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SCREENING FOR EXERCISE INDUCED BRONCHOCONSTRCTION IN HIGH LEVEL ATHLETES

L Stephens

Abstract

Luke Stephens

University of Missouri, Columbia, Missouri

INTRODUCTION: Exercise induced bronchoconstriction (EIB) is a common respiratory ailment that affects athletes of all levels of competition. Screening for EIB in athletes has historically occurred preferentially in those determined to be at risk for EIB, as determined by self-reported symptoms or physician directed history. However, this approach has been shown by numerous prior studies to exclude a significant portion of athletes that will have objective evidence of EIB upon formal testing. The goal of screening for EIB is to correctly identify athletes whose performance will be negatively affected by this respiratory process, so they can be directed to treatment and therefore more able to achieve their ideal cardiopulmonary performance during competition. This review will include a discussion of prior attempts at screening both individual and team sport high level athletes for EIB and highlight the methods that have been successful at this stated goal of screening. DISUCSSION: EIB has shown a significant prevalence within Olympic and college individual and team sport athletes. Prior studies have shown prolonged endurance training can precipitate objective bronchoconstriction in athletes, who will then not have evidence of bronchoconstriction during low or no training periods. This inducible effect of training further complicates the screening process. Clinical symptoms of EIB are not consistent with objective measurement of decreases in post-exertion respiratory function. Confirmation of diagnosis of EIB is elusive, as a gold standard test for EIB does not exist, and different methods for diagnosis have not shown reliable confirmation amongst themselves. CONCLUSION: Screening for EIB must include objective assessment of respiratory function at baseline and following bronchoprovocation of an appropriate method and must be applied to all high level athletes to ensure appropriate diagnosis. Several different testing methods are appropriate for this objective assessment for the diagnosis of EIB. The most appropriate screening method for EIB in high level athletes should be chosen based upon the specific population, competition and training environment, cardiopulmonary demands of their chosen sport, and the resources of that respective sports program.

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