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Respiratory Muscle Pressure Development during Breath Holding in Apnea Divers


Medicine & Science in Sports & Exercise: January 2013 - Volume 45 - Issue 1 - p 93–101
doi: 10.1249/MSS.0b013e3182690e6a
Basic Sciences

Introduction We sought to characterize the patterns of active pressure development of the inspiratory and expiratory rib cage muscles (Prcm,i and Prcm,e), the diaphragm (Pdi,i), and the expiratory abdominal muscles (Pabm,e) during maximal “dry” breath holding in trained apnea divers (n = 8).

Methods Respiratory contractions were assessed via esophageal and gastric manometry. It was expected that inspiratory/expiratory pressures would progressively increase in both magnitude and frequency during the struggle phase, and that inspiratory rib cage muscle pressures would rise at a rate exceeding that of the diaphragm by the break point.

Results Prcm,i, Pdi,i, Prcm,e, and Pabm,e significantly increased from the beginning until the end of the struggle phase (P < 0.05). Moreover, Pdi,i/Prcm,i and Pabm,e/Prcm,e ratios had declined by the break point (P < 0.05), indicating that rib cage muscles increased their contribution to net inspiratory/expiratory pressure development by the end of the breath hold, relative to that contributed by the diaphragm and abdominal muscles. The pressure–time indices of the diaphragm and inspiratory rib cage muscles continuously increased over the struggle phase (P < 0.05).

Conclusions The “extradiaphragmatic” shift in inspiratory muscle recruitment, commensurate with increasing Prcm,e and Pabm,e, may reflect an extreme loading response to breathing against a heavy elastance (i.e., closed glottis). In addition, the relative intensity of diaphragmatic and inspiratory rib cage muscle contractions approaches potentially “fatiguing” levels by the break point of maximal breath holding.

1Griffith Health Institute and School of Physiotherapy and Exercise Science, Griffith University, Queensland, AUSTRALIA; 2Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN; and 3Department of Physiology, University of Split School of Medicine, CROATIA

Address for correspondence: Troy J. Cross, BExSci (Hons), School of Physiotherapy and Exercise Science, Griffith University, Gold Coast Campus, QLD 4222, Australia; E-mail:

Submitted for publication May 2012.

Accepted for publication July 2012.

©2013The American College of Sports Medicine