Impact of exercise-induced bronchoconstriction on athletic performance and airway health in rugby union players

Background: There is emerging evidence that the prevalence of exercise-induced bronchospasm (EIB) is significantly under-reported in many sports. There is little known about the potential performance improvement that may exist when sports players are detected and treated for EIB. Methods: Professional rugby union players with no previous history of asthma volunteered to participate in the study. Each player performed the rugby football union (RFU) fitness test and completed a eucapnic voluntary hyperpnoea (EVH) challenge at baseline and 12 weeks later. A player with a positive EVH result was prescribed beclomethasone inhaler (200 µg; two puffs per day) for 12 weeks. Players with a negative EVH test were randomly allocated to either a placebo inhaler group or acted as controls. Results: Twenty-nine rugby union players (mean ± SD; age 22.1 ± 4.2 years; body mass 100.1 ± 6.9 kg; height 1.84 ± 0.07 m) were recruited. Seven players (24% of total) had a positive EVH challenge with a mean decrease in FEV1 of -13.6 ±3.5 % from baseline. There was no significant group difference (P=0.359)in performance improvement of the RFU fitness test between the EVH positive group (mean ?: -22.3 seconds; 8.0 ± 2.8% improvement), placebo group (mean ?: -16.5 seconds; 6.7 ± 1.6% improvement), and controls (mean ?: -12.2 seconds; 5.7 ± 3.5% improvement). Conclusion: Prevalence of EIB in professional rugby union players was 24%. A 12-week prescription of beclomethasone (200 µg) showed similar improvements in RFU fitness test performance in players diagnosed with EIB compared to players with healthy airway responsiveness.