Exercise and other indirect challenges to demonstrate asthma or exercise-induced bronchoconstriction in athletes
Received 10 April 2008; received in revised form 30 May 2008; accepted 2 June 2008.
The prevalence of exercise-induced bronchoconstriction is reported to be high among recreational and elite athletes, yet diagnosis is often symptom-based. Indirect challenges such as the laboratory exercise challenge provide objective criteria for proper diagnosis and treatment. However, a standardized protocol using appropriate exercise intensity, duration, and dry air inhalation is often not implemented, and thus a false-negative test may result. This article reviews and describes the symptom-based diagnosis, the exercise challenge, and other indirect challenges such as eucapnic voluntary hyperpnea, hypertonic saline inhalation, and inhaled powdered mannitol as methods to diagnose and evaluate exercise-induced bronchoconstriction. Advantages and disadvantages of each diagnostic procedure are presented.
Human Physiology Laboratory, Keith J. O'Neill Center for Healthy Families, Marywood University, Scranton, Pa
Reprint requests: Kenneth W. Rundell, PhD, Director or Respiratory Research and the Human Physiology Laboratory, Keith J. O'Neill Center for Healthy Families, Marywood University, Scranton, PA 18509.
(Supported by an educational grant from Merck & Co., Inc.)
Series editors: Joshua A. Boyce, MD, Fred Finkelman, MD, William T. Shearer, MD, PhD, and Donata Vercelli, MD
Research by K.W.R. is supported by the American Heart Association and the World Anti-Doping Agency. Clinical trials performed in the Human Physiology Laboratory are supported by Forest Laboratories, Merck Inc, Pharmaxis, Schering-Plough, and SkyePharma.
Terms in boldface and italics are defined in the glossary on page 239.
ABSTRACT