Respiratory muscle training in healthy humans: resolving the controversy

Specific respiratory muscle training offers the promise of improved exercise tolerance and athletic performance for a wide range of users. However, the literature addressing respiratory muscle training in healthy people remains controversial. Studies into the effect of respiratory muscle training upon whole body exercise performance have used at least one of the following modes of training: voluntary isocapnic hyperpnea, flow resistive loading, and pressure threshold loading. Each of these training modes has the potential to improve specific aspects of respiratory muscle function. Some studies have demonstrated significant improvements in either time to exhaustion or time trial performance, whilst others have demonstrated no effect. We present an overview of the literature that rationalizes its contradictory findings. Retrospective analysis of the literature suggests that methodological factors have played a crucial role in the outcome of respiratory muscle training studies. We conclude that in most well controlled and rigorously designed studies, utilizing appropriate outcome measures, respiratory muscle training has a positive influence upon exercise performance. The mechanisms by which respiratory muscle training improves exercise performance are unclear. Putative mechanisms include a delay of respiratory muscle fatigue, a redistribution of blood flow from respiratory to locomotor muscles, and a decrease in the perceptions of respiratory and limb discomfort.