensity and Unpleasantness and Leg Fatigue8 weeks

More specifically, whether IMT affects an individual's perception of exertional dyspnea (revised Borg Scales from 0-10 to rate breathing intensity and unpleasantness) and revised Borg Scales from 0-10 to rate leg fatigue during constant load cycling and a 16-km cycling time-trial. Scores will be reported as whole numbers between 0-10. Higher scores indicate extreme intensity, unpleasantness, or fatigue.

Deoxygenation of the respiratory and limb locomotor muscles by near-infrared spectroscopy8 weeks

More specifically, the effects of IMT on the deoxygenation of the respiratory and limb locomotor muscles during constant load cycling and a 16-km cycling time-trial

Trial Locations

Locations (1)

School of Public Health-Bloomington

🇺🇸

Bloomington, Indiana, United States

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