DOES TRAINING IMPROVE THE PULMONARY

FUNCTION AMONGST SRI LANKAN NATIONAL LEVEL

ATHLETES?

Wijayasiri K.D.C.U.1, Wimalasekera S. W.2, Thurairaja C3.

Colombo South Teaching Hospital, Kalubowila, Sri Lanka1. Department of Physiology, Faculty of Medical sciences, University of

Sri Jayewardenepura, Nugegoda, Sri Lanka2, Post Graduate Institute of Medicine, University of Colombo, Sri

Lanka3.

INTRODUCTION

The performance of an athlete mainly depends on the player’s physical fitness, mental fitness and correct technical training.

Our athletes performances at the international level are not up to the optimal standards.

Why?

INTRODUCTION cont…

Our players are always assessed by their training techniques but; do we assess them for their physical fitness?

NO

Physical fitness mainly depends on the optimal function of Respiratory system and Cardiovascular system.

Literature Review International studies

Mahotra and Shrestha, 2013- Nepal* Sen and Raveendran , 2013- India* Ghanbari et al, 2013 - Canada Kim & lee, 2012 – Korea* Illi at all, 2012- Switzerland West CR, 2012- UK Griffits et al, 2006- UK Wells et al, 2005- Canada Dereulla et al, 2005 Nourry , Deruelle, Guinhouya , et al, 2005 Mcconnel and romer, 2004- UK,USA Vincent et al, 2002- USA Ortega et al, 2001- Spain

No studies done in Sri Lanka on Pulmonary Functions amongst Athletes

Objective of the Study

To determine the Effects of Training on Pulmonary Function amongst Sri Lankan National Level Athletes in comparison to matched controls.

Methodology

A Descriptive cross sectional study

Sixty three (n= 63) National level Athletes engaged in different sports.

Endurance type athletes = 30

Resistance type athletes = 33

Control subjects(age, height, weight and gender

matched)= 63

Methodology cont….

Questionnaire : Socio-demographic data Medical examination of the athletes/

controls done. Pulmonary Function Tests were done

using Vitallograph spirometer. the player/ control was in standing

position the best volume curve of 3

consecutive blows was taken Data analyzed with SPSS-16 statistical

package.(Student t-Test and Pearson correlation)

Socio - Demographic dataMean value

Male Athletes(Mean ±SD)( n= 34)

Male controls(Mean ± SD)

Female Athletes(Mean ± SD)( n = 29)

Female controls (Mean ± SD)

p value

Age (yrs.)

22.8 ± 3.0

23.2 ± 2.0 23.2 ± 5.5

22.2 ± 2.1

p > 0.05

Height (Cm)

172.3±10.0

170.3 ± 5.6

160.0 ± 4.6

158.00±7.0

p > 0.05

Weight (Kg)

65.3 ± 13.0

65.6 ± 12.0

54.0 ± 15.3

53.22 ± 2.8

p > 0.05

BMI 22.3 ± 6.0

22.3 ± 6.0 21.0 ± 5.5 20.77 ± 2.8

p > 0.05

Socio - Demographic data

Gender ratio of the Athletes and Controls were similar.

Male : Female ratio –1.2 : 1 Mean duration of training

Male Athletes: 5 to 10 years.Female Athletes: 5 yrs

Mean Training Hours Male Athletes: 4hrs/ day Female Athletes: 4hrs/ day

Pulmonary Function Tests All Athletes – Male

Mean value

Male Athletes(n = 34)

Control group

p value

FVC (L) 3.7 ± 0.6* 3.3 ± 0.6 p < 0.05

FIVC (L) 3.6 ± 0.6* 3.1 ± 0.7 p < 0.05

FEV1 (L) 3.4 ± 0.5* 3.0 ± 0.5 p < 0.05

FEF25-75%

(L/min)

4.0 ± 0.9 4.3 ± 1.7 p > 0.05

PEFR(L/min)

533.6 ± 64.3 571.9 ± 262.2

p > 0.05

FEV1 / FVC 89.9 ± 4.8 90.1 ± 6.4 p > 0.05

Pulmonary Function Tests Male Athletes

Mean value

Control group

Endurance Athletes(n = 16)

Resistance Athletes(n = 18)

FVC (L) 3.3 ± 0.6 3.6 ± 0.6 4.1 ± 0.6*

FIVC (L) 3.1 ± 0.7 3.5± 0.5* 3.9 ± 0.6*

FEV1 (L) 3.0 ± 0.5 3.2 ± 0.5 3.6 ± 0.5

FEF25-75%

(L/min)

4.3 ± 1.7 3.8 ± 0.8 4.2 ± 0.7

PEFR(L/min)

572.0 ± 262.0

528.0 ± 54.4 551.3 ± 74.2

FEV1/FVC 90.1 ± 6.4 89.8 ± 5.1 88.6 ± 5.5

Training Duration and PFTsMale Athletes

Lung functions Pearson correlation

p value

FVC 0.14 p>0.05

FIVC 0.10 p>0.05

FEV1 0.10 p>0.05

FEF25%-75% -0.14 p>0.05

PEFR 0.88 p>0.05

FEV1/FVC -0.14 p>0.05

Pulmonary Function Tests All Athletes – Female

Mean value

Female Athletes(n = 29)

Control group

p value

FVC (L) 3.3 ± 0.3* 2.3 ± 0.4 p < 0.05

FIVC (L) 2.7 ± 0.3 2.3 ± 0.6 p > 0.05

FEV1 (L) 2.6 ± 0.5 2.1 ± 0.4 p < 0.05

FEF25-75%

(L/min)

3.4 ± 0.6 3.1 ± 1.1 p > 0.05

PEFR(L/min)

408.2 ± 99.9 439.0 ± 182.0

p > 0.05

FEV1 / FVC 90.0 ± 6.5 91.3 ± 7.0 p > 0.05

Pulmonary Function Tests Female Athletes

Mean value

Control group

Endurance Athletes(n = 14)

Resistance Athletes(n = 15)

FVC (L) 2.3 ± 0.4 2.6 ± 0.3* 2.6 ± 0.1*

FIVC (L) 2.3 ± 0.6 2.4 ± 0.3 2.5 ± 0.2

FEV1 (L) 2.1 ± 0.4 2.5 ± 0.1 2.4 ± 0.2

FEF25-75%

(L/min)

3.1 ± 1.1 3.7 ± 0.1 3.0 ± 0.5

PEFR(L/min)

439.0 ± 182.0

400.0 ± 58.0

370.0 ± 68.0

FEV1/FVC 91.1 ± 7.0 94.4 ± 6.3 88.6 ± 7.6

Training Duration and PFTsFemale Athletes

Lung functions Pearson correlation

p value

FVC 0.25 p>0.05

FIVC 0.13 p>0.05

FEV1 0.19 p>0.05

FEF25%-75% 0.75 p>0.05

PEFR 0.58 p>0.05

FEV1/FVC 0.45 p>0.05

Discussion

Only inspiratory Pulmonary Function parameters of the Male Athletes were significantly improved with training than the controls (p<0.05).

Endurance Athletes: FIVC Resistance Athletes: FVC, FIVC

Collectively : FVC, FIVC No significant improvement of PFTs

with duration of training.

Discussion cont….

Only inspiratory Pulmonary Function parameters of the Female Athletes were significantly improved with training than the controls (p<0.05).

Endurance Athletes: FVC Resistance Athletes: FVC

Collectively : FVC No significant improvement of PFTs

with duration of training

Specific inspiratory muscle training does not improve performance or VO2max levels in well trained Rowers (Riganas et al, 2008)

Inspiratory muscles alone does not limit the incremental exercise performance in healthy subjects (Rommer et al, 2007)

Literature…

Discussion cont….

PEFR, FEF25-75% , FEV1/ FVC% no significant improvement

No significant improvement of Expiratory Muscle Strength Small Airway functions in Athletes after training when compared to the Controls.

Conclusion

The results indicate the poor Respiratory Efficiency amongst Sri Lankan National level Athletes.

Recommendation The training programmes should be planned to

optimize the Respiratory Functions of the Sri Lankan national level athletes.

Respiratory Muscle Endurance Training (RMET) (Ghanbari et al, 2013/ Illi et al, 2012 ), Respiratory Muscle strength Training (RMST) (Illi et al, 2012).

Combined RMET and RMST is more superior method (Illi et al, 2012).

Core Muscles (including Deep Abdominal Muscles) training ( Kim & Lee, 2012) also has to be implemented in the training schedules of the Sri Lankan national level athletes to ensure the better Expiratory function.

Acknowledgement Sport Associations and the Players

Athletics, Badminton, Foot ball, Cricket and Rugby.

All the Academic staff and Non-Academic

staff Department of Physiology, Faculty of Medical Sciences, University of Sri Jayawardenepura, Nugegoda, Sri Lanka.

All the Doctors and other staffSports Medicine Unit, Colombo South Teaching Hospital, Kalubowila, Colombo, Sri Lanka.

Questions and Clarifications

Thank you