Respiratory muscle fatigue was most commonly assessed indirectly using maximal static mouth-pressure manoeuvres, and respiratory muscle endurance via maximum voluntary ventilation (MVV 12). This highlights the virtue of healthy baseline parameters prior to competition and, although speculative, there may be more potent clinical manifestations in individuals with below-average baseline function, or those with pre-existing respiratory disorders (e.g., asthma). Nevertheless, an independent analysis revealed that post-race values rarely fell below the lower-limit of normal and are unlikely, therefore, to be clinically significant. All studies observed statistically significant post-race reductions in one-or-more metrics of pulmonary function, with or without evidence of airway obstruction. Pulmonary function was most commonly assessed using spirometry, with infrequent use of techniques including single-breath rebreathe and whole-body plethysmography. This paper provides an up-to-date review of the literature pertaining to acute pulmonary and respiratory muscle responses to marathon and ultra-marathon running. There have been several reviews on the physiological contraindications of participation nevertheless, the respiratory implications have received relatively little attention. The physiological demands of marathon and ultra-marathon running are substantial, affecting multiple body systems.
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