Computer Spirometry: Research of Respiratory System Functionality

and Its Enhancement in Young Swimmers

Anna Zakharova

, Alexey Gorelov

and Tatiana Miasnikova

Institute of Physical Education, Sport and Youth Policy, Ural Federal University named after the first President of Russia

B.N. Yeltsin, Mira Street, Ekaterinburg, Russia

Keywords: Respiratory System, Spirometry, Vital Capacity, Forced Vital Capacity, Swimmers, Respiratory Muscle

Training.

Abstract: The control of the swimmers' fitness should include an assessment the respiratory system. The aim of the

study to evaluate the age features of respiratory system in young swimmers and suggest the methods for

respiratory system improvement. Methods: young athletes underwent two tests with MicroLab spirometry;

relaxed and forced vital capacity measurement. Findings: (i) young swimmers 10-11 years old with at least 5

years of experience in swimming showed low spirometry indicators (85% of predicted value); (ii) the more

experienced and successful swimmers the better their respiratory system developed. High-performance sport

swimmers have high level (120 % of predicted value) of all spirometry indicators; (iii) breathing exercises

selected for solving the respiratory problems in swimmers improve the respiratory muscles functionality.

1 INTRODUCTION

Respiratory system is one of the essential factor

providing general endurance in sport (Sheel, 2010).

Competitive swimming is challenging to human

pulmonary system as (i) whole body muscles are

required for propulsion through water thus O

intake

should be high; (ii) swimmer’s face is submerged in

water; (iii) breathing is constrained by swimming

technique, that is stroke cycles, etc. Moreover, in

normal (dry land) breathing, only inhalation is active,

and exhalation occurs passively, due to the relaxation

of the muscles that provide inhalation. In water,

exhalation should be forced, with the participation of

the muscles that produce exhalation.

Breathing in swimmers was under consideration

in a number of articles (Vašíčková, 2017, Bovard,

2018, Rosser-Stanford, 2019). It was reported that

functional readiness of athletes-swimmers was

largely determined by functional mobilization of

physiological systems, namely of respiratory and

circulatory systems’ functionality.

Respiratory muscles dysfunction manifests itself

in a decrease in their functional properties - strength

https://orcid.org/0000-0002-8170-2316

https://orcid.org/0000-0002-9550-1793

https://orcid.org/0000-0002-0894-1337

(the ability to develop maximum effort) and/or

endurance (the ability to continuously maintain

submaximal efforts). is expressed in the development

of their fatigue or weakness (Segizbaeva, 2019). An

important result of numerous studies in recent years

is the physiological substantiation of the possibility of

training the respiratory muscles in order to increase

their strength and endurance, as well as increase the

overall physical performance of healthy subjects

(Segizbaeva, 2019) and athletes (Vašíčková, 2017).

The purpose of the study was twofold – to

evaluate the age features of respiratory system in

young swimmers and suggest the methods for

respiratory system improvement in young swimmers.

2 METHODS

The study was conducted in the laboratory

“Functional Testing and Complex Control in Sports”

of the Institute of Physical Education, Sports and

Youth Policy, Ural Federal University

(Yekaterinburg, Russia).

228

Zakharova, A., Gorelov, A. and Miasnikova, T.

Computer Spirometry: Research of Respiratory System Functionality and Its Enhancement in Young Swimmers.

DOI: 10.5220/0010147302280233

In Proceedings of the 8th International Conference on Sport Sciences Research and Technology Support (icSPORTS 2020), pages 228-233

ISBN: 978-989-758-481-7

The investigation conforms to the principles of the

Declaration of Helsinki of the World Medical

Association. Subjects involved in the study and their

parents had been provided with comprehensive

information on the procedures, methods, benefits and

possible risks before their written consent was

obtained. The study protocol was approved by the

Ural Federal University Ethics Committee (#05-

2020).

To evaluate respiratory system correctly it is

obligatory to determine the anthropometric

measurements as the lungs volume and their

functionality depend upon the patient physical

development (that is height and weight).

2.1 Anthropometry

The height was measured with height meter in

vertical position without shoes. Weighting was done

with Mi Body Composition Scale (Xiaomi, China).

2.2 MICROLAB™ Spirometry

The portable spirometer MicroLab (Care Fusion,

USA) was used to measure respiratory volumes and

functions. The device is an essential spirometer in

today's healthcare professional. Vyaire's Gold

Standard Turbine measurement technology is

certified by the American Thoracic Society (ATS),

the internationally recognized body for spirometry

performance. MicroLab spirometer is provided with

Spirometry PC Software program to calculate the

expiratory and inspiratory indices, taking into account

age, gender, weight and height. There is a built-in

strip printer which prints out the individual report

after spirometry testing.

A nose-clip was used for accuracy of measured

spirometry data (Figure 1) and the disposable

mouthpieces Ø28 mm were used for the patients’

safety.

Figure 1: Spirometry test procedure.

Before running the spirometry tests it was

necessary to enter a patient’s details (identity, sex,

date of birth, height, weight).

Two tests were conducted: relaxed vital capacity

measurement prior to performing a forced vital

capacity manoeuvre.

2.2.1 Relaxed Vital Capacity Measurement

For relaxed vital capacity (VC) testing the patient was

instructed to breathe in until their lungs are

completely full, to seal the lips around the mouthpiece

and to blow out at a comfortable rate until he (she)

cannot push out any more air.

Three attempts were allowed.

2.2.2 Forced Vital Capacity Measurement

A Forced vital capacity test was conducted three

minutes later after completion of a Relaxed VC test.

The patient was instructed to breathe in as in the

previous test ̶ until the lungs were completely full,

seal their lips around the mouthpiece and blow out as

hard and as fast as possible until he (she) cannot push

any more air out, then breathe in immediately after

the expiratory manoeuvre and repeat this cycle

(inspiration-expiration) three times without stop.

As the patient details had been entered before the

first test the spirometry screen displayed the predicted

Flow/Volume curve as a dashed line. During the test

the patient is looking after his Flow/Volume curve

and predicted one (dashed line) and try to enhance the

breathing performance to achieve the breathing

pattern (Figure 2).

Figure 2: The Flow/Volume loop.

2.2.3 Spirometry Test Results

After the completion of both tests Spirometry PC

Software fulfills manoeuvre quality check to allow a

decision to be made to accept or reject these blows.

There are four quality checks performed on each

Computer Spirometry: Research of Respiratory System Functionality and Its Enhancement in Young Swimmers

229

spirometry manoeuvre to determine its acceptability.

If the patient performs an acceptable manoeuvre

‘Good blow’ is displayed at the top of the screen.

Automatically or manually the ‘best’ blows for the

report are selected (MicroLab Operating Manual,

2004).

The MicroLab Spirometer report includes (i)

respiratory performance and (ii) a graphic depiction

of the breathing loop and (iii) the contours of the

proper breathing loop based on the patient's height,

weight and age.

Following indicators were under consideration:

vital capacity (VC, l), forced vital capacity (FVC, l)

and forced expiratory volume in the first second

(FEV1) as well as the percentage of the predicted

values along with the Flow/Volume loop.

The testing procedures were explained to each

participant and informed consent was obtained in

accordance with the Declaration of Helsinki of the

World Medical Association.

2.3 Statistics

Statistical analysis was performed with the use of

statistic software package “SPSS Statistics 17.0”

(IBM). The descriptive analysis of the obtained data

was applied. Normality of distribution was assessed

by the Shapiro-Wilk test. Mean value (M) and

standard deviation (SD) of the measured parameters

were calculated. The level of significance was set at

P < 0.05.

2.4 Subjects

In October 2019 in the sport scientific laboratory of

the Ural Federal University stage control including

spirometry was carried out for the group of swimmers

(6 boys and 5 girls) 10-11 years old (height 148.9 ±

9.12 cm, weight 38.8 ± 7.87 kg). These athletes have

been engaged in sports swimming for at least 5 years

and had I youth and III sport category in swimming

In Russia there is a system of sport categories

according to competition results: to achieve I youth

category and III sport category in swimming one must

cover the distance of 200 m for boys 3:08.0 and 2:42.5

and for girls 3:29.0 and 2:58.0 in crawl swimming

respectively.

To reveal the level of respiratory system

development in other athletes spirometry tests were

carried out with a group of 12 young professional

hockey players of 9 years old (height 135.75 ± 4.69

cm, weight 34.3 ± 2.22 kg) and 10 amateur hockey

players 10–11 years old (height 143.33 ± 4.46 cm,

weight 35.7 ± 5.92kg), engaged in the outdoors

training all year round.

For comparison “young athletes vs a group of

classmates” 28 pupils of one form (18 boys and 10

girls) aged 9-10 years (height 138.9 ± 7cm, weight 32

± 6.32kg) were studied with spirometry (Zakharova,

2020).

3 RESULTS

Analysing the spirometry indicators of the respiratory

system in a group of swimmers aged 10-11 (Table 1),

we found that only 2 swimmers or 18% of the studied

subjects showed a normal VC with a proper

individual indicator above 100%, 2 swimmers (18%)

were within the norm of 95-100%, 27% (3 swimmers)

had the result below normal (80–95% of VC) and

36% or 4 swimmers had extremely low VC.

Table 1: Pulmonary system function indicators of

swimmers’ group 10-11 years old (М±m (min-max)).

Indicator

Vital

capacity

Forced

Vital

Capacity

FEV1

Absolute

measure, l

2.50±0.58

(1.51-2.9)

2.41±0.58

(1.37-3.3)

2.03±0.40

(1.36-2.7)

Percentage

of proper

value, %

86.2±15.3

(60-111)

85.2±16.7

(55-108)

85.6±12.9

(65-109)

One swimmer coped with the FVC test as he had

only excellent indicators (above 100%) of the FVC

test (VC, FVC and FEV1) and 27% (3 swimmers)

were within normal FVC.

7 swimmers showed an FVC indicator below

normal: 4 swimmers demonstrated 80-95% of

predicted FVC and 3 swimmers had poor FVC, that

is, below 80% of predicted FVC).

Taking into account that, first, predicted by

Spirometry PC Software values of respiratory system

intend for healthy children but not for athletes

specially and, second, larger lungs are necessary for

competitive swimming, we conclude that young

swimmers with more than 5 years of sport swimming

experience showed poor results in spirometry tests.

So we came to the idea to check the spirometry in

other young athletes and non-athletes of the same age.

Ice hockey players (n=12) training in modern

indoor ice palaces demonstrated satisfactory

spirometry data (table 2).

icSPORTS 2020 - 8th International Conference on Sport Sciences Research and Technology Support

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Table 2: Spirometry indicators of different groups of children 9-11 years old (М±m (min-max)).

Indicators

Ice hockey

Outdoor amateur

ice hockey

Swimming Pupils of one class

9 years old 10-11 years old 10-11 years old 9-10 years old

VC, l

2.35±0.3

(1.88-2.51)

2.53±0.15

(2.36-2.75)

2.50±0.58

(1.51-2.92)

2.11±0.36

(1.45-3.12)

FVC, l

2.32±0.26

(1.98-2.55)

2.57±0.24

(2.28-2.95)

2.41±0.58

(1.37-3.33)

2.10±0.36

(1.38-3.16)

FEV1, l

2.13±0.19

(1.93-2.40)

2.24±0.28

(1.82-2.59)

2.03±0.40

(1.36-2.77)

1.87±0.26

(1.35-2.56)

Percentage of predicted value

VC, %

97.3±16.8

(72-106)

98±4.65

(93-105)

86.2±15.3

(60-111)

89.7±11.2

(64-112)

FVC, %

98.5±17.1

(78-110)

101.8±6.27

(94-112)

85.2±16.7

(55-108)

89.9±10.4

(74-110)

FEV1, %

108±17.06

(91-128)

105.5±6.69

(99-117)

85.6±12.9

(65-109)

97.3±7.9

(85-114)

VC- vital capacity, FVC- forced vital capacity and FEV1 - forced expiratory volume in the first second

Amateur hockey players (n=10), training outdoors

all year round had even better results in relative

values than young professional hockey players.

Group of 11 athletes-swimmers and ordinary

pupils from one class both have the spirometry data

statistically not distinguished.

So all average spirometry indicators (VC, FVC

and FEV1) in swimmers (Table 2) were lower than

necessary for healthy children. We found that

swimmers 10-11 years old with at least 5 years of

experience have an insufficiently developed

respiratory system, that is, they cannot breathe

correctly and use the respiratory muscles effectively.

These spirometry results were unexpected both

for us and for the coach. What is the reason of such a

backlog in the respiratory muscles functionality?

In conversation with the swimming coach it was

revealed that the motor tasks for breathing were used

in training of studied swimmers: under water

swimming without breath, swimming with one intake

of breath for three- four strokes, etc. These exercises

adapt the swimmers for swimming in lack of

breathing but do not improve the breathing pattern.

So we can’t consider these exercises as respiratory

muscle training. Moreover, speed swimming with

high frequency of strokes suppress the normal

breathing.

It was reported that swimming training did not

enlarge the lungs in children (Bovard, 2018). To

reveal the level of the respiratory system development

in swimmers of different sport categories we carried

out the spirometry research with young swimmers

(n=10) aged 11-12 years old (height 149.2±8.78 cm,

weight 37.9±7.59kg), more experienced swimmers

(n=5) 15-18 years old (height 184.4±4.4 cm, weight

77± 4.2 kg) and high performance sport swimmers

(n=4) 20-23 years old (height 187.5±3.5cm, weight

84.5±2.1kg) and used the earlier obtained data of

studied swimmers aged 10-11 (Table 3).

The spirometry results of swimmers (Table 3)

prove that the more experienced and successful

swimmers the better their respiratory system

developed. High-performance sport swimmers have

high level (120 % predicted value) of all spirometry

indicators.

It is not clear: the large lungs of swimmers is the

result of intensive training or swimmers with low

respiratory functions give up competitive sport. But

our next task was to help the young swimmers with

low respiratory functions to improve them.

From the above mentioned spirometry results and

swimmers’ Flow/Volume loops with insufficient

strength of expiration muscles and short breathing

cycle (Figure 3) we stated following respiratory

problems in swimmers:

 Low vital capacity;

 Low FEV1 id est power of expiratory muscles;

 Insufficient (short) expiration;

 Weak inhale.

FEV1 is associated with the power of expiratory

muscles as the power is defined as the ability to

produce large force in a limited period of time with

high rates of force development. So the value of

Forced Expired Volume in the first second may be

high only in case of good strength and what is more

important of good ability to produce high expiration

in short time.

Computer Spirometry: Research of Respiratory System Functionality and Its Enhancement in Young Swimmers

231

Table 3: Spirometry indicators of swimmers of different sport qualification (М±m (min-max)).

Spirometry

indicators

Age

10-11 years old 11-12 years old 15-18 years old 20-23 years old

VC, l

2.50±0.50

(1.51-3.28)

2.74±0.47

(2.09-3.28)

5.99 ± 1.7

(4.18-7.59)

7.42±0.1

(7.35-7.49)

FVC, l

2.41±0.58

(1.37-3.337)

2.72±0.51

2.07-3.33

5.63±1.5

(3.96-6.82)

7.12±0.06

(7.07-7.16)

FEV1, l

2.03±0.40

(1.36-2.77)

2.51±0.46

(1.84-3.32)

4.85±1.1

(3.75-5.96)

5.62±0.19

(5.48-5.75)

Percentage of predicted value

VC, %

86.2±15.3

(60-111)

96.1±13.16

(70-115)

117.3±9.7

(109-135)

120±4.24

(117-123)

FVC, %

85.2±16.7

(55-108)

97.7±12.18

(80-120)

117.3±9.7

(109-128)

120±4.24

(117-123)

FEV1, %

85.6±12.9

(65-109)

107.2±9.70

(93-120)

114±5.6

109-120

120.5±7.78

(115-126)

Figure 3: The Flow/Volume loop of the swimmer#1.

Short expiration may have place in two cases: low

strength or endurance of expiratory muscles.

For each respiratory problem the exercises were

selected:

1) to increase VC, it is necessary to ensure

correct posture, chest mobility with stretching and

bending, and elasticity of the muscles responsible for

the function of breathing, especially the diaphragm;

2) for the development of the expiratory

muscles power - blowing out the candles, blowing off

the ball rolled from A4 paper sheet and explosive

exhalations through a swimming tube dipped in

water.

or the development of the duration of

exhalation;

3) for longer expiration ̶ blowing off a paper ball

folded from a napkin; play "tennis" blowing a paper

ball in pairs, blowing out 5–10 candles placed in a

row at a distance of 5–10 cm from each other, etc;

4) for developing the strength of inspiration –

swimming with a tube with a clamp restricting the

flow of air.

We considered these exercises would help young

swimmers to learn how to breathe correctly.

The experiment for respiratory system

improvement via exercises was organized. Initial

spirometry testing were held in October 2019 with the

group of swimmers 10-11 years old. The coaching

part of the experiment included:

• Conversation with the trainer based on the test

results;

• Conducting theoretical and practical classes on

respiratory system exercises with the swimmers;

• Informing parents about the importance of

breathing exercises for encouraging the swimmers to

fulfil the exercises at home;

• Performing breathing exercises during the

period from December 1, 2019 to February 16, 2020,

at home (daily) and in training (5 times a week).

Due to the outbreak of acute respiratory none in

January-February 2020 only 4 swimmers were able to

take part in post-experiment spirometry. Comparing

the results of spirometry indicators before and after

experiment in four swimmers, we found

improvements in the functioning of the respiratory

system for each indicator (Table 4). In swimmer # 1

after the experiment we found an increase in the FVC,

FEV1 and his Flow/Volume loop was normalized

(Figure 4) in comparison with his primary spirometry

(Figure 3).

Figure 4: Post- experiment Flow/Volume loops of swimmer

#1.

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Table 4: Spirometry indicators of young swimmers before

and after experiment (М±m (min-max)).

Indicators Pre- Post-

VC, l

2.15± 0.58

(1.51-2.92)

2.59 ±0.39

(2.32-3.16)

FVC, l

2.05±0.24

(1.81-2.38)

2.46 ±0.48

(2.1-3.14)

FEV1, l

1.91±0.18

(1.64-2.05)

2.21 ±0.6

(1.7-2.93)

VC, %

80.7±15.6

(60-97)

97.2 ±4.79

(92-103)

FVC, %

81.5±18.8

(59-98)

94.2 ±5.3

(88-100)

FEV1, %

89.7±17.7

(71-109)

99.5 ±11.7

(89-114)

In swimmer #2 at the first testing the following

problems were identified: weak inhalation, weak

exhalation and its duration (Figure 5a). After the

experiment there was an improvement in the depth of

inhalation, the peak of exhalation and the duration of

exhalation as well as in FVC (Figure 5b). Thus we

can conclude that breathing exercises helped the

swimmer#2 to improve his respiratory muscles

functionality: enhance their strength and workability.

a b

Figure 5: Pre- and post- experiment Flow/Volume loops of

swimmer #2.

Although the results of the experiment reveal no

statistically significant differences (Table 4) but

qualitative information from the Flow/Volume Loops

(Figures 4 and 5) proves that experiment was

successful.

Thus breathing exercises selected according to

respiratory system problems revealed with the help of

MicroLab spirometry are effective for young

swimmers.

4 CONCLUSIONS

1. Competitive swimming does not develop

respiratory system in young swimmers.

2. The level of respiratory functionality of

swimmers must be under supervision with the help of

computer spirometry.

3. Swimmers’ breathing requires special training

including exercises for lungs enlargement,

development of power and endurance of expiratory

muscles as well as strength of inspiratory muscles.

ACKNOWLEDGEMENTS

The work was supported by Act 211 Government of

the Russian Federation, contract № 02.A03.21.0006.

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