Exercise-induced bronchoconstriction in athletes - A qualitative assessment of symptom perception.
A poor relationship between perceived respiratory symptoms and objective evidence of exercise-induced bronchoconstriction (EIB) in athletes is often reported; however, the reasons for this disconnect remain unclear. The primary aim of this study was to utilise a qualitative-analytical approach to compare respiratory symptoms in athletes with and without objectively confirmed EIB.



Endurance athletes who had previously undergone bronchoprovocation test screening for EIB were divided into sub-groups, based on the presence or absence of EIB ± heightened self-report of dyspnoea: (i) EIB-Dys- (ii) EIB + Dys+ (iii) EIB + Dys- (iv) EIB-Dys+. All athletes underwent a detailed semi-structured interview.



Twenty athletes completed the study with an equal distribution in each sub-group (n = 5). Thematic analysis of individual narratives resulted in four over-arching themes: 1) Factors aggravating dyspnoea, 2) Exercise limitation, 3) Strategies to control dyspnoea, 4) Diagnostic accuracy. The anatomical location of symptoms varied between EIB + Dys + athletes and EIB-Dys + athletes. All EIB-Dys + reported significantly longer recovery times following high-intensity exercise in comparison to all other sub-groups. Finally, EIB + Dys + reported symptom improvement following beta-2 agonist therapy, whereas EIB-Dys + deemed treatment ineffective.



A detailed qualitative approach to the assessment of breathlessness reveals few features that distinguish between EIB and non-EIB causes of exertional dyspnoea in athletes. Important differences that may provide value in clinical work-up include (i) location of symptoms, (ii) recovery time following exercise and (iii) response to beta-2 agonist therapy. Overall these findings may inform clinical evaluation and development of future questionnaires to aid clinic-based assessment of athletes with dyspnoea.
Carnegie School of Sport, Leeds Beckett University, Leeds, UK. Electronic address: o.price@leedsbeckett.ac.uk.
Oliver J
OJ
Price
Department of Respiratory Medicine, Royal Brompton Hospital, UK.
James H
JH
Hull
Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
Les
L
Ansley
Primary Care and Population Science, Faculty of Medicine, University of Southampton, Southampton, UK.
Mike
M
Thomas
Primary Care and Population Science, Faculty of Medicine, University of Southampton, Southampton, UK.
Caroline
C
Eyles
D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use; D000328:Adult; D001250:Asthma, Exercise-Induced / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D056352:Athletes; D016084:Bronchoconstriction / Q000187:drug effects / Q000502:physiology*; D059026:Diagnostic Self Evaluation; D004417:Dyspnea / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D005069:Evaluation Studies as Topic; D015444:Exercise / Q000502:physiology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D012129:Respiratory Function Tests / Q000379:methods; D057566:Self Report; D011795:Surveys and Questionnaires; D014797:Vital Capacity
D058666:Adrenergic beta-2 Receptor Agonists
Athletes; Dyspnoea; Exercise-induced bronchoconstriction; Perception; Qualitative methods; Respiratory symptoms