Exercise Physiology Lab, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.
LungenZentrum Hirslanden, Zurich, Switzerland.
Respiration. 2019;97(6):558-568. doi: 10.1159/000496028. Epub 2019 Apr 1.
The beneficial effects of exercise training for asthmatics might relate to repetitive airway stretching. Thus, a training with more pronounced airway stretch using isolated, volitional hyperpnea (HYP) might be similarly or more effective. However, in healthy subjects, a bout of HYP training is known to cause an acute FEV1 decline.
The aim of the present study was therefore to test whether these changes are more pronounced in asthmatics, possibly putting them at risk with HYP training.
Nine subjects with mild-moderate asthma (confirmed by mannitol challenge) and 11 healthy subjects performed six 5-min bouts (with 6-min breaks; HYP1) and one 30-min bout (HYP2) of normocapnic HYP at 60% of maximal voluntary ventilation using warm and humid air. FEV1 and airway resistance (R5) were measured before, in breaks (HYP1), and immediately after HYP, and during 60 min of recovery.
In both groups, a significant and similar decrease in FEV1 during HYP1 (asthmatics: -3 ± 3%; healthy subjects: -2 ± 3%), after HYP1 (asthmatics: -2 ± 5%; healthy subjects: -1 ± 4%), and after HYP2 (asthmatics: -4 ± 5%; healthy subjects: -3 ± 3%), and an increase in R5 during and after both HYPs were observed. Maximal changes in FEV1 and R5 did not correlate with baseline lung function or responsiveness to mannitol.
A bout of HYP does not lead to relevant bronchoconstriction and the observed changes in lung function and airway resistance are neither of the magnitude of clinical relevance, nor do they differ from responses in healthy individuals. Thus, HYP training can safely be tested as an airway-specific exercise training alternative (or add-on) modality to regular aerobic exercise training.
运动训练对哮喘患者的有益影响可能与反复气道拉伸有关。因此，使用孤立的、自主的深呼吸（HYP）进行更明显的气道拉伸的训练可能同样有效或更有效。然而，众所周知，健康受试者进行一次 HYP 训练会导致急性 FEV1 下降。
本研究的目的是测试这些变化在哮喘患者中是否更为明显，这可能使他们在 HYP 训练中面临风险。
9 名轻度至中度哮喘患者（通过甘露醇挑战证实）和 11 名健康受试者在 60%最大自主通气量下使用温暖潮湿的空气进行了六次 5 分钟的 HYP 训练（HYP1）和一次 30 分钟的 HYP 训练（HYP2），每次训练之间有 6 分钟的休息时间。FEV1 和气道阻力（R5）在 HYP1 之前、HYP1 期间和之后以及 60 分钟恢复期间进行测量。
在两组中，HYP1 期间（哮喘患者：-3 ± 3%；健康受试者：-2 ± 3%）、HYP1 后（哮喘患者：-2 ± 5%；健康受试者：-1 ± 4%）和 HYP2 后（哮喘患者：-4 ± 5%；健康受试者：-3 ± 3%）FEV1 均显著且相似下降，并且在两种 HYP 期间和之后 R5 均增加。FEV1 和 R5 的最大变化与基线肺功能或甘露醇反应性无关。
一次 HYP 不会导致明显的支气管收缩，并且观察到的肺功能和气道阻力变化既没有临床相关性的程度，也与健康个体的反应没有差异。因此，HYP 训练可以作为一种安全的气道特异性运动训练替代（或附加）方式进行测试，作为常规有氧运动训练的补充。
