Abstract
Purpose
To compare deoxygenation of the sternocleidomastoid, scalenes, and diaphragm/intercostals (Dia/IC) during submaximal intermittent neck flexion (INF) versus submaximal inspiratory threshold loading (ITL) in healthy adults.
Methods
Fourteen participants performed a randomized, cross-over, repeated measures design. After evaluation of maximal inspiratory pressures (MIP) and maximum voluntary contraction (MVC) for isometric neck flexion, participants were randomly assigned to submaximal ITL or INF until task failure. At least 2 days later, they performed the submaximal exercises in the opposite order. ITL or INF targeted 50 ± 5% of the MIP or MVC, respectively, until task failure. Near-infrared spectroscopy (NIRS) was applied to evaluate changes of deoxy-hemoglobin (ΔHHb), oxy-hemoglobin (ΔO2Hb), total hemoglobin (ΔtHb), and tissue saturation of oxygen (StO2) of the sternocleidomastoid, scalenes, and Dia/IC. Breathlessness and perceived exertion were evaluated using Borg scales.
Results
Initially during INF, sternocleidomastoid HHb slope was greatest compared to the scalenes and Dia/IC. At isotime (6.5–7 min), ΔtHb (a marker of blood volume) and ΔO2Hb of the sternocleidomastoid were higher during INF than ITL. Sternocleidomastoid HHb, O2Hb, and tHb during INF also increased at quartile and task failure timepoints. In contrast, scalene ΔO2Hb was higher during ITL than INF at isotime. Further, Dia/IC O2Hb and tHb increased during ITL at the third quartile and at task failure. Borg scores were lower at task failure during INF compared to ITL.
Conclusion
Intermittent INF induces significant metabolic activity of the sternocleidomastoid and a lower perception of effort, which may provide an alternative inspiratory muscle training approach for mechanically ventilated patients.
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Data availability
Data available on request due to privacy/ethical restrictions.
Abbreviations
- Dia/IC:
-
Diaphragm/intercostals
- INF:
-
Intermittent neck flexion
- ITL:
-
Inspiratory threshold loading
- HHb:
-
Deoxyhemoglobin
- ICU:
-
Intensive care unit
- MIP:
-
Maximal inspiratory pressure
- MV:
-
Mechanical ventilation
- MVC:
-
Maximal voluntary contraction
- NIRS:
-
Near-infrared spectroscopy
- O2Hb:
-
Oxyhemoglobin
- SCM:
-
Sternocleidomastoid
- StO2 :
-
Tissue saturation of oxygen:
- tHb:
-
Total hemoglobin
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Funding
MM and DR were funded in part by Sandra Faire and Ivan Fecan Professorship in Rehabilitation Medicine. MM was also funded by a grant from the Ontario Respiratory Care Society and an Ontario Graduate Scholarship.
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WDR and ECG developed the concept and designed the study; all authors participated in study design; the analysis was performed by MM, DR, and WDR. All authors were involved in data interpretation; MM, DR, and WDR drafted the manuscript; all authors read, revised, and approved the final manuscript.
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Miles, M., Davenport, P., Mathur, S. et al. Intermittent neck flexion induces greater sternocleidomastoid deoxygenation than inspiratory threshold loading. Eur J Appl Physiol 124, 1151–1161 (2024). https://doi.org/10.1007/s00421-023-05338-6
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DOI: https://doi.org/10.1007/s00421-023-05338-6