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Self-reported Symptoms after Induced and Inhibited Bronchoconstriction in Athletes.
Med Sci Sports Exerc. 2015 Oct; 47(10):2005-13.MS

Abstract

PURPOSE

A change in the perception of respiratory symptoms after treatment with inhaled beta2 agonists is often used to aid diagnosis of exercise-induced bronchoconstriction (EIB). Our aim was to test the association between subjective ratings of respiratory symptoms and changes in airway caliber after induced and inhibited bronchoconstriction in athletes with EIB.

METHODS

Eighty-five athletes with diagnosed or suspected EIB performed a eucapnic voluntary hyperpnea (EVH) challenge with dry air. Of the 45 athletes with hyperpnea-induced bronchoconstriction [i.e., post-EVH fall in forced expiratory volume in 1 s (FEV1) ≥10%, EVH], 36 were randomized in a double-blind, placebo-controlled, crossover study. Terbutaline (0.5 mg) or placebo was administered by inhalation 15 min before EVH. Spirometry (for FEV1) was performed before and after EVH, and respiratory symptoms were recorded 15 min after EVH on visual analog scales.

RESULTS

Terbutaline inhibited bronchoconstriction (i.e., maximal fall in FEV1 <10% after EVH) in 83% of the EVH-positive athletes, with an average degree of bronchoprotection of 53% (95% confidence interval [CI], 45% to 62%). Terbutaline reduced group mean symptom scores (P < 0.01), but the degree of bronchoprotection did not correlate with individual differences in symptom scores between terbutaline and placebo. Of the 29 athletes who had less than 10% FEV1 fall after EVH in the terbutaline condition, almost half (48%) rated at least one respiratory symptom higher under terbutaline, and more than one quarter (28%) had a higher total symptom score under terbutaline.

CONCLUSION

Self-reports of respiratory symptoms in conditions of induced and inhibited bronchoconstriction do not correlate with changes in airway caliber in athletes with EIB. Therefore, subjective ratings of respiratory symptoms after treatment with inhaled beta2 agonists should not be used as the sole diagnostic tool for EIB in athletes.

Authors+Show Affiliations

Centre for Sports Medicine and Human Performance, Department of Life Sciences, Brunel University London, UNITED KINGDOM.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

25710876

Citation

Simpson, Andrew J., et al. "Self-reported Symptoms After Induced and Inhibited Bronchoconstriction in Athletes." Medicine and Science in Sports and Exercise, vol. 47, no. 10, 2015, pp. 2005-13.
Simpson AJ, Romer LM, Kippelen P. Self-reported Symptoms after Induced and Inhibited Bronchoconstriction in Athletes. Med Sci Sports Exerc. 2015;47(10):2005-13.
Simpson, A. J., Romer, L. M., & Kippelen, P. (2015). Self-reported Symptoms after Induced and Inhibited Bronchoconstriction in Athletes. Medicine and Science in Sports and Exercise, 47(10), 2005-13. https://doi.org/10.1249/MSS.0000000000000646
Simpson AJ, Romer LM, Kippelen P. Self-reported Symptoms After Induced and Inhibited Bronchoconstriction in Athletes. Med Sci Sports Exerc. 2015;47(10):2005-13. PubMed PMID: 25710876.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Self-reported Symptoms after Induced and Inhibited Bronchoconstriction in Athletes. AU - Simpson,Andrew J, AU - Romer,Lee M, AU - Kippelen,Pascale, PY - 2015/2/25/entrez PY - 2015/2/25/pubmed PY - 2016/6/10/medline SP - 2005 EP - 13 JF - Medicine and science in sports and exercise JO - Med Sci Sports Exerc VL - 47 IS - 10 N2 - PURPOSE: A change in the perception of respiratory symptoms after treatment with inhaled beta2 agonists is often used to aid diagnosis of exercise-induced bronchoconstriction (EIB). Our aim was to test the association between subjective ratings of respiratory symptoms and changes in airway caliber after induced and inhibited bronchoconstriction in athletes with EIB. METHODS: Eighty-five athletes with diagnosed or suspected EIB performed a eucapnic voluntary hyperpnea (EVH) challenge with dry air. Of the 45 athletes with hyperpnea-induced bronchoconstriction [i.e., post-EVH fall in forced expiratory volume in 1 s (FEV1) ≥10%, EVH], 36 were randomized in a double-blind, placebo-controlled, crossover study. Terbutaline (0.5 mg) or placebo was administered by inhalation 15 min before EVH. Spirometry (for FEV1) was performed before and after EVH, and respiratory symptoms were recorded 15 min after EVH on visual analog scales. RESULTS: Terbutaline inhibited bronchoconstriction (i.e., maximal fall in FEV1 <10% after EVH) in 83% of the EVH-positive athletes, with an average degree of bronchoprotection of 53% (95% confidence interval [CI], 45% to 62%). Terbutaline reduced group mean symptom scores (P < 0.01), but the degree of bronchoprotection did not correlate with individual differences in symptom scores between terbutaline and placebo. Of the 29 athletes who had less than 10% FEV1 fall after EVH in the terbutaline condition, almost half (48%) rated at least one respiratory symptom higher under terbutaline, and more than one quarter (28%) had a higher total symptom score under terbutaline. CONCLUSION: Self-reports of respiratory symptoms in conditions of induced and inhibited bronchoconstriction do not correlate with changes in airway caliber in athletes with EIB. Therefore, subjective ratings of respiratory symptoms after treatment with inhaled beta2 agonists should not be used as the sole diagnostic tool for EIB in athletes. SN - 1530-0315 UR - https://www.unboundmedicine.com/medline/citation/25710876/Self_reported_Symptoms_after_Induced_and_Inhibited_Bronchoconstriction_in_Athletes_ L2 - https://doi.org/10.1249/MSS.0000000000000646 DB - PRIME DP - Unbound Medicine ER -