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J Appl Physiol (December 20, 2007). doi:10.1152/japplphysiol.01157.2007
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Submitted on October 29, 2007
Accepted on December 19, 2007

Exercise-induced respiratory muscle fatigue: implications for performance

Lee M. Romer1* and Michael I Polkey2

1 Centre for Sports Medicine and Human Performance, Brunel University, Uxbridge, Middlesex, United Kingdom
2 Respiratory Muscle Laboratory, Royal Brompton Hospital, London, United Kingdom

* To whom correspondence should be addressed. E-mail: lee.romer{at}brunel.ac.uk.

It is commonly held that the respiratory system has ample capacity relative to the demand for maximal O2 and CO2 transport in healthy humans exercising near sea level. However, this situation may not apply during heavy-intensity, sustained exercise where exercise may encroach on the capacity of the respiratory system. Nerve stimulation techniques have provided objective evidence that the diaphragm and abdominal muscles are susceptible to fatigue with heavy, sustained exercise. The fatigue appears to be due to elevated levels of respiratory muscle work combined with an increased competition for blood flow with limb locomotor muscles. When respiratory muscles are pre-fatigued using voluntary respiratory maneuvers, time-to-exhaustion during subsequent exercise is decreased. Partially unloading the respiratory muscles during heavy exercise using low-density gas mixtures or mechanical ventilation can prevent exercise-induced diaphragm fatigue and increase exercise time-to-exhaustion. Collectively, these findings suggest that respiratory muscle fatigue may be involved in limiting exercise tolerance, or that other factors including alterations in the sensation of dyspnea or mechanical load may be important. The major consequence of respiratory muscle fatigue is an increased sympathetic vasoconstrictor outflow to working skeletal muscle through a respiratory muscle metaboreflex, thereby reducing limb blood flow and increasing the severity of exercise-induced locomotor muscle fatigue. An increase in limb locomotor muscle fatigue may play a pivotal role in determining exercise tolerance through a direct effect on muscle force output and a feedback effect on effort perception causing reduced motor output to the working limb muscles.




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