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      Evaluation of exercise-induced bronchoconstriction and rhinitis in adolescent elite swimmers

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          Abstract

          OBJECTIVE:

          Exercise-induced bronchoconstriction (EIB) without asthma and non-allergic rhinitis is frequently reported in athletes who are facing high-risk of airway dysfunctions such as elite swimmers. Therefore, we aimed to evaluate the effect of exercise on nasal and pulmonary functions, additionally to determine the prevalence of EIB and rhinitis in adolescent elite swimmers.

          METHODS:

          The study included 47 adolescent licensed-swimmers (26 males and 21 females) aged between 10 and 17 years old. The prevalence of asthma and allergic disease and the symptom severity scores measured before and after swimming training were assessed through an interview form which includes information related to our study goal. In addition, acoustic rhinometry was utilized to evaluate nasal airway, spirometry was utilized to evaluate EIB in accordance with standard protocols.

          RESULTS:

          Six swimmers had a history of allergic rhinitis (12.8%), while three (6.4%) had asthma. Post-swim mean forced vital capacity (FVC) was significantly higher than pre-swim FVC (p=0.019) and forced expiratory volume 1 (FEV-l)/FVC ratio was significantly lower than pre-swim FEV-l/FVC ratio (p=0.034). In addition, the prevalence of EIB was 8.5%. Moreover, level of nasal discharge statistically increased in post-swim period (p=0.003).

          CONCLUSION:

          We have documented that swimming cause’s nasal discharge but do not effect nasal passages. In addition, we observed that the overall prevalence of EIB in swimmers was not different from that of the general population, furthermore swimming exercise significantly increased FVC of swimmers. Therefore, we concluded swimming training can be recommended for children diagnosed with asthma or allergic rhinitis.

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          Inflammatory basis of exercise-induced bronchoconstriction.

          Mark Wurfel, Teal S. Hallstrand, R. C. W. Henderson … (2005)
          Exercise-induced bronchoconstriction (EIB) is a highly prevalent condition with unclear pathogenesis. Two competing theories of the pathogenesis of EIB differ regarding the inflammatory basis of this condition. Our goals were to establish whether epithelial cell and mast cell activation with release of inflammatory mediators occurs during EIB and how histamine and cysteinyl leukotriene antagonists alter the airway events occurring during EIB. Induced sputum was used to measure mast cell mediators and eicosanoids at baseline and 30 minutes after exercise challenge in 25 individuals with asthma with EIB. In a randomized, double-blind crossover study, the cysteinyl leukotriene antagonist montelukast and antihistamine loratadine or two matched placebos were administered for two doses before exercise challenge. The percentage of columnar epithelial cells in induced sputum at baseline was associated with the severity of EIB. After exercise challenge, histamine, tryptase, and cysteinyl leukotrienes significantly increased and prostaglandin E(2) and thromboxane B(2) significantly decreased in the airways, and there was an increase in columnar epithelial cells in the airways. The concentration of columnar epithelial cells was associated with the levels of histamine and cysteinyl leukotrienes in the airways. Treatment with montelukast and loratadine inhibited the release of cysteinyl leukotrienes and histamine into the airways, but did not inhibit the release of columnar epithelial cells into the airways. These data indicate that epithelial cells, mast cell mediators, and eicosanoids are released into the airways during EIB, supporting an inflammatory basis for EIB.
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            Exercise-induced bronchoconstriction in school-aged children who had chronic lung disease in infancy.

            Nicholas W. Watkins, Nathalie E. Williams, Suchita Joshi … (2013)
            To assess for exercise-induced bronchoconstriction in 8- to 12-year-old children who had chronic lung disease (CLD) in infancy, and to evaluate the response of bronchoconstriction to bronchodilation with albuterol in comparison with preterm and term controls. Ninety-two children, including 29 with CLD, 33 born preterm at ≤32 weeks' gestation, and 30 born at term, underwent lung spirometry before and after cycle ergometry testing and after postexercise bronchodilation with albuterol. Doctor-diagnosed asthma and exercise-induced wheeze were reported more frequently in the CLD group than in the preterm and term groups, but only 10% were receiving a bronchodilator. There were no differences among the groups in peak minute ventilation, oxygen uptake, or carbon dioxide output at maximum exercise. After maximal exercise, predicted forced expiratory volume in 1 second (FEV1) decreased from a mean baseline value of 81.9% (95% CI, 76.6-87.0%) to 70.8% (95% CI, 65.5-76.1%) after exercise in the CLD group, from 92.0% (95% CI, 87.2-96.8%) to 84.3% (95% CI, 79.1-89.4%) in the preterm group, and from 97.5% (95% CI, 92.5-102.6%) to 90.3% (95% CI, 85.1-95.5%) in the term group. After albuterol administration, FEV1 increased to 86.8% (95% CI, 81.7-92.0%) in the CLD group, 92.1% (95% CI, 87.3-96.9%) in the preterm group, and 97.1% (95% CI, 92.0-102.3%) in the term group. The decrease in predicted FEV1 after exercise and increase in predicted FEV1 after bronchodilator use were greatest in the CLD group (-11.0% [95% CI, -18.4 to -3.6%] and 16.0% [95% CI, 8.6-23.4%], respectively; P < .005 for both), with differences of <8% in the 2 control groups. School-age children who had CLD in infancy had significant exercise-induced bronchoconstriction that responded significantly to bronchodilation. Reversible exercise-induced bronchoconstriction is common in children who experienced CLD in infancy and should be actively assessed for and treated. Copyright © 2013 Mosby, Inc. All rights reserved.
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              Effects of concurrent inspiratory and expiratory muscle training on respiratory and exercise performance in competitive swimmers.

              Scott Thomas, Michael Plyley, Gary G. Wells … (2005)
              The efficiency of the respiratory system presents significant limitations on the body's ability to perform exercise due to the effects of the increased work of breathing, respiratory muscle fatigue, and dyspnoea. Respiratory muscle training is an intervention that may be able to address these limitations, but the impact of respiratory muscle training on exercise performance remains controversial. Therefore, in this study we evaluated the effects of a 12-week (10 sessions week(-1)) concurrent inspiratory and expiratory muscle training (CRMT) program in 34 adolescent competitive swimmers. The CRMT program consisted of 6 weeks during which the experimental group (E, n = 17) performed CRMT and the sham group (S, n = 17) performed sham CRMT, followed by 6 weeks when the E and S groups performed CRMT of differing intensities. CRMT training resulted in a significant improvement in forced inspiratory volume in 1 s (FIV1.0) (P = 0.050) and forced expiratory volume in 1 s (FEV1.0) (P = 0.045) in the E group, which exceeded the S group's results. Significant improvements in pulmonary function, breathing power, and chemoreflex ventilation threshold were observed in both groups, and there was a trend toward an improvement in swimming critical speed after 12 weeks of training (P = 0.08). We concluded that although swim training results in attenuation of the ventilatory response to hypercapnia and in improvements in pulmonary function and sustainable breathing power, supplemental respiratory muscle training has no additional effect except on dynamic pulmonary function variables.
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                Author and article information

                Journal
                Journal ID (nlm-ta): North Clin Istanb
                Journal ID (iso-abbrev): North Clin Istanb
                Title: Northern Clinics of Istanbul
                Publisher: Kare Publishing (Turkey )
                ISSN (Print): 2148-4902
                ISSN (Electronic): 2536-4553
                Publication date Collection: 2021
                Publication date (Electronic): 20 October 2021
                Volume: 8
                Issue: 5
                Pages: 493-499
                Affiliations
                [1 ]Department of Otorhinolaryngology, Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
                [2 ]Department of Pulmonology, Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
                Author notes
                Correspondence: Nurullah SEYHUN, MD. Saglik Bilimleri Universitesi, Sisli Hamidiye Etfal Egitim ve Arastirma Hastanesi, Kulak Burun Bogaz Klinigi, Istanbul, Turkey. Tel: +90 212 373 50 00 e-mail: seyhun90@ 123456hotmail.com
                Article
                Publisher ID: NCI-8-493
                DOI: 10.14744/nci.2021.99327
                PMC ID: 8630724
                PubMed ID: 34909588
                SO-VID: 3dd6663a-5cea-419e-811b-cffbf0f31059
                Copyright © Copyright: © 2021 by Istanbul Northern Anatolian Association of Public Hospitals
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

                History
                Date received : 03 July 2020
                Date accepted : 23 January 2021
                Categories
                Subject: Original Article

                Keywords: exercise,exercise-induced bronchospasm,nasal symptoms,pulmonary functions,rhinitis,swimmers
                Data availability:
                Keywords: exercise, exercise-induced bronchospasm, nasal symptoms, pulmonary functions, rhinitis, swimmers

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