Article Text

PDF
Diagnosis of exercise-induced bronchoconstriction: eucapnic voluntary hyperpnoea challenges identify previously undiagnosed elite athletes with exercise-induced bronchoconstriction
  1. John Dickinson1,
  2. Alison McConnell2,
  3. Greg Whyte1
  1. 1Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
  2. 2Centre for Sports Medicine and Human Performance, Brunel University, Uxbridge, UK
  1. Correspondence to Dr John Dickinson, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Riley Building, Byrom Street, Liverpool L3 3AF; Merseyside, UK; j.w.dickinson{at}ljmu.ac.uk

Abstract

Background There is increasing evidence to suggest many elite athletes fail to recognise and report symptoms of exercise-induced bronchoconstriction (EIB), supporting the contention that athletes should be screened routinely for EIB.

Purpose To screen elite British athletes for EIB using eucapnic voluntary hyperpnoea (EVH).

Methods 228 elite athletes provided written informed consent and completed an EVH challenge with maximal flow volume loops measured at baseline and 3, 5, 10 and 15 min following EVH. A fall of 10% in forced expiratory volume in 1 s (FEV1) from baseline was deemed positive. Two-way analysis of variance was conducted to compare FEV1 at baseline and maximal change following EVH between EVH-positive and EVH-negative athletes who did and did not report a previous diagnosis of EIB. Significance was assumed if p≤0.05.

Results Following the EVH challenge 78 athletes (34%) demonstrated EVH positive. 57 out of the 78 (73%) athletes who demonstrated EVH positive did not have a previous diagnosis of EIB. 30 athletes reported a previous diagnosis of asthma, nine (30%) of whom demonstrated EVH negative. There was no significant difference between the magnitude of the fall in FEV1 between athletes who reported a previous diagnosis of EIB and demonstrated EVH positive, and those with no previous diagnosis of EIB who demonstrated EVH positive (mean±SD; −21.6±16.1% vs −17.1±9.7%; p=0.07).

Conclusion The high proportion of previously undiagnosed athletes who demonstrated EVH positive suggests that elite athletes should be screened routinely for EIB using a suitable bronchoprovocation challenge.

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Harrow Local Research Ethics Committee, England.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.