Int J Sports Med 2007; 28(6): 456-462
DOI: 10.1055/s-2006-924583
Physiology & Biochemistry

© Georg Thieme Verlag KG Stuttgart · New York

Comparative Effects of a High-Intensity Interval Warm-Up and Salbutamol on the Bronchoconstrictor Response to Exercise in Asthmatic Athletes

T. D. Mickleborough1 , M. R. Lindley1 , 2 , L. A. Turner1 , 2
  • 1Human Performance Laboratory, Department of Kinesiology, Indiana University, Bloomington, IN, USA
  • 2School of Sport Science, University of Wales Institute Cardiff, Cyncoed Campus, Cardiff, UK
Further Information

Publication History

Accepted after revision: June 10, 2006

Publication Date:
16 November 2006 (online)

Abstract

Approximately half of all asthmatics become refractory to exercise-induced bronchoconstriction (EIB) with repeated challenges. Exercise refractoriness has been utilized by asthmatic athletes to reduce the bronchoconstrictor response to exercise prior to competition, and this has led to the observation that some asthmatic athletes can “run through” their asthma. The main aim of this study was to investigate the efficacy of short high-intensity, repeated warm-ups compared with salbutamol (a commonly used inhaled β2-agonist) on the severity of EIB. Eight moderately trained (V·O2peak, 51.9 ± 2.3 ml · kg-1 · min-1) recreational asthmatic athletes with documented EIB were tested under 4 experimental conditions: 1) control (CON) condition; 2) an interval warm-up (WU) consisting of 8 × 30-sec runs at peak treadmill speed, with 45-sec recovery between each sprint; 3) inhaling 200 µg of salbutamol (Ventolin®, GlaxoSmithKline, Uxbridge, Middlesex, U.K.) (IH); and 4) combining both the WU and IH session. All 4 experimental sessions were followed by an exercise challenge test (85 - 90 % predicted maximum heart rate for 8 min). Pulmonary function was measured pre-exercise and at 1, 5, 10, 15 min postexercise. The mean maximum percent fall in pre- to postexercise forced expiratory volume in 1-sec (FEV1) for all 8 asthmatic subjects during the EIB screening test (CON session) was - 18.25 ± 4.01 %. The mean maximum percent decrease in postexercise FEV1 significantly decreased (p < 0.05) to only - 9.1 ± 0.6 % following the WU condition, which is below the EIB diagnostic threshold of a 10 % fall in postexercise FEV1. The IH and WU + IH condition resulted in a substantial postexercise bronchodilation as shown by a significant increase (p < 0.05) in the mean maximum percent change in postexercise FEV1 following the IH (+ 8.9 ± 6.1 %) and WU + IH (+ 15.2 ± 4.6 %) condition. Similar changes as a result of experimental condition were observed for FEF25 - 75 %. These data indicate that repeated high-intensity warm-ups can lessen the bronchoconstrictor response to exercise. In addition, combining the interval warm-up with salbutamol prior to exercise resulted in substantial bronchodilation and conferred a greater protective effect against developing EIB than either intervention alone.

References

  • 1 American Thoracic Society . Guidelines for methacholine and exercise challenge testing - 1999.  Am J Respir Crit Care Med. 2000;  161 309-329
  • 2 American Thoracic Society . Standardization of spirometry - 1994 update.  Am J Respir Crit Care Med. 1995;  152 1107-1136
  • 3 British Association of Sport and Exercise Sciences .Guidelines of the Physiological Testing of Athletes. 3rd edn. Leeds; BASES 1997: 59-65
  • 4 National Heart, Lung and Blood Institute .Expert Panel Report 2. Guidelines for the Diagnosis and Management of Asthma. NIH Publication No 97 - 4051. Bethesda, MD; NIH 1997
  • 5 Anderson S D, Holzer K. Exercise-induced asthma: is it the right diagnosis in elite athletes?.  J Allergy Clin Immunol. 2000;  106 419-428
  • 6 Anderson S D, Kippelen P. Exercise-induced bronchoconstriction: Pathogenesis.  Curr Allergy Asthma Rep. 2005;  5 116-122
  • 7 Anderson S D, Schoeffel R E. Respiratory heat and water loss during exercise in patients with asthma. Effect of repeated exercise challenge.  Eur J Respir Dis. 1982;  63 472-480
  • 8 Beck K C, Offord K P, Scanlon P D. Bronchoconstriction occurring during exercise in asthmatic subjects.  Am J Respir Crit Care Med. 1994;  149 352-357
  • 9 Becker A. Controversies and challenges of exercise-induced bronchoconstriction and their implications for children.  Pediatr Pulmonol. 2001;  21 (Suppl) 38-45
  • 10 Belcher N G, Murdoch R, Dalton N, Clark T J, Rees P J, Lee T H. Circulating concentrations of histamine, neutrophil chemotactic activity, and catecholamines during the refractory period in exercise-induced asthma.  J Allergy Clin Immunol. 1988;  81 100-110
  • 11 Ben-Dov I, Bar-Yishay E, Godfrey S. Refractory period after exercise-induced asthma unexplained by respiratory heat loss.  Am Rev Respir Dis. 1982;  125 530-534
  • 12 Ben-Dov I, Gur I, Bar-Yishay E, Godfrey S. Refractory period following induced asthma: contributions of exercise and isocapnic hyperventilation.  Thorax. 1983;  38 849-853
  • 13 de Bisschop C, Guenard H, Desnot P, Vergeret J. Reduction of exercise-induced asthma in children by short, repeated warm ups.  Br J Sports Med. 1999;  33 100-104
  • 14 Dessanges J F, Prefaut C, Taytard A, Matran R, Naya I, Compagnon A, Dinh-Xuan A T. The effect of zafirlukast on repetitive exercise-induced bronchoconstriction: the possible role of leukotrienes in exercise-induced refractoriness.  J Allergy Clin Immunol. 1999;  104 1155-1161
  • 15 Edmunds A T, Tooley M, Godfrey S. The refractory period after exercise-induced asthma: its duration and relation to the severity of exercise.  Am Rev Respir Dis. 1978;  117 247-254
  • 16 Giannini D, Paggiaro P L, Moscato G, Gherson G, Bacci E, Bancalari L, Dente F L, Di Franco A, Vagaggini B, Giuntini C. Comparison between peak expiratory flow and forced expiratory volume in one second (FEV1) during bronchoconstriction induced by different stimuli.  J Asthma. 1997;  34 105-111
  • 17 Gilbert I A, Lenner K A, McFadden Jr E R. Sympathoadrenal response to repetitive exercise in normal and asthmatic subjects.  J Appl Physiol. 1988;  64 2667-2674
  • 18 Gotshall R W. Exercise-induced bronchoconstriction.  Drugs. 2002;  62 1725-1739
  • 19 Hancox R J, Subbarao P, Kamada D, Watson R M, Hargreave F E, Inman M D. Beta2-agonist tolerance and exercise-induced bronchospasm.  Am J Respir Crit Care Med. 2002;  165 1068-1070
  • 20 Harling S A, Tong R J, Mickleborough T D. The oxygen uptake response running to exhaustion at peak treadmill speed.  Med Sci Sports Exerc. 2003;  35 663-668
  • 21 Haverkamp H C, Dempsey J A, Miller J D, Romer L M, Pegelow D F, Lovering A T, Eldridge M W. Repeat exercise normalizes the gas-exchange impairment induced by a previous exercise bout in asthmatic subjects.  J Appl Physiol. 2005;  99 1843-1852
  • 22 Inman M D, O'Byrne P M. The effect of regular inhaled albuterol on exercise-induced bronchoconstriction.  Am J Respir Crit Care Med. 1996;  153 65-69
  • 23 Manning P J, Watson R M, O'Byrne P M. Exercise-induced refractoriness in asthmatic subjects involves leukotriene and prostaglandin interdependent mechanisms.  Am Rev Respir Dis. 1993;  148 950-954
  • 24 Margolskee D J, Bigby B G, Boushey H A. Indomethacin blocks airway tolerance to repetitive exercise but not to eucapnic hyperpnea in asthmatic subjects.  Am Rev Respir Dis. 1988;  137 842-846
  • 25 McKenzie D C, McLuckie S L, Stirling D R. The protective effects of continuous and interval exercise in athletes with exercise-induced asthma.  Med Sci Sports Exerc. 1994;  26 951-956
  • 26 Melillo E, Woolley K L, Manning P J, Watson R M, O'Byrne P M. Effect of inhaled PGE2 on exercise-induced bronchoconstriction in asthmatic subjects.  Am J Respir Crit Care Med. 1994;  149 1138-1141
  • 27 Mickleborough T D, Gotshall R W, Cordain L, Lindley M. Dietary salt alters pulmonary function during exercise in exercise-induced asthmatics.  J Sports Sci. 2001;  19 865-873
  • 28 Mickleborough T D, Murray R L, Ionescu A A, Lindley M R. Fish oil supplementation reduces severity of exercise-induced bronchoconstriction in elite athletes.  Am J Respir Crit Care Med. 2003;  168 1181-1189
  • 29 Morton A R, Fitch K D, Davis T. The effect of “warm-up” on exercise-induced asthma.  Ann Allergy. 1979;  42 257-260
  • 30 Noakes T D, Myburgh K H, Schall R. Peak treadmill running velocity during the V·O2max test predicts running performance.  J Sports Sci. 1990;  8 35-45
  • 31 Nowak D, Jorres R, Magnussen H. Influence of exercise-induced bronchoconstriction on refractoriness.  Lung. 1992;  170 75-84
  • 32 O'Byrne P M. Exercise refractoriness. McFadden ER Exercise-Induced Asthma. New York; Marcel Dekker 1999: 181-193
  • 33 O'Byrne P M. Leukotriene bronchoconstriction induced by allergen and exercise.  Am J Respir Crit Care Med. 2000;  161 S68-S72
  • 34 O'Byrne P M, Jones G L. The effect of indomethacin on exercise-induced bronchoconstriction and refractoriness after exercise.  Am Rev Respir Dis. 1986;  134 69-72
  • 35 Parsons J P, Mastronarde J G. Exercise-induced bronchoconstriction in athletes.  Chest. 2005;  128 3966-3974
  • 36 Ramsdell J W, Colice G L, Ekholm B P, Klinger N M. Cumulative dose response study comparing HFA-134a albuterol sulfate and conventional CFC albuterol in patients with asthma.  Ann Allergy Asthma Immunol. 1998;  81 593-599
  • 37 Reiff D B, Choudry N B, Pride N B, Ind P W. The effect of prolonged submaximal warm-up exercise on exercise-induced asthma.  Am Rev Respir Dis. 1989;  139 479-484
  • 38 Rundell K W, Spiering B A, Judelson D A, Wilson M H. Bronchoconstriction during cross-country skiing: is there really a refratcory period?.  Med Sci Sports Exerc. 2003;  35 18-26
  • 39 Schnall R P, Landau L I. Protective effects of repeated short sprints in exercise-induced asthma.  Thorax. 1980;  35 828-832
  • 40 Schoeffel R E, Anderson S D, Gillam I, Lindsay D A. Multiple exercise and histamine challenge in asthmatic patients.  Thorax. 1980;  35 164-170
  • 41 Soferman R, Spirer Z, Topilsky M. Small airway responsiveness to exercise as an objective measure of exercise-induced asthma in children.  Pediatr Asthma Allergy Immunol. 2003;  16 77-84
  • 42 Stearns D R, McFadden Jr E R, Breslin F J, Ingram Jr R H. Reanalysis of the refractory period in exertional asthma.  J Appl Physiol. 1981;  50 503-508
  • 43 Sue-Chu M, Karjalainen E M, Laitinen A, Larsson L, Laitinen L A, Bjermer L. Placebo-controlled study of inhaled budesonide on indices of airway inflammation in bronchoalveolar lavage fluid and bronchial biopsies in cross-country skiers.  Respiration. 2000;  67 417-425
  • 44 Suman O E, Morrow J D, O'Malley K A, Beck K C. Airway function after cyclooxygenase inhibition during hyperpnea-induced bronchoconstriction in guinea pigs.  J Appl Physiol. 2000;  89 1971-1978
  • 45 Wilson B A, Bar-Or O, O'Byrne P M. The effects of indomethacin on refractoriness following exercise both with and without a bronchoconstrictor response.  Eur Respir J. 1994;  7 2174-2178

PhD Timothy D. Mickleborough

Human Performance Laboratory
Department of Kinesiology

1025 E. 7th St. HPER 112

Bloomington, IN 47404

USA

Phone: + 81 28 55 07 53

Fax: + 81 28 55 31 93

Email: tmickleb@indiana.edu

    >