Jordan Guenette: Professor at Department of Physical Therapy, UBC Faculty of Medicine

Professor

Faculty of Medicine

Research Classification

Respiratory diseases

Other biological sciences

Research Interests

Clinical exercise physiology

Cardiorespiratory physiology

Mechanisms and management of breathlessness and exercise intolerance

Chronic respiratory diseases

Relevant Thesis-Based Degree Programs

Physical Therapy, Master of Physical Therapy and Doctor of Philosophy in Rehabilitation Science

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Affiliations to Research Centres, Institutes & Clusters

Centre for Heart Lung Innovation

Providence Health Care Research Institute

Research Options

I am available and interested in collaborations (e.g. clusters, grants).

I am interested in and conduct interdisciplinary research.

I am interested in working with undergraduate students on research projects.

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Research Methodology

Cardiopulmonary exercise testing

Near Infrared Spectroscopy

Respiratory muscle electromyography

Respiratory mechanics

Respiratory and limb muscle fatigue using magnetic stimulation

Dyspnea evaluation using multiple scales

Recruitment

Looking to recruit:

Master's students

Doctoral students

Postdoctoral Fellows

Desired start dates: Any time / year round

Other options:

I support public scholarship, e.g. through the Public Scholars Initiative, and am available to supervise students and Postdocs interested in collaborating with external partners as part of their research.

I support experiential learning experiences, such as internships and work placements, for my graduate students and Postdocs.

I am open to hosting Visiting International Research Students (non-degree, up to 12 months).

I am interested in hiring Co-op students for research placements.

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Graduate Student Supervision

Doctoral Student Supervision

Dissertations completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest dissertations.

Impact of air pollution on exercise responses, dyspnea, and respiratory health in adults with and without chronic obstructive pulmonary disease (2023)

Problem: Little is known about which demographic and pulmonary function characteristics are associated with exertional dyspnea and whether or not acute exposure to traffic-related air pollution (TRAP) impacts dyspnea, pulmonary function, and exercise responses in older adults with and without chronic obstructive pulmonary disease (COPD). Methods: Study 1: We investigated the association between exertional dyspnea and select outcome measures in a random population sample (n=844) of healthy controls, at-risk smokers, and COPD (Chapter 2). Study 2: We investigated the acute effects of TRAP versus filtered air on a wide range of outcomes in healthy controls (n=11) and ex-smokers with (n=9) or without (n=9) mild-to-moderate COPD. Data from study 2 was divided into three chapters. Study 3: The association between short-term increases in ambient air pollution with rescue inhaler use, sleep duration, and physical activity was tested in COPD using remote monitoring technology (RMT) (Chapter 6).Results: Study 1 demonstrated that exertional dyspnea is significantly associated with sex, forced expiratory volume in 1 second, COPD Assessment Test score, and Medical Research Council Dyspnea score, but not lung diffusion capacity for carbon monoxide in healthy individuals, at-risk smokers, and COPD (Chapter 2). Study 2 showed that TRAP did not affect routine measures of pulmonary function in any group (Chapter 3) or impulse oscillometry-derived data, except total airway resistance at 5Hz (R₅) in healthy never smokers (Chapter 4). TRAP had a deleterious effect on exercise endurance, absolute operating lung volumes, and exertional dyspnea in healthy controls but not in ex-smokers with and without COPD (Chapter 5). Lastly, in Study 3 we showed that RMT could be useful to track inhaler use, sleep, and physical activity during periods of increased ambient air pollution in COPD (Chapter 6). Conclusion: This thesis demonstrates that exertional dyspnea is associated with disease severity and burden in COPD and that TRAP negatively impacts dyspnea, exercise endurance, and select ventilatory responses in healthy older adults but not ex-smokers with and without COPD. We also demonstrated that RMT can be useful for monitoring inhaler use, sleep, and physical activity in individuals with COPD during periods of increased air pollution.

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Sex differences in voluntary activation of the diaphragm (2022)

Purpose: Three studies were performed to examine how voluntary activation of the diaphragm changes after fatiguing tasks in young, healthy males and females. The change in diaphragm voluntary activation (D-VA) was also compared to the change in contractile function, assessed by the change in transdiaphragmatic twitch pressure (P¬DI,TW).Methods: Study 1 (Chapter 2) investigated the within- and between-session reliability of D-VA using cervical magnetic stimulation (CMS) to evoke twitches. Study 2 (Chapter 3) examined changes in D-VA after high intensity, whole-body exercise between sexes. Study 3 (Chapter 4) examined changes in D-VA after inspiratory pressure threshold loading (IPTL) between sexes.Conclusions: CMS can be used to reliably assess D-VA, measured via intraclass correlation coefficients (ICC) both within- (ICC: 0.76) and between-session (ICC: 0.88). After exercise, D-VA decreased in males and females. The decrease in D-VA was greater in males compared to females (87.4±10.8 vs 95.4±4.9%basline, respectively, p=0.036). The magnitude of the decrease in D-VA was less than the decrease in PDI,TW (Males: 70.3±12.4, Females: 85.2±16.7%baseline, p=0.024). After IPTL, both males and females showed a decrease in D-VA and PDI,TW. While males showed a greater decrease in PDI,TW (73.3±12.1 vs 87.1±15.0%baseline, respectively, p=0.016) compared to females, the decrease in D-VA was similar between sexes (88.2±10.5 vs 91.4±7.6%baseline, respectively, p=0.432). After IPTL, the decrease in PDI,TW correlated with the total respiratory work performed whereas the decrease in D-VA correlated with time until task failure. The magnitude of the decrease in PDI,TW was greater than the decrease in D-VA after IPTL. Collectively, the results of this thesis suggest that there are sex differences in the change in D-VA after exercise but not IPTL. This thesis provides a foundation for future work to investigate how diaphragm fatigability can affect exercise performance in humans.

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Physiological mechanisms of dyspnoea in patients with fibrotic interstitial lung disease and the role of hyperoxia as an exercise intervention (2018)

Problem: Dyspnoea is a common and debilitating symptom in patients with fibrotic interstitial lung disease (ILD). Unfortunately, there are no therapies that consistently reduce exertional dyspnoea in this population. Hyperoxia is a potential intervention to acutely address many of the pathophysiological mechanisms thought to be associated with dyspnoea and exercise intolerance in fibrotic ILD. However, additional research is needed to clarify the role and specific physiological and perceptual effects of hyperoxia during exercise in these patients.Methods: Study 1: Twenty fibrotic ILD patients performed two symptom limited constant work-rate cycle exercise tests at 75% of peak work-rate while breathing room air or hyperoxia, in randomized order. Ventilatory responses as well as both the intensity and qualitative dimensions of dyspnoea were measured throughout exercise. Study 2: Fourteen patients with fibrotic ILD completed an incremental cycle exercise test while breathing room air and two constant work-rate cycle exercise tests while breathing room air or hyperoxia. Diaphragmatic electromyography (EMGdi), a surrogate of neural respiratory drive (NRD), was measured with an oesophageal catheter. Neuromechanical uncoupling (NMU) was calculated as the ratio between EMGdi (% max) and tidal volume (% vital capacity). Dyspnoea intensity was recorded throughout exercise. Study 3: Sixteen patients with fibrotic ILD performed incremental and constant work-rate cycle exercise tests while breathing room air until exhaustion, wherein dyspnoea quality was evaluated throughout exercise. Conclusions: Study 1 demonstrated that hyperoxia results in clinically significant improvements in exercise tolerance, dyspnoea intensity, and dyspnoea quality. Study 2 found that dyspnoea intensity was more strongly associated with estimates of NRD than NMU during normoxic incremental cycling. However, improvements in dyspnoea intensity with hyperoxia were more strongly correlated with NMU than NRD. Study 3 showed increased work/effort was the dominant descriptor of dyspnoea throughout incremental and constant work-rate cycle exercise, but there was an increase in the selection of unsatisfied inspiration once further tidal volume expansion was constrained. Collectively, these results may contribute to the development and enhancement of symptom management in patients with ILD. In the context of rehabilitation, this may translate into improvements in patient outcomes from exercise training programs.

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Master's Student Supervision

Theses completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest theses.

Face masks during exercise : investigating sex differences in the multidimensional components of dyspnea (2023)

Introduction: Despite consistent evidence that face masks (FM) increase dyspnea (i.e., breathlessness), very few studies have examined whether dyspnea and other physiological responses to FMs during exercise differ on the basis of sex. Accordingly, the purpose of this study was to evaluate sex differences in the multidimensional components of dyspnea, exercise performance and other physiological responses when wearing a FM during a maximal incremental exercise in healthy young males and females.Methods: In a randomized cross-over design, thirty-two healthy individuals (n=16 females, 23 ± 3 years) completed two testing sessions separated by ≥48 h. Each visit included a maximal incremental cycling test where visits 1 & 2 were randomized to either FM or control condition. Dyspnea intensity and unpleasantness were assessed using the modified 0-10 category-ratio (CR) Borg scale and the Multidimensional Dyspnea Profile was administered immediately following exercise. Diaphragmatic electromyography (EMGdi), esophageal pressure swings (Peso), and transdiaphragmatic pressure swings (Pdi) were measured via a specialized catheter to estimate neural respiratory drive and respiratory muscle pressures, respectively. Heat perception was measured using the Frank Comfort scale and a skin probe was used to measure facial temperature.Results: There were no differences in exercise duration between FM and control in males (20.3±4.3 vs. 20.9±4.2 min, p=0.13) whereas there was a significant reduction in females (13.2±3.5 vs. 13.8±3.3 min, p=0.006). At peak exercise, males exhibited significantly higher ratings of dyspnea unpleasantness and Peso in the FM condition with an increase of 2.1 Borg 0-10 units (95% CI [0.6, 3.6], p=0.01) and 4.3 cmH₂O (95% CI [0.6, 8.1], p=0.001), respectively. Both sexes experienced significantly higher facial temperatures at specified submaximal work rates (all p
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Effects of face masks on the multiple dimensions and neurophysiological mechanisms of exertional dyspnea (2022)

Introduction: During the coronavirus disease 2019 (COVID-19) pandemic, public health officials have widely adopted the use of face masks (FM) to limit the spread of infection. Despite consistent evidence that FMs increase dyspnea (i.e., breathlessness), no studies have examined the multidimensional components of dyspnea or the physiological mechanisms of dyspnea with FMs. Methods: In a randomized cross-over design, sixteen healthy individuals (n=9 females, 25±3 y) completed three testing sessions separated by ≥48 h. Each visit included a maximal incremental cycling test where visits 2 & 3 were randomized to either FM or control condition. Dyspnea intensity and unpleasantness were assessed using the 0-10 Borg scale and the Multidimensional Dyspnea Profile (MDP) was administered immediately following exercise. Crural diaphragmatic electromyography (EMGdi), esophageal pressure (Peso), and transdiaphragmatic pressure (Pdi) were measured via a specialized catheter to estimate neural respiratory drive and respiratory muscle pressures respectively. Results: Dyspnea unpleasantness was significantly greater with the FM at the highest equivalent submaximal work rate (HESWR) (2.5±2.0 vs. 1.5±1.5 Borg 0-10 units, P=0.01) and at peak exercise (7.8±2.1 vs. 5.9±3.4 Borg 0-10 units, P=0.01) with no differences in dyspnea intensity ratings throughout exercise compared to control. There were also significant increases in the sensory quality of “smothering/air hunger” (P=0.01) and the emotional response of “anxiousness” (P=0.04) in the FM condition. There were significant increases in EMGdi (P=0.001) and esophageal pressure swings (P=0.006) at the HESWR but no differences in heart rate, peripheral oxygen saturation or breathing frequency throughout exercise with FMs compared to control. Conclusions: Our findings suggest that FMs negatively impact the affective domain of dyspnea during exercise and increase neural respiratory drive and respiratory muscle effort requirements during exercise, although the impact on other cardiopulmonary responses are minimal.

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The effect of diaphragm fatigue on the multidimensional components of dyspnea and diaphragm EMG during exercise (2019)

Purpose: To determine the effect diaphragm fatigue (DF) has on the multidimensional components of dyspnea and diaphragm EMG (EMGdi) during exercise.Methods: Sixteen healthy males (age=27, V̇O2Max=45.8 ± 9.8) underwent three study visits. Visit 1 comprised of an incremental cycle exercise test to determine maximal work rate. The following two visits involved a constant work rate (CWR) exercise test at an intensity equal to their gas exchange threshold (GET) plus 60% of the delta between GET and peak. One of the two CWR exercise tests was performed following pressure threshold loading (PTL) to induce DF, while the other served as a control. PTL involved inspiring to 60% of maximum transdiaphragmatic pressure (Pdi) to overcome a weighted load in order to initiate inspiration. DF was assessed by measuring transdiaphragmatic pressure in response to cervical magnetic stimulation of the phrenic nerves. Pdi and EMGdi were both assessed by the same esophageal balloon catheter. Breathing intensity, unpleasantness and leg discomfort ratings were assessed with the modified 0-10 category ratio Borg scale. Participants were also asked to select applicable breathing sensations during and after exercise. Peak dyspnea responses were assed via the Multidimensional Dyspnea Profile (MDP). Results: Exercise performance decreased by 1.7 minutes in the pre-fatigue condition compared to control (p=0.04). There were no changes in breathing intensity and leg discomfort (p>0.05) throughout exercise. Breathing unpleasantness increased in the pre-fatigue condition by 0.2 (p=0.09), 0.6 (p=0.04), and 0.6 (p=0.04) units at all three of the dyspnea measurement points achieved by every participant during exercise. One additional time point achieved by fifteen of the sixteen participants increased by 0.9 units (p=0.03). There were no differences in EMGdi. EMGdi significantly correlated with intensity and unpleasantness ratings in both conditions (all p
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Effects of cycling cadence on respiratory and haemodynamic responses in trained cyclists (2018)

The physiological consequences of cycling cadence selection are poorly understood. Purpose: To determine the impact of cadence on cardiorespiratory and metabolic parameters; perceptual responses; power of breathing (Pb); electromyography of the diaphragm (EMGdi) and leg muscles; and microvascular leg blood flow. Methods: Eleven trained cyclists (10M:1F; age=27±6yrs; V̇O2max=60.8±3.7ml·kg-¹·min-¹) completed four 6-min constant-load cycling trials at 10% below their gas exchange threshold (63±5% peak power) while pedaling at 60rpm, 90rpm, 120rpm, and a freely chosen cadence (FCC, 94.3±6.9 rpm), in randomized order, on an electromagnetically braked cycle ergometer. Ventilatory and metabolic parameters were measured using a commercially available metabolic cart. An oesophageal electrode balloon catheter was used to assess Pb and EMGdi. Surface EMG was placed on four leg muscles predominant in cycling. Blood flow index (BFI) was determined on the same muscles of the contralateral limb using near-infrared spectroscopy and indocyanine green. Perceptual responses were measured using the modified 0-10 category ratio Borg scale. Results: With each increase in cadence there was a corresponding increase in V̇O2 (all pairwise comparisons p0.05). Conclusion: Relative blood flow appears to be closely linked with metabolic activity of the muscle, which was significantly elevated during the highest cadence condition. In combination with the substantial rise in respiratory variables and the Pb, cadence may represent the balance between peripheral and central stressors.

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The Effects of Inspiratory Muscle Training on Physiological and Sensory Responses to Exercise in Healthy Males (2016)

Inspiratory muscle training (IMT) is an efficacious intervention to reduce dyspnoea in health and disease. Growing evidence also suggests that IMT can improve whole body exercise performance. However, the physiological mechanisms for these improvements are not well understood. We sought to examine the effects of IMT on dyspnoea, respiratory muscle electromyography (EMG), and respiratory and locomotor oxygenation to examine potential mechanisms of action for any IMT-related improvements in dyspnoea and exercise performance. 25 recreationally active healthy men completed two maximal incremental cycle exercise tests separated by 5 weeks of randomly assigned pressure threshold IMT or sham control training (SC). The IMT group (n = 12) performed 30 inspiratory efforts twice daily against a 30 repetition maximum intensity. The SC (n = 13) group performed a daily bout of 60 inspiratory efforts against 10% maximal inspiratory pressure (MIP), with no weekly adjustments. EMG electrodes on the sternocleidomastoid (SCM) and scalene muscles measured changes in muscle activity, and near-infrared spectroscopy (NIRS) optodes on the SCM, parasternal intercostals, 7th intercostal space, and vastus lateralis muscle measured changes in oxygenated and deoxygenated haemoglobin during each exercise test. Dyspnoea was measured throughout exercise using the modified Borg scale. Finally, a subset of participants (IMT: n = 11; SC: n = 11) were instrumented with a multi-pair oesophageal electrode catheter containing two balloons, to measure diaphragm EMG and respiratory pressures. IMT significantly improved MIP (pre: -138±45 vs. post: -160±43, cm H₂O, p
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