An integrative approach to the pulmonary physiology of exercise: when does biological sex matter?

Archiza, Bruno; Leahy, Michael G.; Kipp, Shalaya; Sheel, A. William

doi:10.1007/s00421-021-04690-9

Cited by 12 publications

(13 citation statements)

References 121 publications

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“…Finally, work led by Dominelli et al (2015a , b) , Molgat-Seon et al (2018a , b) , Welch et al (2018a , b) , Geary et al (2019) , and Archiza et al (2021) has shown apparent sex differences in respiratory muscle fatigability and workload, which is important to consider in the context of IMT. Due in part to anatomical differences, such as smaller airway diameter and smaller thoracic volume compared to males, females generally have a higher work of breathing when minute ventilation, operating lung volume, breathing frequency, and tidal volume are matched ( Dominelli et al, 2019 ).…”

Section: Training Prescription Considerationsmentioning

confidence: 99%

Time to Move Beyond a “One-Size Fits All” Approach to Inspiratory Muscle Training

et al. 2022

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Inspiratory muscle training (IMT) has been studied as a rehabilitation tool and ergogenic aid in clinical, athletic, and healthy populations. This technique aims to improve respiratory muscle strength and endurance, which has been seen to enhance respiratory pressure generation, respiratory muscle weakness, exercise capacity, and quality of life. However, the effects of IMT have been discrepant between populations, with some studies showing improvements with IMT and others not. This may be due to the use of standardized IMT protocols which are uniformly applied to all study participants without considering individual characteristics and training needs. As such, we suggest that research on IMT veer away from a standardized, one-size-fits-all intervention, and instead utilize specific IMT training protocols. In particular, a more personalized approach to an individual’s training prescription based upon goals, needs, and desired outcomes of the patient or athlete. In order for the coach or practitioner to adjust and personalize a given IMT prescription for an individual, factors, such as frequency, duration, and modality will be influenced, thus inevitably affecting overall training load and adaptations for a projected outcome. Therefore, by integrating specific methods based on optimization, periodization, and personalization, further studies may overcome previous discrepancies within IMT research.

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Section: Training Prescription Considerationsmentioning

confidence: 99%

Time to Move Beyond a “One-Size Fits All” Approach to Inspiratory Muscle Training

et al. 2022

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“…At exercise around or above 80%–85% VO 2max , three primary mechanisms cause the respiratory system to limit performance: exercise-induced arterial oxyhemoglobin desaturation, excessive ventilatory muscle work, and intrathoracic pressure effects on cardiac output ( Amann, 2012 ). Specific scenarios (e.g., hypoxia and cold/dry climates) expose respiratory system vulnerabilities at submaximal intensities, and certain populations (e.g., elite athletes, females, and elderly) are especially susceptible; these phenomena have been recently detailed in extensive reviews ( Dempsey et al, 2020 ; Archiza et al, 2021 ). While the exact limiting mechanisms differ (structural or functional), these situations and individuals bring the respiratory system close to its physiological limits.…”

Section: Respiration During Exercisementioning

confidence: 99%

Breath Tools: A Synthesis of Evidence-Based Breathing Strategies to Enhance Human Running

et al. 2022

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Running is among the most popular sporting hobbies and often chosen specifically for intrinsic psychological benefits. However, up to 40% of runners may experience exercise-induced dyspnoea as a result of cascading physiological phenomena, possibly causing negative psychological states or barriers to participation. Breathing techniques such as slow, deep breathing have proven benefits at rest, but it is unclear if they can be used during exercise to address respiratory limitations or improve performance. While direct experimental evidence is limited, diverse findings from exercise physiology and sports science combined with anecdotal knowledge from Yoga, meditation, and breathwork suggest that many aspects of breathing could be improved via purposeful strategies. Hence, we sought to synthesize these disparate sources to create a new theoretical framework called “Breath Tools” proposing breathing strategies for use during running to improve tolerance, performance, and lower barriers to long-term enjoyment.

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“…smaller airways in females could predispose to expiratory flow limitation (EFL) and dynamic hyperinflation; and differences in rib cage geometry and respiratory musculature could induce respiratory muscle fatigue or increase the oxygen cost of breathing (Archiza et al, 2021;McClaran et al, 1998). Alternatively, the android obesity pattern (i.e., more abdominal, especially visceral, fat) in males could push up against the diaphragm altering breathing mechanics and provoking EFL, but their relatively larger airways could also defend against some of these changes.…”

Section: Introductionmentioning

confidence: 99%

“…Obesity imposes a mechanical load on the respiratory system, reducing functional residual capacity (FRC) and altering breathing mechanics during exercise (Babb, 2013b; Salome et al., 2010). The pathophysiological changes imposed by obesity on the respiratory system could be amplified in females, who already exhibit morphological differences in the respiratory system compared with males (Archiza et al., 2021; Molgat‐Seon et al., 2018). The distribution of fat deposits also differs by sex, with females having relatively more subcutaneous and less visceral fat in the abdomen and a gynoid obesity pattern (Karastergiou et al., 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Morphological sex differences combined with obesity‐related changes in respiratory function could affect ventilatory responses during exercise. For example, smaller lung volumes could lead females with obesity to adopt a rapid and shallow breathing pattern and experience ventilatory constraints; smaller airways in females could predispose to expiratory flow limitation (EFL) and dynamic hyperinflation; and differences in rib cage geometry and respiratory musculature could induce respiratory muscle fatigue or increase the oxygen cost of breathing (Archiza et al., 2021; McClaran et al., 1998). Alternatively, the android obesity pattern (i.e., more abdominal, especially visceral, fat) in males could push up against the diaphragm altering breathing mechanics and provoking EFL, but their relatively larger airways could also defend against some of these changes.…”

Section: Introductionmentioning

confidence: 99%

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Sex differences in the ventilatory responses to exercise in mild to moderate obesity

Bhammar

Balmain

Babb

et al. 2022

Experimental Physiology

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Obesity is associated with altered ventilatory responses, which may be exacerbated in females due to the functional consequences of sex-related morphological differences in the respiratory system. This study examined sex differences in ventilatory responses during exercise in adults with obesity. Healthy adults with obesity (n = 73; 48 females) underwent pulmonary function testing, underwater weighing, magnetic resonance imaging (MRI), a graded exercise test to exhaustion, and two constant work rate exercise tests; one at a fixed work rate (60 W for females and 105 W for males) and one at a relative intensity (50% of peak oxygen uptake, VO 2 peak ). Metabolic, respiratory and perceptual responses were assessed during exercise. Compared with males, females used a smaller proportion of their ventilatory capacity at peak exercise (69.13 ± 14.49 vs. 77.41 ± 17.06% maximum voluntary ventilation, P = 0.0374). Females also utilized a smaller proportion of their forced vital capacity (FVC) at peak exercise (tidal volume: 48.51 ± 9.29 vs. 54.12 ± 10.43%FVC, P = 0.0218). End-expiratory lung volumes were 2-4% higher in females compared with males during exercise (P < 0.05), while endinspiratory lung volumes were similar. Since the males were initiating inspiration from a lower lung volume, they experienced greater expiratory flow limitation during exercise.Ratings of perceived breathlessness during exercise were similar between females and males at comparable levels of ventilation. In summary, sex differences in the manifestations of obesity-related mechanical ventilatory constraints were observed.Since dyspnoea on exertion is a common complaint in patients with obesity, particularly in females, exercise prescriptions should be tailored with the goal of minimizing unpleasant respiratory sensations.

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An integrative approach to the pulmonary physiology of exercise: when does biological sex matter?

Cited by 12 publications

References 121 publications

Time to Move Beyond a “One-Size Fits All” Approach to Inspiratory Muscle Training

Time to Move Beyond a “One-Size Fits All” Approach to Inspiratory Muscle Training

Breath Tools: A Synthesis of Evidence-Based Breathing Strategies to Enhance Human Running

Sex differences in the ventilatory responses to exercise in mild to moderate obesity

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