
Improving Lung Function Through Strength Training
The diaphragm is an essential skeletal muscle that is chronically active and is among the most aerobically adapted muscles (Ottenheijm et al., 2008). During inspiration, the diaphragm and external intercostal muscles contract, causing the rib cage to expand, moving the thoracic cavity outward and increasing lung volume. During exhalation, the diaphragm and intercostals relax, causing the thorax and lungs to recoil.
Patients with COPD have greater diaphragmatic recruitment than healthy subjects during resting breathing. One theory is due to hyperinflation-induced diaphragm shortening. Along with increased fiber recruitment, there is a reduced cross-sectional area of Type I and II fibers.
It has been reported that the diaphragm of patients with COPD has a higher proportion of fatigue-resistant Type I fibers, a lower proportion of fatigue-resistant Type IIa fibers, and very few fatigue-sensitive Type IIx fibers (Kim et al., 2008). Furthermore, Orozco-Levi and colleagues (2001) reported that FEV1 was inversely correlated with sarcomere disruption density (2–45 abnormal areas/100 m2) and area fraction (1.3–17.3%).
What does this mean?
Adaptive changes in respiratory neuromuscular facilitation in chronic lung diseases change the contractile force production, leading to increased abdominal muscle strength and decreased diaphragmatic strength (Pinet et al., 2003).
How to improve diaphragm efficiency?
Increased muscle tensile strength can improve mechanical muscle function and heighten motor unit recruitment, frequency, and excitability (Gransee et al., 2012). The respiratory muscles have similar characteristics to peripheral muscles,
Resistance training improves Type I and Type II skeletal tissue. This is why inspiratory muscle training is commonly used to improve diaphragmatic strength and endurance. However, it is essential to understand that inspiratory muscle training is not the ONLY resistance training approach to improve respiration.
Multi-joint strength training increases adaptive changes in skeletal muscle that can improve posture and bone density, leading to improvements in stresses applied to the body during everyday movements.
These adaptive changes increase movement efficiency leading to decreases in resting heart rate and reducing the work needed by the diaphragm to get oxygen to the muscles. When the body is strong, the capacity to move is high, leading to respiratory demand.
Remember, the diaphragm has similar skeletal tissue characteristics to peripheral muscles (arms & legs). Therefore, improving overall strength will help improve the role of the diaphragm within respiration and help enhance lung function.
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