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Clin Physiol Funct Imaging. 2018 Jul;38(4):554-565. doi: 10.1111/cpf.12473. Epub 2017 Sep 22.

Deoxygenation of inspiratory muscles during cycling, hyperpnoea and loaded breathing in health and disease: a systematic review.

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Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Physical Therapy, University of Toronto, Toronto, ON, Canada.
College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Keenan Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
Department of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Medicine, Division of Respirology, University Health Network and Mount Sinai Hospital, Toronto, ON, Canada.
Toronto Rehabilitation Institute, University Hospital Network, Toronto, ON, Canada.


Assessing inspiratory muscle deoxygenation and blood flow can provide insight into anaerobic stress, recruitment strategies and mechanisms of inspiratory muscle limitation. Therefore, this review aimed to synthesize measurements of inspiratory muscle oxyhaemoglobin (O2 Hb), deoxyhaemoglobin (HHb), blood volume and flow of the inspiratory muscles acquired via near-infrared spectroscopy (NIRS) during cycling, hyperpnoea and loaded breathing in healthy non-athletes, healthy athletes and patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF). Searches were performed on Medline and Medline in-process, EMBASE, Central, Sportdiscus, PubMed and Compendex. Reviewers independently abstracted articles and assessed their quality using the modified Downs and Black checklist. Of the 644 articles identified, 21 met the inclusion criteria. Studies evaluated non-athletes (n = 9), athletes (n = 5), COPD (n = 2) and CHF (n = 5). The sample was 90% male and 73% were non-athletes and athletes. Interventions included cycle ergometry, hyperpnoea, loaded breathing, elbow flexor loading and combined loaded breathing and ergometry. Athletes and patients with CHF or COPD demonstrated deoxygenation of inspiratory accessory muscles that was often an opposite or exaggerated pattern compared to non-athletes. O2 Hb decreased and HHb increased significantly in inspiratory muscles during cycle ergometry and loaded breathing with accentuated changes during combined ergometry and loaded breathing. During different regimens of hyperpnoea or loaded breathing, comparisons of inspiratory muscles demonstrated that the sternocleidomastoid deoxygenated more than the intercostals, parasternals or scalenes. Evaluating inspiratory muscle deoxygenation via NIRS can inform mechanisms of inspiratory muscle limitation in non-athletes, athletes and patients with CHF or COPD.


blood flow; breathing exercise; exercise; muscles; near-infrared spectroscopy

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