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Dickinson JW, Smyth CME, Winter SL. Breathing pattern changes in response to bronchoconstriction in physically active adults. J Asthma 2024:1-10. [PMID: 39058599 DOI: 10.1080/02770903.2024.2383632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/12/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVES To determine whether Opto-Electronic Plethysmography (OEP) can distinguish Exercise-Induced Bronchoconstriction (EIB) breathing patterns by comparing individuals with and without EIB, and between broncho-constriction and recovery. Breathing pattern was quantified in terms of regional contribution, breathing timing, and the phase between chest sub-compartments which indicates the synchronization in movement of the different sub-compartments. METHODS Individuals (n = 47) reporting no respiratory symptoms and no history of any respiratory disease or disorder were assumed to have a healthy breathing pattern. Of 38 participants reporting respiratory symptoms during exercise, and/or a previous diagnosis of asthma or EIB, 10 participants had a positive result to the Eucapnic Voluntary Hyperpnea test, defined as a fall of at least 10% in FEV1 from baseline at two consecutive time points and were classified into the EIB group. OEP data was obtained from 89 markers and an 11-camera motion capture system operating at 100 Hz as follows: pre- and post-EVH challenge, and post-inhaler in participants who experienced a bronchoconstriction, and 2) for the healthy group during tidal breathing. RESULTS RCpRCa-Phase (upper versus lower ribcage), RCaS-Phase (lower ribcage versus shoulders), and RCpS-Phase (upper ribcage versus shoulders) differed between bronchoconstriction and rest in athletes with EIB and rest in healthy participants (p < 0.05), in all cases indicating greater asynchrony post-bronchoconstriction, and later movement of the abdominal ribcage (RCa) post-bronchoconstriction. RCpS-Phase was different (p < 0.05) between all conditions (rest, post-bronchoconstriction, and post-inhaler) in EIB. CONCLUSIONS OEP can characterize and distinguish EIB-associated breathing patterns compared to rest and individuals without EIB at rest.
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Affiliation(s)
- John W Dickinson
- School of Sport and Exercise Sciences, University of Kent, Canterbury, Kent, UK
| | - Carol M E Smyth
- School of Sport and Exercise Sciences, University of Kent, Canterbury, Kent, UK
| | - Samantha L Winter
- School of Sport, Exercise and Health Sciences, Loughborough University, National Centre for Sport and Exercise Medicine, Loughborough, UK
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Goossens J, Decaesteker T, Jonckheere AC, Seys S, Verelst S, Dupont L, Bullens DMA. How to detect young athletes at risk of exercise-induced bronchoconstriction? Paediatr Respir Rev 2022; 44:40-46. [PMID: 34740520 DOI: 10.1016/j.prrv.2021.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 12/14/2022]
Abstract
Exercise-induced bronchoconstriction (EIB) is a prevalent condition in elite athletes caused by transient airway narrowing during or after exercise. Young athletes nowadays start early to perform high level exercise, highlighting the need to screen for EIB in a younger population. The purpose of this review is to evaluate current evidence of pre-tests with high probability to predict a positive provocation test in young and adolescent athletes, aged 12-24 years and thus indicate whether a young athlete is at risk of having EIB. Up to now, there is no validated screening test available to increase the pre-test probability of a provocation test of EIB in young and adolescent athletes. We would recommend that a clinical guideline committee might consider the development of a flow chart to screen for EIB in adolescent athletes. It could be composed of a symptom-based questionnaire focusing on wheezing during exercise, atopic state, reversibility test (to exclude EIB with asthma) and completed with markers in blood/serum. However, more research is necessary.
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Affiliation(s)
- Janne Goossens
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven 3000, Belgium.
| | - Tatjana Decaesteker
- KU Leuven, Department of Chronic Diseases, Metabolism and Ageing, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Leuven 3000, Belgium
| | - Anne-Charlotte Jonckheere
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven 3000, Belgium
| | - Sven Seys
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven 3000, Belgium
| | - Sophie Verelst
- UZ Leuven, Clinical Division of Paediatrics, Leuven 3000, Belgium
| | - Lieven Dupont
- KU Leuven, Department of Chronic Diseases, Metabolism and Ageing, Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Leuven 3000, Belgium; UZ Leuven, Clinical Division of Respiratory Medicine, Leuven 3000, Belgium
| | - Dominique M A Bullens
- KU Leuven, Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven 3000, Belgium; UZ Leuven, Clinical Division of Paediatrics, Leuven 3000, Belgium
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Salem L, Dao VA, Shah-Hosseini K, de Marees M, Mester J, Mösges R, Vent J. Impaired sports performance of athletes suffering from pollen-induced allergic rhinitis: a cross-sectional, observational survey in German athletes. J Sports Med Phys Fitness 2018; 59:686-692. [PMID: 30009588 DOI: 10.23736/s0022-4707.18.08556-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Allergic rhinitis has major impacts on sports performance of athletes. The present study aimed at determining the frequency of seasonal pollen allergy and analyzing the impacts of pollen allergy, the choice of allergy treatments and their benefits for sports performance in a group of professional and recreational athletes. METHODS The study was conducted as a self-reported questionnaire survey. Subjects were recruited from the German Sport University and the Cologne Marathon 2014 during the peak pollen season of 2014. RESULTS Athletes returned 636 completed questionnaires, 42.6% of participants reported suffering from a pollen allergy and 30.2% also suffered from asthma. Performance impairments were reported in more than 80% of allergic subjects. In all, 82.2% of subjects used symptomatic medications, 32.3% alternative therapies, and 47.6% allergen immunotherapy. Subjects who used immunotherapy had fewer impaired training bouts than those who used symptomatic and alternative therapies. The majority of subjects had concerns about allergy treatment such as side effects, negative impacts on sports performance and lack of long-term effects. CONCLUSIONS This study confirmed a high prevalence of pollen allergy among German athletes. The majority of allergic rhinitis athletes were undertreated, and the reason could be their reservations about allergy treatments. Pollen allergy tremendously reduced sports performance of athletes during the pollen season. This impact can be lessened with proper treatment such as immunotherapy. Better understanding of available treatment modalities should be provided to patients and physicians to improve sports performance of athletes suffering from pollen allergy.
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Affiliation(s)
- Laura Salem
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Van-Anh Dao
- Clinical Research International Ltd. (CRI), Cologne, Germany
| | - Kija Shah-Hosseini
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Markus de Marees
- The German Research Center of Elite Sports, German Sports University of Cologne, Cologne, Germany
| | - Joachim Mester
- The German Research Center of Elite Sports, German Sports University of Cologne, Cologne, Germany
| | - Ralph Mösges
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany.,Clinical Research International Ltd. (CRI), Cologne, Germany
| | - Julia Vent
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine, University of Cologne, Cologne, Germany - .,Department of Otorhinolaryngology, Medical Faculty at Mannheim, University of Heidelberg, Mannheim, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne Medical Center (UKK), Cologne, Germany
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Albuquerque Rodrigues Filho ED, Rizzo JÂ, Gonçalves AV, Correia Junior MADV, Sarinho ESC, Medeiros D. Exercise-induced bronchospasm in children and adolescents with allergic rhinitis by treadmill and hyperventilation challenges. Respir Med 2018; 138:102-106. [PMID: 29724380 DOI: 10.1016/j.rmed.2018.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/18/2018] [Accepted: 04/01/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Respiratory complaints after exercise are common in patients with rhinitis. Exercise-induced bronchospasm (EIB) may be one of the causes. OBJECTIVES To evaluate EIB prevalence in a group of children and adolescents with allergic rhinitis, to compare the treadmill running (TR) and eucapnic voluntary hyperventilation (EVH) challenge methods as diagnostic tools and to assess the association between respiratory complaints on exercise and EIB. METHODS Patients aged between 10 and 20 years were studied at the Pulmonology Department of the Hospital das Clínicas -UFPE- Recife, Brazil. The severity of symptoms of rhinitis and exercise-related respiratory complaints in the past year were evaluated. Challenges were performed in random sequence, no more than 72 h apart and followed international guidelines. Forced expiratory volume in the first second (FEV1) was determined before and 3, 5, 7, 10, 15 and 30 min after each challenge. A >10% reduction in FEV1 from baseline at two points after the challenge was considered sufficient to diagnose EIB. RESULTS Of the thirty-five subjects evaluated, thirteen (37%) showed EIB, six by both methods, three only after TR and four only after EVH (Coens' Kappa = 0.489). There was no association between respiratory complaints after exercise and EIB (p = 0.74). CONCLUSION A high prevalence of EIB was found in this population but only moderate agreement between the challenges used to diagnose EIB. Caution should be adopted when comparing these methods or interpreting their results interchangeably. There was no association between reported respiratory symptoms after exercise and EIB.
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Affiliation(s)
- Edil de Albuquerque Rodrigues Filho
- Health Sciences Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil; Child and Adolescent Health Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - José Ângelo Rizzo
- Health Sciences Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil; Pneumology Department, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil; Center for Research in Allergy and Clinical Immunology, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil; Child and Adolescent Health Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
| | - Adriana Velozo Gonçalves
- Health Sciences Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Marco Aurélio de Valois Correia Junior
- Health Sciences Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil; Center for Research in Allergy and Clinical Immunology, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil; Child and Adolescent Health Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil; Postgraduate Course in Hebiatrics and Physical Education at the University of Pernambuco, Recife, Pernambuco, Brazil
| | - Emanuel Sávio Cavalcanti Sarinho
- Health Sciences Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil; Center for Research in Allergy and Clinical Immunology, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil; Child and Adolescent Health Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Décio Medeiros
- Health Sciences Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil; Center for Research in Allergy and Clinical Immunology, Clinical Hospital, Federal University of Pernambuco, Recife, Brazil; Child and Adolescent Health Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
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