Misdiagnosis of exercise-induced bronchoconstriction in professional soccer players

Ansley, Les, Kippelen, Pascale, Dickinson, John W. and Hull, James (2012) Misdiagnosis of exercise-induced bronchoconstriction in professional soccer players. Allergy, 67 (3). pp. 390-395. ISSN 0105-4538

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Official URL: http://dx.doi.org/10.1111/j.1398-9995.2011.02762.x

Abstract

Background
Physicians typically rely heavily on self-reported symptoms to make a diagnosis of exercise-induced bronchoconstriction (EIB). However, in elite sport, respiratory symptoms have poor diagnostic value. In 2009, following a change in international sports regulations, all elite athletes suspected of asthma and/or EIB were required to undergo pulmonary function testing (PFT) to permit the use of inhaled β2-agonists. The aim of this study was to examine the diagnostic accuracy of physician diagnosis of asthma/EIB in English professional soccer players.

Methods
Sixty-five players with a physician diagnosis of asthma/EIB were referred for pulmonary function assessment. Medication usage and respiratory symptoms were recorded by questionnaire. A bronchial provocation test with dry air was conducted in 42 players and a mannitol challenge in 18 players. Five players with abnormal resting spirometry performed a bronchodilator test.

Results
Of the 65 players assessed, 57 (88%) indicated regular use of asthma medication. Respiratory symptoms during exercise were reported by 57 (88%) players. Only 33 (51%) of the players tested had a positive bronchodilator or bronchial provocation test. Neither symptoms nor the use of inhaled corticosteroids were predictive of pulmonary function tests’ outcome.

Conclusion
A high proportion of English professional soccer players medicated for asthma/EIB (a third with reliever therapy only) do not present reversible airway obstruction or airway hyperresponsiveness to indirect stimuli. This underlines the importance of objective PFT to support a symptoms-based diagnosis of asthma/EIB in athletes.

Item Type: Article
Uncontrolled Keywords: asthma, athletes, bronchial provocation, eucapnic voluntary hyperpnoea, football, mannitol
Subjects: C600 Sports Science
Department: Faculties > Health and Life Sciences > School of Life Sciences > Sport, Exercise and Rehabilitation
Depositing User: Ay Okpokam
Date Deposited: 19 Jan 2012 13:48
Last Modified: 10 Aug 2015 11:35
URI: http://nrl.northumbria.ac.uk/id/eprint/4579

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