Training Mask and the Effects on Respiratory Peak Flow (PEF), SPO2, Red Blood Cell Chemistry, Pulse and Endurance performance levels over a 6 week period during weight resistance exercises and a high level cycling interval training program

Dr. Joseph A. Sheppard, D.C., A Case Report


Athletes have agreed for many years of the cardiovascular benefits of training for endurance. Recently, advancements in training have given the rise to multiple options in tents or rooms and the most effective is the mask based hypoxicator system (Training Mask). Hypoxic training which involves living and or training at a reduced oxygen level for the purpose of improved athletic performance or health benefits. The Mask reduces the partial pressure of oxygen while keeping the barometric pressure the same with the convenience of training at home or gym. Training showed improvements in EPO and red blood cells with performance gains in speed, strength, endurance and recovery.

A Complete Blood Chemistry or CBC is s test that shows the overall health of the red and white blood cells. The complete blood count is the calculation of the cellular (formed elements) of blood. Red Blood Cells carry oxygen from your lungs to all parts of the body, while white blood cells are part of your immune system, which fights infections and diseases. This test also measures the space, volume, density and oxygen carrying ability of the blood particles, which is not only important for overall health but for athletic performance.

Spirometry and the SPO2 pulse oximeter are objective, specific and non-invasive testing to measure lung and vascular function in the beginner and elite athlete. Expiratory peak flow (PEF) is the maximum flow generated during expiration performed with maximal force and started after a full inspiration. PEF is the fastest speed air can be blown out of the lungs after inhalation. FEV1 measures the volume after exhaling in 1-second. Peak Flow (PEF) and Forced Expiratory Volume in 1-second (FEV1) measurements can tell how well lungs are breathing by monitoring airflow. Pulse oximetry is a technology that enables the noninvasive measurement of oxygen saturation, contributing to this measure’s rapid acceptance as a “fifth vital sign” (in addition to temperature, blood pressure, pulse, and respiratory rate) in clinical assessment. A pulse oximeter shines light at two wavelengths—red and infrared—through a part of the body that is relatively translucent and has good arterial pulsed blood flow (e.g., finger, toe, ear lobe). The ratio of red to infrared light that passes through the measurement site and is received by the oximeter’s detector depends on the percentage of oxygenated versus deoxygenated hemoglobin through which the light passes. The percentage of oxygen saturation thus calculated is referred to as the percent SpO2. An SPO2 of greater than 95% is generally considered to be normal.

This study will show the correlation of Simulated Training and the effects on Blood Chemistry, lung function and oxygenation in the cardiovascular and pulmonary systems.


A 46 year old Ovo-lacto Vegetarian male used the Training Mask 2.0 with Multi Air Resistance Cells over a 6 week period. Testing was recorded on the Microlife peak flow spirometry, Blood Chemistry with differential and PC based SPO2 Pulse oximeter equipment initial and every 3 weeks during the test period. Interval cycling traininTraining mask worn approximately 50% of the entire workout. Nutritional supplementation in the athletes diet consisted of 2 Tablespoons Organic Flax seed oil, MHP Probolic SR Protein powder 1 scoop daily, 1 scoop of FLUID recovery drink and a desiccated liver supplement were consumed. My diet also included 6-7 eggs per week, 7-9 daily servings of Fruits and vegetables, 2 cheese serving per week with 2 Soy (soy/rice milk, Tofu or soy based protein) based servings a day with 2.5 cups of coffee with flavored creamer every day.

The Mask (ETM) protocol was as follows;

Week 1: 4-8-4 (4 inlet holes open on left 8 holes open on breathing out and 4 inlet holes on the right) for the first week.

Week 2, 2-8-2. Week 3, 1-8-1.

Week 3, the right side valve was shut off or also known as “flux valve flip”. Now with this flipped, training continued with the combination of 4-8-4.

Week 4, 2-8-2

5th and final week, the combination of 1-8-1 was performed.


The results of the Training study showed that there were mild improvements in total Peak Expiratory Flow (PEF) spirometry by 4% and Forced Expiratory Volume in 1 second (FEV1) by 1.3%. The additional strength of the respiratory expiration musculature is increased with long term resistance exercise training. It is my opinion that the greater change was in inspiration, which will be measure in the next study due to forced inhaled breathing.

There was a mild change in the pulse oximetry SPO2 values from 96% to 99% which was a 3% improvement. The oximeter’s detected a change in the percentage of oxygenated versus deoxygenated hemoglobin in the blood which did improve the oxygenation of the blood over a 6 week time period. I do feel that this change was significant that oxygenation reached the 99%. Increased oxygenation gives the athlete better performance, and recovery with increased delayed onset soreness and lactic acid buildup to the skeletal muscular system, The resting heart rate value (pulse) decreased by 8.45% from 71 bpm to 65 bpm over the 6 week time frame, which showed the improved resting ability and relaxed state of the heart and parasympathetic nervous system.

The CBC and blood chemistry showed that the Hematocrit value increased by 6.82 percent, which is ratio of RBCs to the total volume of blood. Increased Hematocrit means that the ratio or balance of cells of the blood enhanced. This resulted in a compaction of the cells in the same amount of plasma liquid. Mean corpuscular volume (MCV) is a measurement of the average size of RBCs. The MCV value increased by 6.36 percent. This objective finding showed that as the body is stressed during intense exercise thru Training Mask, this survival adaption occurs for a growth in the size of the RBC itself. Red cell distribution width (RDW) is a calculation of the variation in the size of RBCs. The variety of the RBC sizes enlarged by 4%, which gave insight to the adaption process of volume and size of the oxygen carrying RBC. Mean platelet volume (MPV) is a calculation of the average size of platelets. Platelets are essential for clotting of the blood. While the amount of platelets decreased, the average size of the platelets increased by over 20%. The change in Red Blood Cell count was less than 1%, but this does show that in a very short amount of time, Training causes an alteration in the blood chemistry. I do feel that the RBC would continue to increase over longer period of testing of 6 months as the body adapts to additional environments stressors or training. This will be observed during the next ETM project. While we did use WBC in the study, there were no acute/chronic infections and or colds during the testing to quantify the results of the Blood Chemistry profile during the training period. There were also additional physiological changes in the quality of my sleep and not quantity of require sleep and recovery. The mental focus and toughness of the multiplied intense training while wearing the mask was also an added psychological benefit.

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