Respiratory Muscle Training: Theory and Practice, 1e

543 Pages·2013·5.92 MB·English

by  Alison McConnell PhD FACSM FBASES

Respiratory Muscle Training
Theory and Practice
Alison McConnell, PhD, FACSM,
FBASES
Professor of Applied Physiology, Centre for Sports Medicine and Human
Performance, Brunel University, UK
Foreword by Rik Gosselink
Table of Contents
Cover image
Title page
Copyright
Acknowledgements
Dedication
Foreword
Preface
Part I: Theoretical basis of respiratory muscle training
Introduction
Introduction To Part I
Chapter 1: Anatomy and physiology of the respiratory system
THORACIC STRUCTURE AND FUNCTION
GAS EXCHANGE
OXYGEN AND CARBON DIOXIDE TRANSPORT
ACID–BASE BALANCE
CONTROL OF BREATHING
MECHANICS OF BREATHING
DYSPNOEA AND BREATHING EFFORT
Chapter 2: Exercise physiology and training principles
CARDIORESPIRATORY RESPONSES TO EXERCISE
MECHANISMS OF FATIGUE
CARDIORESPIRATORY LIMITATION OF EXERCISE TOLERANCE
CARDIORESPIRATORY FITNESS
PRINCIPLES OF CARDIORESPIRATORY TRAINING
METHODS OF CARDIORESPIRATORY TRAINING
Chapter 3: The respiratory muscles
CHANGES IN RESPIRATORY MUSCLE FUNCTION AND BREATHING MECHANICS
RESPIRATORY MUSCLE INVOLVEMENT IN EXERCISE LIMITATION
NON-RESPIRATORY FUNCTIONS OF THE RESPIRATORY MUSCLES
THE RATIONALE FOR RESPIRATORY MUSCLE TRAINING
Chapter 4: Functional benefits of respiratory muscle training
RESPIRATORY MUSCLE RESPONSES TO RMT
RESPONSES TO RMT IN HEALTHY PEOPLE
DISEASE-SPECIFIC FUNCTIONAL RESPONSES TO RMT
Part II: Practical application of respiratory muscle training
Introduction
Introduction To Part II
Chapter 5: Methods of respiratory muscle training
GENERAL TRAINING PRINCIPLES
DIFFERENT FORMS OF RMT AND THEIR OUTCOMES
PROPRIETARY TRAINING EQUIPMENT
MERITS AND LIMITATIONS OF DIFFERENT TRAINING METHODS AND EQUIPMENT
Chapter 6: Implementing respiratory muscle training
GENERAL PRINCIPLES OF FOUNDATION IMT
PRACTICAL ISSUES
MONITORING PROGRESS
GETTING STARTED
PROGRESSING TRAINING
MAINTENANCE TRAINING
INCORPORATING RMT INTO A STRUCTURED REHABILITATION PROGRAMME
INSPIRATORY MUSCLE ‘WARM-UP’ AND STRETCHING
INSPIRATORY MUSCLE ‘COOL-DOWN’
Chapter 7: Functional training of the respiratory muscles
THE RATIONALE FOR FUNCTIONAL TRAINING
ASSESSING PATIENT NEEDS
FUNCTIONAL TRAINING EXERCISES
Glossary
Index
Copyright
© 2013 Elsevier Ltd. All rights reserved.
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ISBN 978-0-7020-5020-6
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Notices
Knowledge and best practice in this field are constantly changing. As
new research and experience broaden our understanding, changes in
research methods, professional practices, or medical treatment may
become necessary.
Practitioners and researchers must always rely on their own
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Acknowledgements
There are so many people who have contributed directly and indirectly to this
book. These include the academic colleagues and PhD students with whom I
have worked over the years, as well as the many scientists whose research has
provided the insights that have shaped my thinking – you are too numerous to
mention individually, but you know who you are, and you have all made some
contribution to the development of the ideas that have led to this book.
I have expressed my gratitude to two particularly influential individuals
previously, and my appreciation of their contributions is no less heartfelt for
being repeated here. In 1996, Professor Mike Caine and Claire Hodson joined
me on my perilous journey to create an innovative product that people could use
to train their breathing. Without Mike and Claire's faith and talent, the
POWERbreathe® might never have seen the light of day, let alone commercial
success. The insights on which this book are founded were made possible by the
collective contribution that all three of us made to the creation of
POWERbreathe® – thank you both (again).
I am also extremely grateful to Research Into Ageing (now part of Age UK),
and its former Director, Elizabeth Mills. In 1990, the charity funded my original
research on breathlessness in older people; that first step on my long journey
could not have been made without the leap of faith required to give a junior
lecturer her first research grant.
In terms of the creation of this book, I owe a special debt of gratitude to four
individuals who provided invaluable feedback on my draft chapters. They are
Professor Rik Gosselink, Cath O'Connor, Emma Hamilton and Dr Bernie Bissett.
I'd also like to thank Drs Pete Brown and Graham Sharpe for debating the
mechanisms underlying changes in blood lactate concentration after respiratory
muscle training with me. Thank you all for your time, your insights, and for
enabling me to keep to my submission timetable!
Writing any book is a time consuming journey requiring an obsessive focus
that is difficult to achieve amidst one's normal daily routine. I am therefore
grateful to Brunel University and to my colleagues for allowing me the time and
thinking space to complete this journey.
I am also very grateful to my long-suffering photography model, Michèle
Bonmati, who withstood two days of filming during a heat wave in Quebec. I am
also enormously grateful to Physiotec (www.physiotec.ca), and in particular to
Pierre Labonté, Jessica Babin and Alexandra Tétreault Ayotte for their assistance
with the photography, and to POWERbreathe International Ltd.
(www.powerbreathe.com) for donating the inspiratory muscle trainer, as well as
for assisting with the production of the book jacket image. The principals at
POWERbreathe also deserve a special mention – Harry and Anne Brar – thanks
for your continued support, and for investing so much of yourselves in the slow,
but steady process of making respiratory muscle training a mainstream clinical
treatment.
This is my second book, but my first for a clinical audience, so thanks are due
to the expert team at Elsevier for making it an excellent experience. In particular,
I'd like to thank the individuals with whom I've worked directly – Rita
Demetriou-Swanwick, Carole McMurray and Shereen Jameel.
I'm also grateful and honoured that Professor Rik Gosselink agreed to write
the Foreword to Respiratory Muscle Training: Theory and Practice. Rik is a
scientist whom I've admired for many years. Recently, I've finally had the
pleasure and privilege of collaborating with him on a research project - as we say
in Britain, Rik, ‘you're a gentleman and a scholar’.
Last, but by no means least, I want to thank my partner Mel, who has yet
again endured the obsession, bordering on mania, that accompanies my bouts of
writing. Life can now return to some semblance of normality … until the next
time.
Dedication
To my late father-in-law, Dr David Varvel, who was a truly
exceptional human being. This is the book I dearly wish you could
have seen David…