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Training masks are facial masks worn to limit the intake of air during breathing. Their ostensible purpose is to strengthen the respiratory musculature by making it work harder. There is some evidence that they may improve endurance capacity (VO2 max) and power output, but research into their benefits has so far generally proven inconclusive.
Training masks allow users to actively work on their respiratory muscle fitness.
Originally designed to simulate training at altitude, the concept failed to deliver in multiple research trials. Training in hypoxic (low oxygen) environments increases red blood cell mass and improves oxygen transport, giving athletes a measurable performance boost when competing at sea level. [1] The use of training masks, however, has no measurable effect on haemoglobin, hematocrit levels and oxygen transport in athletes, as they do not alter the oxygen concentration of the air taken in.
However, they appear to add resistance to the respiratory muscles by limiting air supply, thus triggering an adaptive physiological response. [2] The muscles of respiration, from the diaphragm and the intercostals to the assisting musculature, need to be trained like any other muscles to increase resistance to fatigue and maximize performance. Respiratory Muscle Training (RMT) is a training method developed to condition the muscles of respiration specifically. RMT has been shown to markedly improve strength, speed, power and endurance in athletes. [3] Preoperative Respiratory Muscle Training (RMT), or Inspiratory Muscle Training (IMT), is also used in the patients who are scheduled to undergo cardiac or abdominal surgery aiming to reduce the risk of postoperative pulmonary complications. [4]
Training masks allow athletes to strengthen their respiratory muscle fitness without having to be confined to stationary devices or special facilities. By restricting the user's breathing, the devices may improve cardiorespiratory fitness, leading to better sport performance. [5] This is especially relevant to elite athletes, where the pulmonary system may become a limiting factor. [6]
During a 6-week high-intensity training program, moderately trained subjects using training masks were found to have improved their endurance capacity (VO2 max) and power output significantly. While observing that the respiratory muscle loading improved performance across multiple metrics, the researchers speculated that the performance increases may also have been attributable to the re-breathing of expired air, which would mean at least some of the positive results were due to improved CO2 tolerance. [7]
There is conflicting research on the performance benefits of RMT, some challenging the assumption that an increase in inspiratory muscle fitness translates to better work capacity and athletic performance. [8] [9] A comprehensive review of the literature by Gigliotti et al. (2006) concluded that RMT does improve relevant performance markers in well-controlled and rigorously designed studies, but the mechanisms behind these improvements are not fully understood and require further research. [10]
Hypoxia is a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level. Hypoxia may be classified as either generalized, affecting the whole body, or local, affecting a region of the body. Although hypoxia is often a pathological condition, variations in arterial oxygen concentrations can be part of the normal physiology, for example, during strenuous physical exercise.
Respiratory arrest is a medical condition caused by apnea or respiratory dysfunction severe enough that it will not sustain the body. Prolonged apnea refers to a patient who has stopped breathing for a long period of time. If the heart muscle contraction is intact, the condition is known as respiratory arrest. An abrupt stop of pulmonary gas exchange lasting for more than five minutes may permanently damage vital organs, especially the brain. Lack of oxygen to the brain causes loss of consciousness. Brain injury is likely if respiratory arrest goes untreated for more than three minutes, and death is almost certain if more than five minutes.
Generalized hypoxia is a medical condition in which the tissues of the body are deprived of the necessary levels of oxygen due to an insufficient supply of oxygen, which may be due to the composition or pressure of the breathing gas, decreased lung ventilation, or respiratory disease, any of which may cause a lower than normal oxygen content in the arterial blood, and consequently a reduced supply of oxygen to all tissues perfused by the arterial blood. This usage is in contradistinction to localized hypoxia, in which only an associated group of tissues, usually with a common blood supply, are affected, usually due to an insufficient or reduced blood supply to those tissues. Generalized hypoxia is also used as a synonym for hypoxic hypoxia This is not to be confused with hypoxemia, which refers to low levels of oxygen in the blood, although the two conditions often occur simultaneously, since a decrease in blood oxygen typically corresponds to a decrease in oxygen in the surrounding tissue. However, hypoxia may be present without hypoxemia, and vice versa, as in the case of infarction. Several other classes of medical hypoxia exist.
VO2 max (also maximal oxygen consumption, maximal oxygen uptake or maximal aerobic capacity) is the maximum rate of oxygen consumption attainable during physical exertion. The name is derived from three abbreviations: "V̇" for volume (the dot appears over the V to indicate "per unit of time"), "O2" for oxygen, and "max" for maximum. A similar measure is VO2 peak (peak oxygen consumption), which is the measurable value from a session of physical exercise, be it incremental or otherwise. It could match or underestimate the actual VO2 max. Confusion between the values in older and popular fitness literature is common. The capacity of the lung to exchange oxygen and carbon dioxide is constrained by the rate of blood oxygen transport to active tissue.
Altitude training is the practice by some endurance athletes of training for several weeks at high altitude, preferably over 2,400 metres (8,000 ft) above sea level, though more commonly at intermediate altitudes due to the shortage of suitable high-altitude locations. At intermediate altitudes, the air still contains approximately 20.9% oxygen, but the barometric pressure and thus the partial pressure of oxygen is reduced.
High-intensity interval training (HIIT) is a training protocol alternating short periods of intense or explosive anaerobic exercise with brief recovery periods until the point of exhaustion. HIIT involves exercises performed in repeated quick bursts at maximum or near maximal effort with periods of rest or low activity between bouts. The very high level of intensity, the interval duration, and number of bouts distinguish it from aerobic (cardiovascular) activity, because the body significantly recruits anaerobic energy systems. The method thereby relies on "the anaerobic energy releasing system almost maximally".
Cardiorespiratory fitness (CRF) refers to the ability of the circulatory and respiratory systems to supply oxygen to skeletal muscles during sustained physical activity. Scientists and researchers use CRF to assess the functional capacity of the respiratory and cardiovascular systems. These functions include ventilation, perfusion, gas exchange, vasodilation, and delivery of oxygen to the body's tissues. As these body's functions are vital to an individual's health, CRF allows observers to quantify an individual's morbidity and mortality risk as a function of cardiorespiratory health.
Interval training is a type of training exercise that involves a series of high-intensity workouts interspersed with rest or relief periods. The high-intensity periods are typically at or close to anaerobic exercise, while the recovery periods involve activity of lower intensity. Varying the intensity of effort exercises the heart muscle, providing a cardiovascular workout, improving aerobic capacity and permitting the person to exercise for longer and/or at more intense levels.
Circuit training is a form of body conditioning that involves endurance training, resistance training, high-intensity aerobics, and exercises performed in a circuit, similar to high-intensity interval training. It targets strength building and muscular endurance. An exercise "circuit" is one completion of all set exercises in the program. When one circuit is completed, one begins the first exercise again for the next circuit. Traditionally, the time between exercises in circuit training is short and often with rapid movement to the next exercise.
An incentive spirometer is a handheld medical device used to help patients improve the functioning of their lungs. By training patients to take slow and deep breaths, this simplified spirometer facilitates lung expansion and strengthening. Patients inhale through a mouthpiece, which causes a piston inside the device to rise. This visual feedback helps them monitor their inspiratory effort. Incentive spirometers are commonly used after surgery or other illnesses to prevent pulmonary complications.
Running economy (RE) a complex, multifactorial concept that represents the sum of metabolic, cardiorespiratory, biomechanical and neuromuscular efficiency during running. Oxygen consumption (VO2) is the most commonly used method for measuring running economy, as the exchange of gases in the body, specifically oxygen and carbon dioxide, closely reflects energy metabolism. Those who are able to consume less oxygen while running at a given velocity are said to have a better running economy. However, straightforward oxygen usage does not account for whether the body is metabolising lipids or carbohydrates, which produce different amounts of energy per unit of oxygen; as such, accurate measurements of running economy must use O2 and CO2 data to estimate the calorific content of the substrate that the oxygen is being used to respire.
A hypoxicator is a medical device intended to provide a stimulus for the adaptation of an individual's cardiovascular system by means of breathing reduced oxygen hypoxic air and triggering mechanisms of compensation. The aim of intermittent hypoxic training or hypoxic therapy conducted with such a device is to obtain benefits in physical performance and wellbeing through improved oxygen metabolism.
Pulmonary rehabilitation, also known as respiratory rehabilitation, is an important part of the management and health maintenance of people with chronic respiratory disease who remain symptomatic or continue to have decreased function despite standard medical treatment. It is a broad therapeutic concept. It is defined by the American Thoracic Society and the European Respiratory Society as an evidence-based, multidisciplinary, and comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and often have decreased daily life activities. In general, pulmonary rehabilitation refers to a series of services that are administered to patients of respiratory disease and their families, typically to attempt to improve the quality of life for the patient. Pulmonary rehabilitation may be carried out in a variety of settings, depending on the patient's needs, and may or may not include pharmacologic intervention.
Intermittent hypoxic training (IHT), also known as intermittent hypoxic therapy, is a technique aimed at improving human performance by way of adaptation to reduced oxygen.
Preoperative rehabilitation, prehabilitation or prehab, is a form of healthcare intervention that takes place before a medical or surgical intervention with the aim to reduce side effects and complications, and enhance recovery. Multidisciplinary team involvement can range from physiotherapists, occupational therapists, respiratory therapists, doctors, pharmacologists, anesthesiologists, psychologists, psychiatrists and sports physiologists.
Cardiovascular fitness refers a health-related component of physical fitness that is brought about by sustained physical activity. A person's ability to deliver oxygen to the working muscles is affected by many physiological parameters, including heart rate, stroke volume, cardiac output, and maximal oxygen consumption.
Hypoventilation training is a physical training method in which periods of exercise with reduced breathing frequency are interspersed with periods with normal breathing. The hypoventilation technique consists of short breath holdings and can be performed in different types of exercise: running, cycling, swimming, rowing, skating, etc.
In kinesiology, the ventilatory threshold (VT1) refers to the point during exercise at which ventilation starts to increase at a faster rate than VO2 (V – volume, O2 – oxygen). One's threshold is said to reflect levels of anaerobiosis and lactate accumulation. As the intensity level of the activity being performed increases, breathing becomes faster; more steadily first and then more rapid as the intensity increases. When breathing surpasses normal ventilation rate, one has reached ventilatory threshold. For most people this threshold lies at exercise intensities between 50% and 75% of VO2 max. A major factor affecting one's ventilatory threshold is their maximal ventilation (amount of air entering and exiting lungs). This is dependent on their personal experience with the activity and how physically fit the person is. Comparison studies of more athletic people have shown that your ventilatory threshold occurs at a higher intensity if you are more active or have been training for that exercise; although, in some cases shorter continuous tests can be used because of rapid alterations in ventilation.
Respiratory adaptation is the specific change that the respiratory system undergoes in response to the demands of physical exertion. Intense physical exertion, such as that involved in fitness training, places elevated demands on the respiratory system. Over time, this results in respiratory changes as the system adapts to these requirements. These changes ultimately result in an increased exchange of oxygen and carbon dioxide, which is accompanied by an increase in metabolism. Respiratory adaptation is a physiological determinant of peak endurance performance, and in elite athletes, the pulmonary system is often a limiting factor to exercise under certain conditions.
A respiratory pressure meter measures the maximum inspiratory and expiratory pressures that a patient can generate at either the mouth (MIP and MEP) or inspiratory pressure a patient can generate through their nose via a sniff manoeuvre (SNIP). These measurements require patient cooperation and are known as volitional tests of respiratory muscle strength. Handheld devices displaying the measurement achieved in cmH2O and the pressure trace created, allow quick patient testing away from the traditional pulmonary laboratory and are useful for ward based, out patient, and preoperative assessment as well as for use by pulmonologists and physiotherapists.