Self-reported symptoms and exercise-induced asthma in the elite athlete

• Published in: Medicine and science in sports and exercise 2001-02, Vol.33 (2), p.208-213
• Main Authors: RUNDELL, Kenneth W, IM, Joohee, MAYERS, Lester B, WILBER, Randall L, SZMEDRA, Leon, SCHMITZ, Heather R
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Asthma, Exercise-Induced - pathology; Biological and medical sciences; Bronchial Spasm; Chronic obstructive pulmonary disease, asthma; Cross-Sectional Studies; Exercise - physiology; Female; Forced Expiratory Volume; Humans; Male; Medical sciences; Physical Endurance; Pneumology; Severity of Illness Index; Space life sciences; Sports; Temperature
• ISSN: 0195-9131; 1530-0315
• DOI: 10.1097/00005768-200102000-00006

The purpose of this study was to compare self-reported symptoms for exercise-induced asthma (EIA) to postexercise challenge pulmonary function test results in elite athletes. Elite athletes (N = 158; 83 men and 75 women; age: 22 +/- 4.4 yr) performed pre- and post-exercise spirometry and were grouped according to postexercise pulmonary function decrements (PFT-positive, PFT-borderline, and PFT-normal for EIA). Before the sport/environment specific exercise challenge, subjects completed an EIA symptoms-specific questionnaire. Resting FEV1 values were above predicted values (114--121%) and not different between groups. Twenty-six percent of the study population demonstrated >10% postexercise drop in FEV1 and 29% reported two or more symptoms. However, the proportion of PFT-positive and PFT-normal athletes reporting two or more symptoms was not different (39% vs. 41%). Postrace cough was the most reported symptom, reported significantly more frequently for PFT-positive athletes (P < 0.05). Sensitivity/specificity analysis demonstrated a lack of effectiveness of self-reported symptoms to identify PFT-positive or exclude PFT-normal athletes. Postexercise lower limit reference ranges (MN-2SDs) were determined from normal athletes for FEV1, FEF25--75% and PEF to be -7%, -12.5%, and -18%, respectively. Although questionnaires provide reasonable estimates of EIA prevalence among elite cold-weather athletes, the use of self-reported symptoms for EIA diagnosis in this population will likely yield high frequencies of both false positive and false negative results. Diagnosis should include spirometry using an exercise/environment specific challenge in combination with the athlete's history of asthma symptoms.