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Diagnosis and management of exercise induced bronchoconstriction in athletes

Jackson, Anna Rose (2018) Diagnosis and management of exercise induced bronchoconstriction in athletes. Doctor of Philosophy (PhD) thesis, University of Kent,. (KAR id:73067)

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Abstract

It is now well established that there is a high prevalence of exercise-induced bronchoconstriction (EIB) amongst athletes. There is still debate however regarding the optimal method of diagnosis in this group and current treatment guidelines are mainly based on recommendations for the general population with asthma. The aim of this thesis was to address these gaps in the literature by investigating methods of diagnosing EIB, the impact of standard asthma treatment upon airway inflammation, EIB severity, health and performance in elite athletes, and the effect of reducing environmental exposure upon EIB severity.

Study 2 reports results of the largest EIB screening in elite footballers to date and evaluates the prevalence of EIB and the impact of standard asthma therapy on airway health and exercise performance. Ninety-seven male professional football players completed an EVH challenge. Players demonstrating a positive result (EVH+) were prescribed standard asthma therapy and underwent repeat assessment after 9 weeks of treatment. Eight players (3 EVH+, 5 EVH-) completed a V̇O2 peak test at initial and follow-up assessments. Of the 97 players, 27 (28%) demonstrated EVH+. Seven of the 27 (24%) EVH+ players attended follow-up and demonstrated improved post-challenge spirometry (FEV1 post-test; pre = -22.9 ± 15.4%, post = -9.0 ± 1.6%, p = 0.018). At follow-up V̇O2 peak improved by 3.4 ± 2.9 ml/kg/min in EVH+ players compared to 0.1 ± 2.3 ml.kg-1.min-1 in EVH- players. It was concluded that elite footballers have a high EIB prevalence and treatment with inhaler therapy reduces EIB severity and may also lead to improved exercise performance.

Study 4 investigated if a heat and moisture exchange mask (HME) face mask could be effective in protecting against EIB in response to a cycle challenge in a cold, dry environment (9°C, 24% RH) in asthmatic individuals. Seventeen participants completed three EXs on a cycle ergometer wearing either an HME mask (MASK), a sham mask (SHAM) or no mask (CON) in a randomised order. There was a significant difference in the % fall in FEV1 following EX (MASK: -6.00, SHAM: -10.00, CON: -13.00%, p

Item Type: Thesis (Doctor of Philosophy (PhD))
Thesis advisor: Dickinson, John
Thesis advisor: Hopker, James
Thesis advisor: Hull, James
Uncontrolled keywords: EIB Asthma Athletes Bronchoconstriction Treatment EVH
Subjects: Q Science
Divisions: Divisions > Division of Natural Sciences > School of Sport and Exercise Sciences
SWORD Depositor: System Moodle
Depositing User: System Moodle
Date Deposited: 19 Mar 2019 08:10 UTC
Last Modified: 16 Feb 2021 14:03 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/73067 (The current URI for this page, for reference purposes)
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