clovis.furb@gmail.com

antoniomuller2@hotmail.com

*Mestre e Doutor em Saúde Pública, área de Epidemiologia

pela Faculdade de Saúde Pública da USP

Residência Multiprofissional em Saúde da Família

pela Universidade Regional de Blumenau (FURB)

e Graduação em Educação Física pela FURB

Atualmente é Professor do departamento de Educação Física, de Medicina

e do Programa de Pós-Graduação Stricto Sensu em Saúde Coletiva da FURB

Líder do Grupo Interdisciplinar de Pesquisa em Saúde (GIPS) do CNPq

**Doutor em Educação - Liderança e Administração Educacional

pela The University of Texas at El Paso

Atualmente é professor titular da FURB (Universidade Regional de Blumenau)

no Programa de Pós Graduação em Educação (Mestrado em Educação)

e Departamento de Educação Física e faz parte do Grupo de Pesquisa

em Filosofia e Educação - EDUCOGITANS da FURB

Licenciado Pleno em Educação Física pela Universidade Regional de Blumenau

Pós-Graduação/Especialização em treinamento desportivo-voleibol pela UNIG/RJ

(Brasil)

Reception: 03/01/2021 - Acceptance: 02/12/2022

1st Review: 01/21/2022 - 2nd Review: 02/09/2022

Accessible document. Law N° 26.653. WCAG 2.0

Suggested reference: Sousa, C.A. de, & Muller, A.J. (2022). Analysis of Respiratory Muscle Training in Basketball Athletes from APAB Blumenau. Lecturas: Educación Física y Deportes, 27(287), 61-72. https://doi.org/10.46642/efd.v27i287.2891

 

Abstract

    The present study has as main objective to analyze the effects of respiratory muscle training on pulmonary function of basketball players in the city of Blumenau-SC. Respiratory muscle training (RMT) improves strength and endurance, and consequently improves athlete performance. However, few studies have analyzed the effects of RMT on the pulmonary function of athletes, especially in non-aquatic sports. Participating in the sample were 10 male athletes, between 19 and 26 years old, mean age of 23 years old, of the basketball team of the Association of Parents and Friends of Basketball (APAB). They were evaluated before and after the RMT application through a Clement Clarke brand One Flow portable digital spirometer. RMT was performed two to four times a week for eight weeks, totaling 16 sessions. Based on the results, it can be concluded that the RMT in basketball athletes presented a significant increase in the pulmonary function assessed by the Expiratory Flow Peak (EFP). Because EFP is related to expiratory force, training has proven to be very effective on expiratory muscles. However, it had no effect on the Forced Expiratory Volume in the first second (FEV1) and Forced Vital Capacity (FVC) variables.

    Keywords: Pulmonary function. Respiratory muscles. Respiratory exercises. Training. Basketball.

 

Resumo

    O presente estudo tem como objetivo principal analisar os efeitos do treinamento dos músculos respiratórios na função pulmonar de atletas profissionais de basquetebol da cidade de Blumenau-SC. O treinamento dos músculos respiratórios (TMR) aprimora sua força e endurance, e consequente melhora do desempenho de atletas. Porém, são poucos os estudos analisando os efeitos do TMR na função pulmonar de atletas, principalmente em esportes não aquáticos. Participaram da amostra 10 atletas do sexo masculino, entre 19 e 26 anos, média de idade de 23 anos, do time de basquetebol da Associação de Pais e Amigos do Basquetebol (APAB). Foram avaliados antes e depois da aplicação do TMR através de um espirômetro digital portátil One Flow da marca Clement Clarke. O TMR foi realizado de duas a quatro vezes por semana durante oito semanas, totalizando 16 sessões. Com base nos resultados obtidos, pode-se concluir que o TMR em atletas de basquetebol apresentou aumento significativo na função pulmonar avaliada pelo Pico de Fluxo Expiratório (PFE). Como o PFE está relacionado à força expiratória, o treinamento se mostrou bastante efetivo sobre os músculos da expiração. Porém, não apresentou efeito sobre as variáveis de Volume de Força Expiratória no primeiro segundo (VEF1) e de Capacidade Vital Forçada (CVF).

    Unitermos: Função pulmonar. Musculatura respiratória. Exercícios respiratórios. Treinamento. Basquetebol.

 

Resumen

    El presente estudio tiene como principal objetivo analizar los efectos del entrenamiento de los músculos respiratorios sobre la función pulmonar de jugadores de baloncesto de la ciudad de Blumenau-SC. El entrenamiento de los músculos respiratorios (EMR) mejora la fuerza y ​​la resistencia y, en consecuencia, mejora el rendimiento en deportistas. Sin embargo, pocos estudios han analizado los efectos del EMR sobre la función pulmonar, especialmente en deportes no acuáticos. Participaron en la muestra 10 jugadores, entre 19 y 26 años, edad media de 23 años, del equipo de baloncesto de la Asociación de Padres y Amigos del Baloncesto (APAB). Fueron evaluados antes y después de la aplicación de EMR a través de un espirómetro digital portátil One Flow marca Clement Clarke. El EMR se realizó de dos a cuatro veces por semana durante ocho semanas, con un total de 16 sesiones. A partir de los resultados, se puede concluir que el EMR en atletas de baloncesto presentó un aumento significativo en la función pulmonar evaluada por el Pico de Flujo Espiratorio (PFR). Debido a que el PFR está relacionado con la fuerza espiratoria, el entrenamiento ha demostrado ser muy efectivo en los músculos espiratorios. Sin embargo, no tuvo efecto sobre las variables Volumen Espiratorio Forzado en el primer segundo (VEF1) y Capacidad Vital Forzada (CVF).

    Palabras clave: Función pulmonar. Músculos respiratorios. Ejercicios respiratorios. Entrenamiento. Baloncesto.

 

Lecturas: Educación Física y Deportes, Vol. 27, Núm. 287, Abr. (2022)

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Introduction 

 

    For regular people, physical exercise is defined as a subset of structured activities aimed at improving cardiorespiratory fitness, balance, flexibility, strength and/or power and even cognitive function, particularly important in the elderly. Physical activity is the instrument to improve sports performance (Fink et al., 2018). One of the most important physical capabilities for an athlete is cardiorespiratory fitness. A good functioning of the cardiorespiratory system is essential for the performance of any physical activity (Cardoso, & Lumini, 2011). Restrictions in the respiratory system may influence the performance of high-level athletes, especially at higher intensities, where increased respiratory work results in impaired sports performance (Harms et al., 2000). Dynamic function of the respiratory muscles can be evaluated through different approaches as the respiratory timing, flow, and volume are transiently altered during brief respiratory mechanical loads. These modifications in the breathing pattern, termed inspiratory load compensation depend upon the nature and magnitude of the imposed load (Smith et al., 2019).

 

Fonte: https://www.wikiwand.com

 

    Knihs et al. (2016), state the high level of basketball is constantly evolving and knowing the variables of the physical fitness of the athletes became an important factor to contribute to the improvement of training and consequently to the performance of the team. Basketball is based mainly on three conditioning capacities: strength, endurance, and speed (Mcinnes et al., 1995 as cited in Vasconcelos, Hall, & Viana, 2017). Featuring situations of attack and defense delimited by the possession or not of the ball, it requires a lot of anaerobic power and explosive force, but due to the fact that it is a sport that requires a good recovery during a training or during a match, there is a great need to obtain a high value on oxygen consumption, because the higher the oxygen consumption, the greater the recovery capacity and the lower the probability of the athlete reaching fatigue (Oliveira, & Navarro, 2007). Since inspiratory muscle training (IMT) has been deemed beneficial only for performance in activities in which aerobic metabolism dominates (Pinto Neto, Viana, & Barreira, 2018). Consequently, special attention must be paid to the factors that determine and ensure the steady increase in the specific performance capacity of the basketball player to play at an ever greater physical and technical level of exigency. (Moreira et al., 2003)

 

    According to Kühn (2010) the muscles of respiration are prone to fatigue and are also equipped with the ability to adapt to adverse conditions, including physical exercise, which may lead to shortening the structure of accessory inspiratory muscles. Fatigue of inspiratory muscles, in addition to decreasing ventilation, increases sympathetic activity and decreases peripheral blood flow (Faria, 2014). According to McConnell, & Lomax (2006), Romer et al. (2006) when inspiratory muscle work is elevated during high-intensity exercise, there is an exacerbation of fatigue in the lower limbs. The stimulus for limb vasoconstriction is a cardiovascular reflex from within the inspiratory muscles (Croix et al., 2000; Sheel et al., 2002). These findings originate the hypothesis of an "inspiratory metaborreflex" activated during exercise, redistributing the blood flow from the active peripheral muscles to the diaphragm, corresponding to more than 14-16% of the cardiac output. (Faria, 2014)

 

    Exercise increases the metabolism of the muscles being worked on and stresses the respiratory system by increasing the demand for oxygen and the production of carbon dioxide. The ability to perform physical exercise increases with training. In exercise of higher intensity, the volume of carbon dioxide eliminated per unit of time is sustained by the effect of the decreased alveolar dead space and increased tidal volume (Patel, & Zwibe, 2020). However, most of the changes that occur because of training are due to changes in the cardiovascular system and muscle metabolism, not the respiratory system. The strength and endurance of the respiratory muscles seem to increase with training (Levitzky, 2004). Large pulmonary volumes of athletes generally reflect the genetic influences and characteristics of body size, since exercise training does not significantly modify static lung volumes. Training with specific exercises of the ventilatory muscles improves its strength and endurance and increases both inspiratory muscle function and maximum voluntary ventilation (MVV). (McArdle, Katch, & Katch, 2016)

 

    However, there are few studies analyzing the effects of respiratory muscle training on the pulmonary function of athletes, especially in non-aquatic sports. To this, the general objective of the study is to analyze the effects of respiratory muscle training on pulmonary function in basketball players from Blumenau-SC. Correspondingly, the specific objectives are to find out the effect of respiratory muscle training on Expiratory Flow Peak (EFP), and to check the effect of respiratory muscle training on forced expiratory volume in the first second (FEV1).

 

Methods 

 

    The research began only after the approval of the Research Ethics Committee of the Universidade Regional de Blumenau (nr. 1,552,352 of 2016) and, after reading and signing the TCLE (Termo de Conduta e Livre Consentimento - Free and Informed Consent Term) by the participants.

 

Participants 

 

    Intervention study with a sample composed of 10 male players were aged between 19 and 26 years, with a mean age of 23 years from the basketball team of the Associação de Pais e Amigos do Basquetebol (APAB) who make up the men's team of the city of Blumenau (Santa Catarina – Brazil) and who represent the city in competitions at the state and national level.

 

Procedures 

 

    The data collection period occurred between August and November 2016 at the club Sociedade Recreativa e Esportiva Ipiranga Gymnasium. Excluded from the study would have some present respiratory infections such as influenza, cold, bronchitis and pneumonia in the last 3 weeks; uses bronco dilators of short action (4 hours before) or prolonged (12 hours before); drink coffee or tea (6 hours before); smoking (2 hours before); drinking alcohol (4 hours before); and individuals who do not agree to participate in the study and/or sign the Free Consent Form.

 

    To carry out the present study, the individuals participated in a personal interview in which they were asked to fill in a questionnaire with basic information about the athlete. Subsequently, this information was used to perform the spirometry test, which measured their lung capacity.

 

    The instrument used to measure lung function, before and after the intervention protocol, was a Clement Clarke brand One Flow portable digital spirometer. After general instructions, the assessor was instructed to sit with both feet on the floor and with his back supported. Holding the device with both hands, after the beep/verbal warning, the patient made a maximum inspiration and in the sequence a blow with full force in the mouth, without hesitation and if possible. The manoeuvre was performed three times.

 

    Respiratory musculature training was performed two times a week for eight weeks, totaling 16 sessions. The sessions consisted of five sets of 20 breaths with maximum abdominal contraction, in inspiration and expiration, with a rest interval of 30 seconds. Approximately twelve minutes of intervention: 100 breaths per session; 200-400 breaths per week; 1600 breaths in 8 weeks. The position used to perform the exercises was in dorsal decubitus, lying with the back on the floor, with the hip and knee flexed.

 

Statistical analysis 

 

    Statistical analysis was performed using the Statistical Package for the Social Sciences, version 22.0. To compare the difference between the group before and after the intervention the Wilcoxon test was used. A significance level of p<0.05 was accepted.

 

Results 

 

    In the sample obtained (n=10), the age of the youngest was 19 years, the median was 22.5 years and the age of the oldest was 26 years. The mean was 22.2 years with standard deviation (SD) of 2.52. In stature, the lowest athlete had 179 cm, the median closed at 195 cm, and the highest athlete had 206 cm. The mean was 192.5 cm with a SD of 9.36. About the weight, the lightest of them weighed 74 kg, the median was 91.5 kg and the heaviest of the group weighed 117 kg. The mean weight was 92.8 kg with a standard deviation of 15.73. The group has an ethnic predominance of white individuals, being 50% of the total athletes, 10% of black ethnic group and the remaining 40% of brown ethnic group.

 

    The minimum basketball training time for the group was 5 years, the median was 10 years, and the maximum training time was 14 years. The average number of years of training was 9.5 years with a SD of 3.06. 40% of the group reported having performed swimming during childhood. Among these, the minimum practice time lasted 2 years, the median was 7 years, and the maximum time was also 7 years. The average practice time closed at 5.3 years with percent deviation (PD) of 2.88.Of the ten athletes, two of them had respiratory diseases, one of them bronchitis and the other one rhinitis. None of the athletes used medication and none of them used bronchial dilators. Only one of the athletes reported having smoked, and the smoking time was 14 months.

 

    The table below shows the Expiratory Flow Peak (EFP), forced expiratory volume in the first second (FEV1); and Forced Vital Capacity (FVC) variables before and after the respiratory muscle training intervention. It also presents the minimum and maximum values ​​obtained, as well as the median, mean and standard deviation. Finally, it presents the p-value, which identifies the level of statistical significance.

 

	EFP before	EFP after	VEF1 before	VEF1 after	VFC before	VFC after
Minimum	380.00	545.00	4.15	4.35	5.65	4,40
Median	587.50	665.00	5.07	5.47	6.30	6,17
Maximum	920.00	965.00	6.55	6.90	7.75	7,85
Average	585.00	669.00	5.32	5.43	6.63	6,15
PD	158.53	120.52	0.75	0.81	0.79	1,16
p	0.019*		0.507		0.066

Legend: EFP: Expiratory Flow Peak; FEV1: Forced Expiratory Volume in the first second; FVC: Forced Vital Capacity; PD: Percentage Deviation. *Significant statistical difference. Source: The authors

 

    As shown in Table 1, only the Expiratory Flow Peak obtained a significant increase. Before the intervention by respiratory muscle training, the lowest value was 380.00 L/min, and after the intervention the lowest value was 545.00 L/min. The mean EFP was 587.50 L/min before and 665.00 L/min after. The highest value recorded before training was 920.00 L/min and then the highest recorded value was 965.00 L/min. The before and after average was 585.00 L/min and 669.00 L/min, respectively. The p-value found was 0.019.

 

Discussion 

 

    The objective of this study, which is to analyze the effects of respiratory muscle training on pulmonary function in basketball players. We will bring here some other important studies related to the topic to better make this discussion. Amateur soccer players initially separated into two groups had an 8% difference in the EFP variable between them. After two weeks of training of the inspiratory muscles in one of the groups using a threshold, the difference in the EFP variable increased to 13%, demonstrating statistically significant variations (Cardoso, & Lumini, 2011). Swimming athletes presented a slight improvement in some respiratory patterns, specifically EFP, after the application of Buteyko's respiratory technique. Although it was created with the objective of controlling the symptoms of asthma (Nóbrega, & Oliveira, 2013). In a sample composed of 20 competition swimmers of both sexes, significant differences were found between the spirometric variables pre and posttest. Through the analysis of the results, it was possible to verify that the training of the inspiratory muscles at 50% of the maximum pressure estimated for 4 weeks increased the pulmonary capacity (FEV 1, FVC and EFP) (Faria, 2014) in athletes submitted to the training regime mentioned above.

 

    To evaluate the effect of inspiratory muscle training, 12 elite swimmers were recruited, who underwent IMT for 12 weeks. At the end of the tests the athletes obtained significant differences in the FEV1 variable, in addition to a lower number of breaths during the performance test in the 50 meters test (Faria, 2014). In previous studies, inspiratory muscle training induced an increase in FEV1 and FVC (Lemaitre et al., 2013; Wells et al., 2005, as cited in Lima, Viana, & Barreira, 2018). The improvements that occurred in FEV1 occurred most probably due to changes in the respiratory mechanism, evidenced by an increase in FVC (Wells et al., 2005). The resistance of the airways decreases in high pulmonary volumes. Therefore, with an increase in FVC, and consequently an evolution of FEV1 in high pulmonary volumes, an increase in FEV1 would be expected due to the reduction of airway resistance. (West, & Luks, 2012)

 

    In the present study, the median FEV1 was 5.07 liters before and 5.47 liters after the intervention with respiratory muscle exercises. There was no significant increase between before and after the intervention (p=0.507), which we concluded that there were no statistically significant changes in the monitoring of the intervention with respiratory muscle exercises among the investigated athletes.

 

    The training of the inspiratory muscles in swimmers, for 8 weeks, provoked an increase in FVC, strength and resistance of respiratory muscles (Lemaitre et al., 2013). A group of 20 sedentary individuals and a group of 20 athletes underwent respiratory muscle training for 8 weeks did not obtain significant changes in the spirometric variables FVC and FEV1 (Valle et al.,1997). In 32 weeks of training of the respiratory muscles, in 20 recruited soldiers, through a manovacuometer, no significant alterations were found before and after training in the spirometric variables FVC and FEV1. (Valle et al., 2002)

 

    In this study, the median FVC was 6.30 liters before and 6.17 liters after the intervention with respiratory muscle exercises. There was no significant increase between before and after the intervention (p=0.066), which we concluded that there were no statistically significant changes in the monitoring of intervention with respiratory muscle exercises among the investigated athletes.

 

Conclusions 

 

    Based on the results obtained, it can be concluded that sixteen sessions in eight weeks of respiratory muscle training in basketball athletes presented a significant increase in the pulmonary function evaluated by the Expiratory Flow Peak. Because EFP is related to expiratory force, training has proven to be very effective on expiratory muscles. However, it had no effect on the variables of forced expiratory volume in the first second and of forced vital capacity.

 

    Since athletes practiced yoga a month earlier, and throughout the intervention for respiratory muscle training, we believe that this factor may have been contributing to the positive results in spirometry tests, since yoga works a lot with breathing as well. Although yoga practice remains below the lactic threshold physical performance may improve due to increased ventilatory efficiency and increased cardiovascular reserve. (Benavides-Pinzón, & Torres, 2017)

 

    As limitations, we did not have to analyze alterations of the inspiratory musculature, since the inspiratory metaborreflex seems to influence mainly this musculature. However, empirically we believe that the musculature responsible for the inspiration also obtained an improvement in the capacity of strength and resistance, thus reducing the blood flow directed to the muscles of the breath, because during the maneuver of inspiration the diaphragm was overloaded by the force of the abdominal muscles in maximum contraction.

 

    Nevertheless, studies with longer duration and/or with more sessions are suggested, or the sample size may be increased, to evaluate possible additional effects.

 

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Lecturas: Educación Física y Deportes, Vol. 27, Núm. 287, Abr. (2022)