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Effects of Inspiratory Training on Respiratory Function in Swimming

12 maggio 2026 aggiornato da: Agustin Velazquez Córdoba, Universidad Rey Juan Carlos

Effects of Inspiratory Training on Respiratory Function, Diaphragmatic Structure, and Cardiac Response in Healthy Adults During Aquatic Exercise.

Introduction:

The diaphragm is the primary inspiratory muscle and plays a key role in ventilation, trunk stability, and exercise efficiency. Its dysfunction is associated with early fatigue, increased respiratory work, and reduced performance. Inspiratory muscle training (IMT) has been shown to improve respiratory function and exercise tolerance. Swimming, due to its specific characteristics, imposes an additional demand on the respiratory muscles.

Objective:

To evaluate the effects of an IMT program on diaphragmatic function, respiratory variables, cardiorespiratory response, and performance in swimmers.

Methods:

A randomized, parallel, double-blind clinical trial with 34 swimmers. The experimental group will perform an 8-week IMT program with progressive loads, while the control group will use a sham device without resistance. Diaphragmatic function will be assessed using ultrasound (thickness and excursion), along with respiratory variables (MIP, FEV₁, MEP, FVC), cardiovascular variables (heart rate, HRV), metabolic variables (lactate), and performance (100 m test).

Expected results:

IMT is expected to improve diaphragmatic function, increase inspiratory muscle strength, enhance ventilatory efficiency, and reduce respiratory fatigue, leading to improvements in performance and physiological responses to exercise.

Conclusion:

IMT could be an effective strategy to enhance respiratory function and swimming performance. This study provides a novel approach by incorporating ultrasound assessment of the diaphragm in an aquatic exercise context.

Panoramica dello studio

Descrizione dettagliata

Diaphragm

The diaphragm is the primary muscle of inspiration. It is a dome-shaped skeletal muscle located between the thoracic and abdominal cavities. Its contraction increases thoracic volume, allowing air to enter the lungs. Beyond respiration, it contributes to core stability and postural control during movement and exercise.

Inspiratory Muscle Training (IMT)

IMT is a training method that involves breathing against a resistive load to strengthen the inspiratory muscles, mainly the diaphragm and accessory muscles. It is used to improve respiratory strength, endurance, and ventilatory efficiency, especially in athletes and clinical populations.

Respiratory function

Respiratory function refers to the ability of the respiratory system to ventilate, exchange gases, and maintain adequate oxygen and carbon dioxide levels. It is commonly assessed using spirometric and pressure-based measures.

Diaphragmatic dysfunction

This refers to a reduced ability of the diaphragm to generate force or excursion, leading to impaired ventilation. It may result in increased breathing effort, reduced exercise tolerance, and earlier onset of respiratory fatigue.

Maximal Inspiratory Pressure (MIP)

MIP is the maximum negative pressure generated during a forceful inspiration against an occluded airway. It is a key indicator of inspiratory muscle strength, especially diaphragmatic function.

Forced Expiratory Volume in 1 second (FEV₁)

FEV₁ is the volume of air that can be forcefully exhaled in the first second of a forced expiration. It is a standard measure of airway function and pulmonary performance.

Maximal Expiratory Pressure (MEP)

MEP represents the maximum pressure generated during a forceful expiration. It reflects the strength of expiratory muscles such as abdominal and intercostal muscles.

Forced Vital Capacity (FVC)

FVC is the total volume of air exhaled forcefully after a maximal inspiration. It reflects lung capacity and ventilatory function.

Heart rate

Heart rate is the number of heartbeats per minute. It reflects cardiovascular response to exercise intensity and autonomic nervous system activity.

Heart Rate Variability (HRV)

HRV is the variation in time intervals between consecutive heartbeats. It is a marker of autonomic nervous system balance, particularly sympathetic and parasympathetic activity.

Blood lactate

Blood lactate is a metabolic byproduct of anaerobic glycolysis. Elevated levels indicate increased reliance on anaerobic energy systems and higher metabolic stress during intense exercise.

100-meter swimming test

A standardized performance test measuring the time required to complete 100 meters freestyle swimming at maximal effort. It is used to assess anaerobic and aerobic performance capacity in swimmers.

Randomized controlled trial (RCT)

An experimental study design in which participants are randomly assigned to different intervention groups to reduce bias and ensure comparability.

Parallel design

A study design where two or more groups are followed simultaneously, each receiving a different intervention throughout the study period.

Double-blind design

A methodological approach in which neither participants nor researchers know group allocation, minimizing expectation and measurement bias.

Sham device (placebo IMT)

A device designed to mimic IMT without providing meaningful resistance, used to control for placebo effects in training studies.

Ultrasound assessment

A non-invasive imaging technique used to evaluate diaphragm structure and function in real time, including thickness and movement during breathing.

Diaphragmatic thickness

The measurement of the muscle layer of the diaphragm, often assessed at rest and during contraction to evaluate contractile capacity.

Diaphragmatic excursion

The movement amplitude of the diaphragm during breathing, reflecting its functional mobility and efficiency.

Tipo di studio

Interventistico

Iscrizione (Stimato)

34

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

      • Madrid, Spagna
        • Club de natación Moscardó

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto
  • Adulto più anziano

Accetta volontari sani

Descrizione

Inclusion Criteria:

  • Participants of both sexes, aged over 18 years.
  • Minimum swimming training frequency of at least two sessions per week, with a minimum duration of 30 minutes per session, consistently maintained over the last three months.

Exclusion Criteria:

  • Current or previous diagnosis of respiratory diseases.
  • Musculoskeletal injuries limiting the ability to perform a 100-meter swimming test.
  • Participation in inspiratory muscle training programs within the last six months.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Separare

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Comparatore attivo: Inspiratory training
The experimental group will perform an eight-week home-based training program using the POWERbreathe EX1-MR device, individually calibrated according to MIP. Participants will complete 30 deep inspirations per session, twice daily, seven days per week, with progressive intensities: 30% of initial MIP during weeks 1-2, 50% of the new MIP during weeks 3-4, 60% during weeks 5-6, and 70% of MIP during weeks 7-8, with the aim of familiarizing participants with the device and progressively adapting the diaphragm to increasing loads.
The experimental group will perform an eight-week home-based training program using the POWERbreathe EX1-MR device, individually calibrated according to MIP. Participants will complete 30 deep inspirations per session, twice daily, seven days a week, with progressive intensities: 30% of initial MIP during weeks 1-2, 50% of the new MIP during weeks 3-4, 60% during weeks 5-6, and 70% of MIP during weeks 7-8, with the aim of familiarizing participants with the device and progressively adapting the diaphragm to increasing loads.
Comparatore placebo: Placebo
The control group will use the same device without resistance, maintaining the same breathing frequency and volume in order to control for the placebo effect.
The control group will use the same device without resistance, maintaining the same breathing frequency and volume to control for the placebo effect.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Sport performance
Lasso di tempo: This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
Total time and split times for completing 100 m freestyle.
This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
Maximal inspiratory pressure.
Lasso di tempo: This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
Inspiratory variables: Inspiratory muscle strength was assessed by measuring MIP using the POWERbreathe Smart Adaptor device. The participant was seated and used a mouthpiece with a leak hole to minimize activation of the orofacial musculature. The procedure consisted of a maximal expiration to residual volume, followed by a maximal inspiration sustained against the device for at least 2 seconds. Three attempts were performed with rest periods of at least 1 minute, and the highest value was selected.
This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
Maximal espiratory pressure.
Lasso di tempo: This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
Expiratory variables: Pulmonary function was assessed using forced spirometry, recording FEV₁, MEP, and FVC with the MIR Spirobank Oxi Portable Spirometer device. For a manoeuvre to be acceptable, the subject had to perform a maximal inspiration followed by a rapid and continuous forced expiration, without coughing during the first second and with a smooth flow-volume curve, without leaks. The expiration had to last at least 6 seconds or until a volume plateau was reached. Manoeuvres with interruptions, false efforts, or closed glottis were discarded. Three acceptable manoeuvres were performed, and results were considered valid when the two best FEV₁ and FVC values differed by less than 150 mL. If this variability criterion was not met, additional attempts were performed until reproducible results were obtained.
This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
lactate
Lasso di tempo: This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
It will be taken from the fingertip immediately after completing the test, following the extraction protocol to ensure measurement validity. The device will be calibrated before each testing session according to the manufacturer's recommendations.
This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
Perceived exertion.
Lasso di tempo: This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
The Borg scale (6-20) will be previously explained to the participant using standardized instructions to ensure full understanding. Perceived intensity will be recorded immediately after the test through a direct interview with the evaluator.
This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
Dysnea
Lasso di tempo: This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
It will be administered verbally and individually by the evaluator immediately after physical exertion, ensuring that the participant understands each item. The test consists of 12 questions rated on a 0-3 Likert scale for each item.
This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
Heart rate.
Lasso di tempo: This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
It will be placed on the anterior thoracic region, just below the xiphoid process. The device will be calibrated and checked according to the manufacturer's instructions before each test. Heart rate will be recorded in real time from the start until five minutes after the test. Data will be analyzed using Polar Flow software, including mean heart rate (HRmean), maximum heart rate (HRmax), recovery time (RT), and heart rate variability (HRV). The data will then be further analyzed in Polar Flow.
This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
Diaphragmatic excursion
Lasso di tempo: This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
It was assessed on the right hemidiaphragm to ensure an adequate acoustic window. The transducer was placed in the anterior subcostal region at the midclavicular line, with a craniocaudal orientation and slight medial angulation. First, B-mode ultrasound was used to identify the diaphragmatic dome as a hyperechoic, mobile line. Subsequently, M-mode was activated, aligning the cursor perpendicular to the diaphragmatic movement, and vertical displacement was recorded from the end of quiet expiration to maximal voluntary inspiration. Three valid manoeuvres were performed, and the highest value was selected for analysis, expressed in centimeters.
This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
Diaphragmatic thickening
Lasso di tempo: This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.
It was assessed by placing the transducer in the diaphragm's zone of apposition, located between the 8th and 10th intercostal spaces along the midaxillary line. In B-mode, the diaphragm was identified as a hypoechoic structure bounded by two hyperechoic lines corresponding to the pleura and peritoneum. Diaphragmatic thickness was measured at the end of quiet expiration and during maximal voluntary inspiration. Three consecutive respiratory cycles were recorded, and the mean value was used for final analysis.
This measurement will be carried out from the randomization process until 8 weeks after the start of the inspiratory training program.

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Investigatori

  • Investigatore principale: Agustin c Velazquez, Universidad Rey Juan Carlos

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 settembre 2026

Completamento primario (Stimato)

1 dicembre 2026

Completamento dello studio (Stimato)

1 gennaio 2027

Date di iscrizione allo studio

Primo inviato

18 aprile 2026

Primo inviato che soddisfa i criteri di controllo qualità

12 maggio 2026

Primo Inserito (Effettivo)

19 maggio 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

19 maggio 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

12 maggio 2026

Ultimo verificato

1 aprile 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Altri numeri di identificazione dello studio

  • 150120261552026
  • Sponsor-Investigator (Altro identificatore: Agustín Velázquez Córdoba)

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

Descrizione del piano IPD

Plan description:

At present, no definitive decision has been made regarding the sharing of individual participant data. The possibility of sharing anonymized data with other researchers is being considered in order to promote scientific transparency, reproducibility of results, and the development of future research.

However, this decision will be subject to strict compliance with applicable data protection regulations (GDPR), the safeguarding of participant confidentiality, and the evaluation of the sample size and the specific context of the study.

If data are shared, they will be provided exclusively in anonymized format, upon justified request and under formal data use agreements.

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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