The Turbine: backed by science or a simple placebo?
After the stage 1 team time trial at this year’s Vuelta a Espana Chris Froome tweeted that he had just used the Turbine breathing aid for the first time, saying that it made a “noticeable difference” and that he’d definitely use it again. So what is the Turbine? What do the creators claim it can do? And do those claims stack up? CyclingTips editor Matt de Neef investigates.
The Turbine is a small, lightweight device that is placed inside the nose with extendable “paddles” used to keep each nostril open to allow greater airflow than would normally be possible. The bridge of The Turbine sits outside the nose — which makes it look like the user is wearing a nose ring — preventing the device from getting stuck and allowing for easy removal. It retails for AUD$29.90 for a pack of three, delivery included.
According to the creators of the Turbine, the device increases airflow to the lungs by 38%, that number coming from a clinical trial conducted by nasal surgeon Mr Simon Braham in 2003.
In the trial, the investigators compared The Turbine (referred to as BreatheAssist) with Breathe Right, external plaster-like strips that many riders in the professional peloton use to help pull their nostrils open (and, hopefully, improve performance). The trial showed that BreatheAssist was able to increase the airflow by 38% compared with a baseline reading, while using Breathe Right resulted in a small decrease in the recorded airflow.
While The Turbine’s marketing literature is centered around the idea that The Turbine “can increase airflow through the nose by 38%”, this idea has been misinterpreted at times according to Dr Mitch Anderson, Sports Medical Advisor for Rhinomed (the company behind the Turbine).
“The aim of the Turbine is not to deliver more air to the lungs, it’s actually to deliver the same amount of air with less energy cost. Reducing the work of breathing — that is, the energy cost of breathing — before/during and after exercise means you get to start a time trial or a rowing 2000m race with more gas (metaphorically and literally).”
The Turbine website suggests that the additional airflow allowed by the device can result in “up to 6% more power”. This claim comes from an “independent high performance cycling user trial” paid for by Rhinomed and conducted over eight weeks by former Olympian, Paralympic gold medalist and Ridewiser founder Rob Crowe.
In the Ridewiser trial, nine A and B Grade-level cyclists underwent tests at endurance level (65-75% of maximum heartrate) and at threshold level (80-90% of maximum heartrate). Each rider did four 10-minute endurance tests and four 10-minute threshold tests in an eight-week period (one per week), with two of each test done while wearing The Turbine and the remaining two without it.
According to a report about the trial, the average power increase across the group was 3.7% when using the Turbine. The Turbine’s claimed 6% power increase comes from the results of six of the nine riders who showed an average power increase of 19.76 watts (or 6.5%) during the threshold tests.
According to Rhinomed, this extra power means riders are able to “ride further” while wearing the Turbine than without it.
“Based on Ridewiser Ergo Machines all being geared similarly, a rider traveling further in 10 minutes is exerting a faster cadence, or producing more power (calculated at around 6% more power)”, Rob Crowe told CyclingTips. “Thus distance traveled can also be equated to power exerted for the 10-minute trials.”
Some criticisms of the Turbine have stemmed from the fact that it’s creators claim possible gains in rider power based on the Ridewiser trial when the trial only featured nine riders. We put those criticisms to Rob Crowe.
“The Turbine product trial done at Ridewiser Ergo Program was intended as a real-life test of cycling performance rather than a research experiment or a study paper”, Rob Crowe told CyclingTips. “I would suggest that it’s more likely we would see a much greater significance in these results if using a larger sample of riders.”
“However, because this trial could be run in the fairly controlled environment of the indoor Ridewiser Ergo sessions, this meant we could see quite clearly observe and compare performances within the riders from one week to the next.”
Dr Mitch Anderson told CyclingTips that Rhinomed is currently in the planning phase of several research projects to test the Turbine. In addition to testing the device’s effectiveness at treating sleeping conditions such as snoring, and allowing effective drug delivery, Rhinomed is doing further testing on whether the Turbine improves exercise performance.
“We’ve engaged a top applied physiologist in WA to run (and publish in a peer reviewed journal) a study looking at the effect the Turbine may have on 20km cycling time trial performance”, Dr Anderson said. “[The study’s] set to recruit 20 sub-elite athletes to compare the Turbine against nasal tape or no device. This should discriminate a placebo effect from the actual effect of the device in question.”
One of the areas of investigation will be whether reducing the energy cost of breathing will improve athletic performance. According to Dr Anderson Rhinomed is “dedicated to generating hard data” with hopes the study will allow the company to “publish a powerful study with results that will stand the scrutiny of the scientific and sporting communities.”
— Baden Cooke (@badencooke) August 23, 2014
The effectiveness of The Turbine and the device’s claimed benefits have come under some scrutiny in recent months, including from Australian National Masters ITT champion and cycling blogger Shane Miller.
Miller compared wearing The Turbine to riding without it, to having his nose fully blocked and to having inhaled nasal decongestant. Over the course of five trials — two without anything up his nose; one on his TT bike, one on his road bike) he set his trainer to 350W and maintained a cadence of roughly 100rpm. According to Shane:
“The feeling of having more airflow through my nose (by use of a device, decongestant, or clearing it) had no positive influence on my average HR or perceived effort for these 4min/350W intervals.”
Miller’s investigation clearly isn’t a comprehensive clinical trial and one person’s perspective can’t be used to say whether or not the device is effective or not. But at the bottom of Miller’s post he quotes the following passage written by two exercise physiologists, suggesting that it’s not possible for the Turbine to improve performance:
The hemoglobin in our blood dictates how much oxygen gets to the working muscle. Hemoglobin is a protein connected to red blood cells. It is responsible for transporting the oxygen in the blood to the muscles that require it.
During exercise the hemoglobin sites are usually 100% saturated with oxygen. This means that it does not matter if you take in more oxygen by wearing the nasal dilator, because the rate at which oxygen can travel from the lungs to the blood is at a maximum.
We put this criticism to Dr Mitch Anderson who agreed that “oxygen saturation is always close to 100%” but suggested there was more to the story:
“The level of O2 in the blood is a direct result of:
a) the presence of O2 in the lungs
b) the efficacy of the blood vessels in the lungs to absorb O2
c) the ability of the blood to carry O2
Breathing through the nose does not impact c). However, breathing through the nose can impact a) and b).”
According to Dr Anderson, breathing through the nose (as opposed to the mouth) not only warms and humidifies the air passing through (keeping your lungs hydrated), but also means the sinuses release nitric oxide. Dr Anderson pointed us towards a 1999 research paper which, he suggests, shows that “air is ‘primed’ by the time it hits the lungs [when breathing through the nose], allowing O2 to be more readily absorbed.”
In other words, it’s not only about how oxygen is absorbed in the blood, but how efficiently it is absorbed.
“If O2 can be absorbed more readily then the energy cost of breathing is lower. This energy saving can be redirected to where you need it. We hypothesis that this is one of the contributors to the impact of the Turbine; a hypothesis we will be testing in forthcoming research.”
It is unclear at this stage how much energy would be saved by making it easier to breathe, and how this energy saving compares with the energy required at the end of a bike race, say.
Wearing the Turbine
So what’s it like to wear the Turbine? We spoke with Avanti Racing’s Mark O’Brien who’s been involved in the testing of the Turbine since 2012, voluntarily to begin with and later as a paid brand ambassador.
“Generally I’ve found the Turbine great for slapping in late into races. For example, at Nationals this year I put my Turbine in with five laps of the 10km circuit to go. Even if it’s just a mental boost, I like the feeling of openness it gives me. Otherwise I tend to use it for shorter duration efforts like ergo sessions.”
One of the criticisms that has been levelled at the Turbine (and indeed at nasal strips) is the fact that while exercising hard, most breathing is done through the mouth and that therefore, increasing the airflow through the nose is of little benefit. A 1999 research paper showed that the switch to mouth breathing during exercise can be delayed by expanding the nostrils (by using nasal strips, and presumably the Turbine as well) but whether that has performance benefits is unclear. Mark O’Brien mentioned a benefit that he had noticed:
“I know for myself, when I have a blocked or snotty nose, I feel it hinders me, therefore having an even easier time breathing through my nose with the Turbine seems worthwhile.”
Here at CyclingTips we also invited more than a dozen recreational riders to try out the Turbine and to provide feedback on how they found it to use. The results were mixed — some riders said it definitely seemed to increase the amount of air they were able to get up their nose and that they’d be happy to use it more going forward. Others found the device uncomfortable to use, with some pointing out that it made blowing their nose impossible. Others dismissed the device outright, saying it made no difference to their breathing and their riding. Here’s a brief selection:
The Turbine in races
While a number of professional cyclists have worn the device in races — including Mark O’Brien, Chris Froome and Trek’s Calvin Watson — there are some concerns that its use might contravene UCI rules, specifically 1.3.004 of the UCI’s Technical Regulations which states “no technical innovation regarding anything used, worn or carried by any rider or license holder during a competition … may be used until approved by the UCI.”. We put this to the UCI who provided the following response (original spelling intact):
UCI do no have any position concerning the gadgets which being used and inserted in the nostrils to improve airflow. Regarding the potential danger, for UCI, it does not cause more danger than wearing glasses, for example.
Cycling Australia confirmed that “with the CA Technical Regulations mirroring the UCI’s in most instances, [the Turbine] will be allowed in events around Australia.”
There have been many people claiming in recent months that the Turbine is ineffective and that any gains claimed by the parent company are non-existent. To those people Dr Mitch Anderson, a self-confessed cynic initially, suggests simply trying it out.
“I think it’s the natural state for Australians to be cynical but the Turbine warrants a go. After all, Greg Lemond won the 1989 TDF by being willing to use TT bars when others thought them a superfluous folly and he won a grand tour by eight seconds …”
Whether the device does everything it’s claimed to do will be clearer at the conclusion of the new study. But if there’s one thing we know for certain, it’s that for many cyclists (at all levels of the sport), even the prospect of potential performance gains is likely to be enough to make the Turbine appealing.
Have you used the Turbine? What’s your take on it? If you haven’t used it before, would you?