Effect of the menthol external nasal dilator on cardiorespiratory capacity and nasal function in adolescent athletes
DOI:
https://doi.org/10.62827/fb.v26i4.1083Keywords:
Exercise; Menthol; Nasal Obstruction; Inspiratory Capacity.Abstract
Introduction: The external nasal dilator (END) is an adhesive strip applied externally to the nose, intended to increase airflow by expanding the cross-sectional area of the nasal valve. Objective: To evaluate cardiorespiratory capacity and nasal function in adolescent athletes using the menthol-enhanced END (END-menthol). Methods: Fifteen adolescents were evaluated, each participating randomly in three experimental conditions: one using the END, another using a placebo END, and the third using the END-menthol. Measurements included peak nasal inspiratory flow (PNIF), maximal oxygen uptake (VO₂ max), and the rating of perceived exertion (RPE). Results: The use of the END-menthol resulted in a statistically significant improvement in VO₂ max (36.0 ± 5.5 mL/kg/min; 33.7 ± 4.0 mL/kg/min; and 36.8 ± 5.4 mL/kg/min), PNIF (200.0 ± 33.0 L/min; 181.3 ± 23.6 L/min; and 198.0 ± 36.7 L/min), and RPE (5.9 ± 1.3; 7.1 ± 1.5; and 2.9 ± 0.6), respectively. Conclusion: The END-menthol improved aerobic capacity, increased nasal patency as measured by PNIF, and reduced RPE in adolescent athletes. Future studies should incorporate larger sample sizes and include direct measurements of cardiorespiratory capacity, including among individuals with other respiratory disorders.
References
Ribeiro F, Teixeira VH. Mentol - O ergogênico refrescante. Acta Port Nutr. 2019;(54):5. Available from: https://actaportuguesadenutricao.pt/wp-content/uploads/2019/12/10_Artigo-Revisao.pd
Aldren C, Tolley NS. Further studies on nasal sensation of airflow. Rhinology. 1993 Mar;29(1):49-55. PMID: 2038654. Available from: https://pubmed.ncbi.nlm.nih.gov/2038654/
Eccles R. Menthol: effects on nasal sensation of airflow and the drive to breathe. Curr Allergy Asthma Rep. 2003 May;3(3):210–214. Available from: https://pubmed.ncbi.nlm.nih.gov/12662469/ doi:10.1007/s11882-003-0041-6. PMID: 12662469.
Jeffries O, Waldron M. The effects of menthol on exercise performance and thermal sensation: a meta-analysis. J Sci Med Sport. 2019 Jun;22(6):707-15. Available from: https://pubmed.ncbi.nlm.nih.gov/30554924/ doi: 10.1016/j.jsams.2018.12.002. PMID: 30554924.
Illidi CR, Romer LM, Johnson MA, Williams NC, Rossiter HB, Casaburi R, Tiller NB. Distinguishing science from pseudoscience in commercial respiratory interventions: an evidence-based guide for health and exercise professionals. Eur J Appl Physiol. 2023 Mar 14:1–27. Available from: https://pubmed.ncbi.nlm.nih.gov/36917254/ doi: 10.1007/s00421-023-05166-8. PMID: 36917254; PMCID: PMC10013266.
Magnus P, Jaakkola JJ. Secular trend in the occurrence of asthma among children and young adults: critical appraisal of repeated cross sectional surveys. BMJ. 1997 Jun 21;314(7097):1795-9. Available from: https://pubmed.ncbi.nlm.nih.gov/9224081/ doi: 10.1136/bmj.314.7097.1795. PMID: 9224081; PMCID: PMC2126951.
Roithmann R, Chapnik J, Zamel N, Barreto SM, Cole P. Acoustic rhinometric assessment of the nasal valve. Am J Rhinol. 1997 Sep-Oct;11(5):379-85. Available from: https://pubmed.ncbi.nlm.nih.gov/9768320/ doi: 10.2500/105065897781286016. PMID: 9768320.
Ellegård E. Mechanical nasal alar dilators. Rhinology. 2006 Dec;44(4):239-48.. Available from: https://pubmed.ncbi.nlm.nih.gov/17216739/ PMID: 17216739
Dinardi RR, de Andrade CR, Ibiapina CC. External nasal dilators: definition, background, and current uses. Int J Gen Med. 2014 Nov 11;7:491-504. Available from: https://pubmed.ncbi.nlm.nih.gov/25419156/ doi: 10.2147/IJGM.S67543. PMID: 25419156; PMCID: PMC4234285.
Dinardi RR, Ferreira CHS, Silveira GS, de Araújo Silva VE, da Cunha Ibiapina C, de Andrade CR. Does the external nasal dilator strip help in sports activity? A systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2021 May;278(5):1307-20. Available from: https://pubmed.ncbi.nlm.nih.gov/32683573/ doi: 10.1007/s00405-020-06202-5. PMID: 32683573.
Léger LA, Mercier D, Gadoury C, Lambert J. The multistage 20 metre shuttle run test for aerobic fitness. J Sports Sci. 1988 Summer;6(2):93-101. Available from: https://pubmed.ncbi.nlm.nih.gov/3184250/ doi: 10.1080/02640418808729800. PMID: 3184250.
Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81. Available from: https://pubmed.ncbi.nlm.nih.gov/7154893/ PMID: 7154893.
Dinardi RR, de Andrade CR, Ibiapina CC. Evaluation of the effectiveness of the external nasal dilator strip in adolescent athletes: a randomized trial. Int J Pediatr Otorhinolaryngol. 2013 Sep;77(9):1500-5. Available from: https://pubmed.ncbi.nlm.nih.gov/23876359/ doi: 10.1016/j.ijporl.2013.06.018. PMID: 23876359.
Dinardi RR, de Andrade CR, da Cunha Ibiapina C. Effect of the external nasal dilator on adolescent athletes with and without allergic rhinitis. Int J Pediatr Otorhinolaryngol. 2017 Jun;97:127-34. Available from: https://pubmed.ncbi.nlm.nih.gov/28483221/ doi: 10.1016/j.ijporl.2017.04.008. PMID: 28483221.
Ferreira CHS, Dinardi RR, da Cunha Ibiapina C, Ribeiro de Andrade C. Nasal function and cardio-respiratory capacity of adolescents with external nasal dilator. Int J Pediatr Otorhinolaryngol. 2020 Dec;139:110430. Available from: https://pubmed.ncbi.nlm.nih.gov/33039717/ doi: 10.1016/j.ijporl.2020.110430. PMID: 33039717.
Sadan O, Shushan S, Eldar I, Evron S, Lurie S, Boaz M, Glazerman M, Roth Y. The effects of an external nasal dilator on labor. Am J Rhinol. 2005 Mar-Apr;19(2):221-4. Available from: https://pubmed.ncbi.nlm.nih.gov/15921225/ PMID: 15921225
Yagihara F, Lorenzi-Filho G, Santos-Silva R. Nasal dilator strip is an effective placebo intervention for severe obstructive sleep apnea. J Clin Sleep Med. 2017 Feb 15;13(2):215-21. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5263077/ doi: 10.5664/jcsm.6450. PMID: 27707442; PMCID: PMC5263077.
Stevens CJ, Taylor L, Dascombe BJ. Cooling during exercise: an overlooked strategy for enhancing endurance performance in the heat. Sports Med. 2017 May;47(5):829-41. Available from: https://pubmed.ncbi.nlm.nih.gov/27670904/ doi: 10.1007/s40279-016-0625-7. PMID: 27670904.
Stevens CJ, Best R. Menthol: a fresh ergogenic aid for athletic performance. Sports Med. 2017 Jun;47(6):1035-42. Available from: https://pubmed.ncbi.nlm.nih.gov/27858306/ doi: 10.1007/s40279-016-0652-4. PMID: 27858306.
Nishino T, Tagaito Y, Sakurai Y. Nasal inhalation of l-menthol reduces respiratory discomfort associated with loaded breathing. Am J Respir Crit Care Med. 1997 Jul;156(1):309-13. Available from: https://pubmed.ncbi.nlm.nih.gov/9230767/ doi: 10.1164/ajrccm.156.1.9609059. PMID: 9230767.
Kanezaki M, Ebihara S. Effect of the cooling sensation induced by olfactory stimulation by L-menthol on dyspnoea: a pilot study. Eur Respir J. 2017 Apr 19;49(4):1601823. Available from: https://pubmed.ncbi.nlm.nih.gov/28424362/ doi: 10.1183/13993003.01823-2016. PMID: 28424362.
Eccles R, Jawad MS, Morris S. The effects of oral administration of (-)-menthol on nasal resistance to airflow and nasal sensation of airflow in subjects suffering from nasal congestion associated with the common cold. J Pharm Pharmacol. 1990 Sep;42(9):652-4. Available from: https://pubmed.ncbi.nlm.nih.gov/1981905/ doi: 10.1111/j.2042-7158.1990.tb06625.x. PMID: 1981905.
Eccles R, Morris S, Jawad MS. The effects of menthol on reaction time and nasal sensation of airflow in subjects suffering from the common cold. Clin Otolaryngol Allied Sci. 1990 Feb;15(1):39-42. Available from: https://pubmed.ncbi.nlm.nih.gov/2323078/ doi: 10.1111/j.1365-2273.1990.tb00430.x. PMID: 2323078.
Pereira EJ, Sim L, Driver H, Parker C, Fitzpatrick M. The effect of inhaled menthol on upper airway resistance in humans: a randomized controlled crossover study. Can Respir J. 2013 Jan-Feb;20(1):e1-4. Available from: https://pubmed.ncbi.nlm.nih.gov/23457678/ doi: 10.1155/2013/383019. PMID: 23457678; PMCID: PMC3628651.
Macfarlane DJ, Fong SK. Effects of an external nasal dilator on athletic performance of male adolescents. Can J Appl Physiol. 2004 Oct;29(5):579-89. Available from: https://pubmed.ncbi.nlm.nih.gov/15507694/ doi: 10.1139/h04-037. PMID: 15507694.
Ibiapina CC, Andrade CR, Camargos PAM, Alvim CG, Cruz AA. Reference values for peak nasal inspiratory flow in children and adolescents in Brazil. Rhinology. 2011 Aug;49(3):304-8. Available from: https://pubmed.ncbi.nlm.nih.gov/21858260/ doi: 10.4193/Rhino10.266. PMID: 21858260.
Bishop CA, Johnson SM, Wall MB, Janiczek RL, Shanga G, Wise RG, et al. Magnetic resonance imaging reveals the complementary effects of decongestant and Breathe Right Nasal Strips on internal nasal anatomy. Laryngoscope. 2016 Oct;126(10):2205-11. Available from: https://pubmed.ncbi.nlm.nih.gov/26865420/ doi: 10.1002/lary.25906. PMID: 26865420.
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