An exploratory study of respiratory muscle endurance training in high lesion level paraplegic handbike athletes

OBJECTIVE:: To investigate the impact of respiratory muscle endurance training (RMET) on lung function and exercise performance in athletes with high lesion level paraplegia. DESIGN:: This was a case-control intervention study. SETTING:: Sport and exercise science laboratories and bike path. PARTICIPANTS:: Twelve competitive handbike athletes with high lesion level paraplegia matched by lesion and fitness level in training (T) group (7) and control (C) group (5). INTERVENTIONS:: The T group performed 20 RMET training sessions over a 4-week period using a SpiroTiger. Each session lasted for 30 minutes. The C group did not perform any RMET. MAIN OUTCOME MEASURES:: Resting lung function, respiratory muscle endurance, and exercise performance (arm cranking maximal incremental test and simulated handbike time trial). RESULTS:: Resting lung function was not different between groups and did not change with the intervention. After RMET, the respiratory muscle endurance was significantly increased by 27% in the T group but did not alter in the C group. Final minute ventilation was increased from 89 ± 20 L/min to 112 ± 20 L/min after RMET in the T group and the sensation of dyspnea decreased (P < 0.05). Peak oxygen consumption, peak mechanical power output, and handbike time trial performance were not different between groups and did not change with the RMET intervention. CONCLUSIONS:: A short-term RMET intervention in handbike athletes with high lesion level paraplegia improved respiratory muscle endurance but had little impact on overall exercise performance. © 2014 by the American Medical Society for Sports Medicine.