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Home CCSU Theses & Dissertations Exercise-induced bronchoconstriction: mechanisms, evaluation, and treatment / Sean P. Riley

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Exercise-induced bronchoconstriction: mechanisms, evaluation, and treatment / Sean P. Riley

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Identifier	Thesis 1610
Author	Riley, Sean P
Title	Exercise-induced bronchoconstriction: mechanisms, evaluation, and treatment / Sean P. Riley
Publisher	Central Connecticut State University
Date	2000
Resource Type	Master's Thesis
Notes	Exercise-induced asthma, more accurately called exercise induced bronchoconstriction (EIB) has been defined as a clinical syndrome characterized by transient airflow obstruction following several minutes of exercise. EIB is also recognized as exercise that reduces peak expiratory flow rate (PEFR) or the forced expiratory volume in 1 second (FEV1) by at least 10% when compared with pre-exercise values. EIB is currently understood as an airflow obstruction that develops with exercise and that is related to thermal events within the intrathoracic airways. During exercise hyperpnea, the upper airway is unable to adequately warm and humidify inspired air to body temperature and 100% saturation. As a result, the lower tracheobronchial tree loses heat and water resulting in bronchoconstriction. Once an athlete has been identified as having EIB their peak expiratory flow rate (PEFR L/min) should be taken using a peak flow meter. The average of 3 forceful expirations are taken. This measurement in the athlete with EIB should represent their normal PEFR, which is then recorded and used as a baseline measurement. Athletes should be instructed to avoid cold, dry climates as much as possible. A prolonged warmup period prior to exercise can be effective in decreasing the degree of bronchoconstriction in some athletes. Warm, humid environments or breathing warm air will improve EIB and will improve the athlete's chance of being refractory to further episodes of EIB during repeated exercise challenges over the next 1 to 3 hours. Wearing a face mask during activity warms and humidifies the inspired air when outdoors in cold dry conditions. Additionally, breathing through the nose rather than the mouth will filter, humidify, and warm the inspired air. Breathing slowly through the nose not only helps to warm and humidify the air but also helps to reduce hyperventilation. A face mask can be helpful by creating a modest "rebreathing environment". During the Eastern Athletic Trainers Association Annual Meeting, January 12, 1999, Rogers presented the Asthma Watch Program, which was created by the Temple University Sports Medicine and Pulmonary Critical Care Unit. The premise of this program is that athletes, when cleared for participation, are only cleared conditionally. This program enpowers sports medicine professionals to revoke clearance when specific conditions are not adhered to. Currently there are very few guidelines and emergency action plans in place to prevent and treat EIB in the sports medicine setting. It is recommended that treatment of EIB begin during the preseason. Athletes who have a history of EIB or a history of respiratory problems stemming from allergies should have their PEFR taken with a peak flow meter during preseason. This value is now a baseline objective measurement that can be used as criteria for reentry into an event. To be effective, the baseline PEFR and a peak flow meter has to be accessible to the sports medicine professional on the field. Under normal circumstances, the conditions of the Asthma Watch Program should be observed. The certified athletic trainer (ATC) should have knowledge of the athletes history of EIB and a recording of the baseline PEFR. The history should include type of medication and dosage. This information should be easily accessible to the ATC during any athletic event, including-practice. The athlete should have two rescue metered-dose inhalers (MDI), one that they keep with them and one that stays with the athletic trainer. If an athlete has to use their rescue medication during practice they should not be allowed to immediately reenter the practice or game. They should be observed until their PEFR is within 80-100% of their normal resting value. To treat the athlete that suffers from EIB, the athlete must have a MDI that is actually prescribed to him or her. Depending on the institution's local protocol, medical control or the team physician should be contacted before you assist with the administration of the inhaler. Understanding EIB and following recommendations that may prevent EIB will help sports medicine professionals to be better prepared to care for those individuals with EIB.
Subject	Bronchoconstrictor agents Bronchodilator agents Exercise -- Physiological aspects
Department	Department of Biological Sciences
Advisor	Rollin, Ruth
Type	Text
Digital Format	application/pdf
Language	eng
OCLC number	45243694
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Exercise-induced bronchoconstriction: mechanisms, evaluation, and treatment / Sean P. Riley

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