Boosting recovery after surgery through breathing exercises

Professor Denny Levett’s INSPIRE study is investigating whether surgical outcomes can be improved through exercises that strengthen the muscles that help us breathe.

Southampton and others’ research has shown that increasing a person’s physical fitness in the weeks before surgery can reduce their risk of complications and speed up recovery.

Stronger breathing muscles

The term ‘breathing exercises’ might bring to mind relaxation techniques, but the resistance training used in the INSPIRE study is designed to give the muscles involved in breathing a proper work out.

Patients who take part will have breathing resistance training for two to eight weeks before their surgery, taking 30 breaths through a special handheld device that restricts air flow twice a day.

Patients will be randomly assigned to three groups to compare effects; one group that has the training, a ‘sham’ group that use the device set at no resistance, and a third group that have standard care.

Professor Levett says that the resistance in the device makes it feel like “sucking through a straw”, meaning the patient needs to work slightly harder to breathe than they normally would.

Just as resistance training exercises like weight lifting or push-ups strengthen a person’s arm muscles, these exercises strengthen the muscles involved in breathing.

Known as inspiratory muscle training (IMT), these targeted breathing exercises have been shown to reduce post operative lung complications in preliminary studies.

The hope is that patients in the IMT group will have fewer complications, a quicker recovery and a shorter hospital stay after their surgery.

Restarting after lockdown

As was the case for many non-COVID studies, INSPIRE was put on hold during the first UK lockdown to enable the nation to focus its research efforts on COVID-19.

However, the study restarted in November and the team at University Hospital Southampton have already recruited their first 17 patients.