The Effect of Exercise on Respiratory Resistance in Athletes With and Without Paradoxical Vocal Fold Motion Disorder

Abstract

Purpose: An investigational, portable instrument was used to assess inspiratory (R(i)) and expiratory (R(e)) resistances during resting tidal breathing (RTB), postexercise breathing (PEB), and recovery breathing (RB) in athletes with and without paradoxical vocal fold motion disorder (PVFMD).

Method: Prospective, controlled, repeated measures within-subject and between-groups design. Twenty-four teenage female athletes, 12 with and 12 without PVFMD, breathed into the Airflow Perturbation Device for baseline measures of respiratory resistance and for two successive 1-min trials after treadmill running for up to 12 min. Exercise duration and dyspnea ratings were collected and compared across groups.

Results: Athletes with PVFMD had lower than control R(i) and R(e) values during RTB that significantly increased at PEB and decreased during RB. Control athletes' R(e) decreased significantly from RTB to PEB but not from PEB to RB, whereas R(i) did not change from RTB to PEB but decreased from PEB to RB. Athletes without PVFMD ran longer, providing lower dyspnea ratings.

Conclusion: Immediately following exercise, athletes with PVFMD experienced increased respiratory resistance that affected their exercise performance. The difference in resting respiratory resistances between groups is intriguing and could point to anatomical differences or neural adaptation in teenagers with PVFMD. The Airflow Perturbation Device appears to be a clinically feasible tool that can provide insight into PVFMD and objective data for tracking treatment progress.

Figure 1.

Mean inspiratory (circles) and expiratory (squares) resistances for 12 athletes with (black) and 12 without (gray) paradoxical vocal fold motion disorder (PVFMD) for resting tidal breathing (RTB), postexercise breathing (PEB), and after 1 min of rest (recovery breathing, RB).

Figure 2.

Modified Borg Dyspnea Scale (MBDS) Ratings (left axis, gray bars) and exercise duration (right axis, black diamonds, in min) for 12 athletes without paradoxical vocal fold motion disorder (PVFMD; control, top graph) and 12 athletes with PVFMD (bottom graph). Data sorted for decreasing exercise duration and, when tied, for increasing MBDR.