Comparative Effects of a High-Intensity Interval Warm-Up and Salbutamol on the Bronchoconstrictor Response to Exercise in Asthmatic Athletes

Mickleborough, Timothy D.; Lindley, Martin R.; Turner, Louise A.

doi:10.1055/s-2006-924583

Cited by 43 publications

(20 citation statements)

References 34 publications

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“…In the present study, moderate-, alternating (high/low)- and high-intensity warm-up strategies were chosen based on previous findings with hyperpnea [14,32] and with physical exercise warm-up trials [8,10]. According to a recent meta-analysis, most pronounced effects were expected to occur after interval and variable intensity respiratory warm-up since both continuous low- and high-intensity warm-up did not provide significant improvements [13].…”

Section: Discussionmentioning

confidence: 99%

“…All test sessions were scheduled at the same time of day. Inhalation of long-acting and short-acting β 2 -agonists was discontinued for 48h and 8h, respectively, prior to each testing session (except for tests on the 1 st day) while subjects continued taking their maintenance medications, if appropriate, in analogy to a previous study [10]. Subjects completely refrained from physical exercise for 24h and from intake of caffeinated products on test days prior to testing.…”

Section: Methodsmentioning

confidence: 99%

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Pre-Exercise Hyperpnea Attenuates Exercise-Induced Bronchoconstriction Without Affecting Performance

2016

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Whole-body warm-up exercises were shown to attenuate exercise-induced bronchoconstriction (EIB). Whether intense pre-exercise hyperpnea offers similar protection and whether this might negatively affect exercise performance is unknown. Nine subjects with EIB (25±5 yrs; forced expiratory volume in 1s [FEV1], 104±15% predicted) performed an exercise challenge (ECh) followed—after 30min—by a constant-load cycling test to exhaustion. The ECh was preceded by one of four conditions: by i) control warm-up (CON) or by 10min of normocapnic hyperpnea with partial rebreathing at either ii) 50% (WU50) or iii) variable intensity (8x 30s-80%/45s-30%; WU80/30), or at iv) 70% (WU70) of maximal voluntary ventilation. FEV1 was measured at baseline and in 5-min intervals until 15min after CON/warm-up and 30min after ECh. None of the warm-up conditions induced EIB. The maximal post-ECh decrease in FEV1 was -13.8±3.1% after CON, −9.3±5.0% after WU50 (p = 0.081 vs. CON), −8.6±7.5% after WU80/30 (p = 0.081 vs. CON) and −7.2±5.0% after WU70 (p = 0.006 vs. CON), and perception of respiratory exertion was significantly attenuated (all p≤0.048), with no difference between warm-up conditions. Only after CON, FEV1 remained significantly reduced up to the start of the cycling endurance test (−8.0±4.3%, p = 0.004). Cycling performance did not differ significantly between test days (CON: 13±7min; WU50: 14±9min; WU80/30: 13±9min; WU70: 14±7min; p = 0.582). These data indicate that intense hyperpnea warm-up is effective in attenuating EIB severity and accelerating lung function recovery while none of the warm-up condition do compromise cycling performance.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Pre-Exercise Hyperpnea Attenuates Exercise-Induced Bronchoconstriction Without Affecting Performance

2016

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“…However, another study found protective effects from high-intensity interval warm-up. 70 Different study protocols and designs make it diffi cult to compare the existing studies, but physical warm-up in some form and extent generally seems to have a protective effect on EIA, and physical warm-up should be advised for all athletes with asthma.…”

Section: Nonpharmacologic Interventionsmentioning

confidence: 99%

Asthma in Elite Athletes: Pathogenesis, Diagnosis, Differential Diagnoses, and Treatment

Pedersen

Elers

Backer

2011

The Physician and Sportsmedicine

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Elite athletes have a high prevalence of asthma and exercise-induced bronchoconstriction. Although respiratory symptoms can be suggestive of asthma, the diagnosis of asthma in elite athletes cannot be based solely on the presence or absence of symptoms; diagnosis should be based on objective measurements, such as the eucapnic voluntary hyperpnea test or exercise test. When considering that not all respiratory symptoms are due to asthma, other diagnoses should be considered. Certain regulations apply to elite athletes who require asthma medication for asthma. Knowledge of these regulations is essential when treating elite athletes. This article is aimed at physicians who diagnose and treat athletes with respiratory symptoms. It focuses on the pathogenesis of asthma and exercise-induced bronchoconstriction in elite athletes and how the diagnosis can be made. Furthermore, treatment of elite athletes with asthma, anti-doping regulations, and differential diagnoses such as exercise-induced laryngomalacia are discussed.

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“…Warm-up exercise before intense exercise has long been recognised as having an inhibitory effect on EIB,60 and this approach enhances the benefit of a β 2 agonist 61. A refractory period (usually <2 h), follows EIB in about 50% of asthmatic subjects 62.…”

Section: Management Of Eibmentioning

confidence: 99%

Assessment and prevention of exercise-induced bronchoconstriction

Anderson

Kippelen

2012

Br J Sports Med

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The assessment of exercise-induced bronchoconstriction (EIB) in athletes requires the measurement of forced expiratory volume in 1 s (FEV(1)) before and after vigorous exercise or a surrogate of exercise such as eucapnic voluntary hyperpnoea (EVH) of dry air or mannitol dry powder. Exercise testing in a laboratory has a low sensitivity to identify EIB, and exercise testing in the field can be a challenge in itself particularly in cold weather athletes. The EVH test requires the subject to ventilate dry air containing ∼5% CO(2) for 6 min through a low-resistance circuit at a rate higher than that usually achieved on maximum exercise. A ≥10% reduction in FEV(1) is a positive response to exercise and EVH and, when sustained, is usually associated with release of inflammatory mediators of broncho constriction. Another surrogate, mannitol dry powder, given by inhalation in progressively increasing doses, is used to mimic the dehydrating stimulus of exercise hyperpnoea. A positive mannitol test is a 15% fall in FEV(1) at ≤635 mg and reveals potential for EIB. Mannitol has a high specificity for identifying a clinical diagnosis of asthma. Once a diagnosis of EIB is established, the athlete needs to know how to avoid EIB. Being treated daily with an inhaled corticosteroid to reduce airway inflammation, inhaling a β(2) agonist or a cromone immediately before exercise, or taking a leukotriene antagonist several hours before exercise, all inhibit or prevent EIB. Other strategies include warming up prior to exercise and reducing respiratory water and heat loss by using face masks or nasal breathing.

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Comparative Effects of a High-Intensity Interval Warm-Up and Salbutamol on the Bronchoconstrictor Response to Exercise in Asthmatic Athletes

Cited by 43 publications

References 34 publications

Pre-Exercise Hyperpnea Attenuates Exercise-Induced Bronchoconstriction Without Affecting Performance

Pre-Exercise Hyperpnea Attenuates Exercise-Induced Bronchoconstriction Without Affecting Performance

Asthma in Elite Athletes: Pathogenesis, Diagnosis, Differential Diagnoses, and Treatment

Assessment and prevention of exercise-induced bronchoconstriction

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