title: The valsalva maneuver revisited: the influence of voluntary breathing on isometric muscle strength.
abstract: We assessed the effects of 4 voluntary breathing conditions on maximal voluntary isometric force of large muscle groups. Ten subjects performed maximum voluntary isometric contractions (MVICs) of knee flexion and extension, shoulder abduction and adduction, and elbow flexion and extension under all breathing conditions: normal breathing, forced inhalation, forced exhalation, and the Valsalva maneuver (VM). Forced exhalation significantly increased peak force during shoulder adduction, elbow extension, and knee extension MVIC tasks (p = 0.001, 0.024, and 0.002, respectively); the peak force during the Valsalva maneuver was not different from forced exhalation for all tested muscle groups. No voluntary breathing condition seemed to influence the peak force during the knee flexion, elbow flexion, and shoulder abduction MVIC tasks. The results demonstrate that voluntary breathing imposes a significant impact on isometric muscle strength. Given the increased cardiovascular risks associated with the Valsalva maneuver, it is highly recommended that forced exhalation be used during exercise at maximal levels, especially in repetitive repetitions.
authors.affiliation: Motor Control Laboratory, School of Physical Therapy and Rehabilitation Science, University of Montana, Missoula, Montana, USA.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Ikeda
authors.forename: Adam
authors.initials: A
authors.lastname: Borg
authors.forename: Devn
authors.initials: D
authors.lastname: Brown
authors.forename: Jessica
authors.initials: J
authors.lastname: Malouf
authors.forename: Kathy M
authors.initials: KM
authors.lastname: Showers
authors.forename: Sheng
authors.initials: S
authors.lastname: Li
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D004551:Elbow Joint / Q000502:physiology; D005260:Female; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology*; D007719:Knee Joint / Q000502:physiology; D008297:Male; D008451:Maximal Voluntary Ventilation / Q000502:physiology*; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D011336:Probability; D016059:Range of Motion, Articular / Q000502:physiology; D012119:Respiration; D012680:Sensitivity and Specificity; D012785:Shoulder Joint / Q000502:physiology; D014636:Valsalva Maneuver / Q000502:physiology*; D055815:Young Adult