PDF herunterladen
Semin Respir Crit Care Med 2018; 39(01): 019-028
DOI: 10.1055/s-0037-1606215
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Exercise and Asthma

Andréanne Côté
1   Department of Critical Care, University of Calgary, Calgary, Alberta, Canada
,
Julie Turmel
2   Department of Medicine, Quebec Heart and Lung Institute, Laval University, Québec, Canada
,
Louis-Philippe Boulet
2   Department of Medicine, Quebec Heart and Lung Institute, Laval University, Québec, Canada
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
10. Februar 2018 (online)

    Lizenzen und Reprints

Abstract

Transient airway narrowing can occur during or following exercise, a phenomenon called exercise-induced bronchoconstriction (EIB). The main mechanism of EIB is considered to be airway dehydration, resulting from increased ventilation during exercise. In asthma, such water loss causes an increase in airway fluid osmolarity, inducing airway smooth muscle contraction following the release of mediators from airway inflammatory cells. Asthmatics frequently experience EIB, but it may also be observed in others not reporting asthma symptoms, particularly elite endurance athletes. Individuals with asthma often refrain from performing physical exercise because they fear troublesome respiratory symptoms. However, in addition to its well-known cardiovascular and metabolic benefits, physical training has been shown to be beneficial for asthmatic adults and children in improving asthma control and asthma-related quality of life. Exercise training also reduces the risk of asthma exacerbations, improves exercise capacity, and decreases frequency and severity of EIB. To minimize the risk of EIB, asthma must be well controlled, and specific pharmacological and nonpharmacological preventative measures can be taken. Counterintuitively, in high-level athletes, the development of asthma, airway hyperresponsiveness, and EIB can be promoted by intense training over many years following exposure to environmental conditions, such as cold air, pollutants, and allergens. As for nonathletes, athletes must have optimal asthma control and apply preventative measures against EIB, taking into account antidoping regulations for asthma medications. A better understanding of the impact of exercise on asthma should improve the overall care of asthmatic patients.

Keywords

asthma - exercise - exercise-induced bronchoconstriction - physical training - athletes
 

  • References

  • 1 Reddel HK, Bateman ED, Becker A. , et al. A summary of the new GINA strategy: a roadmap to asthma control. Eur Respir J 2015; 46 (03) 622-639
    CrossrefPubMedSuche in Google Scholar
  • 2 Crapo RO, Casaburi R, Coates AL. , et al. Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med 2000; 161 (01) 309-329
    CrossrefPubMedSuche in Google Scholar
  • 3 Fitch KD, Sue-Chu M, Anderson SD. , et al. Asthma and the elite athlete: summary of the International Olympic Committee's consensus conference, Lausanne, Switzerland, January 22-24, 2008. J Allergy Clin Immunol 2008; 122 (02) 254-260 , 260.e1–260.e7
    CrossrefPubMedSuche in Google Scholar
  • 4 Boulet LP, O'Byrne PM. Asthma and exercise-induced bronchoconstriction in athletes. N Engl J Med 2015; 372 (07) 641-648
    CrossrefPubMedSuche in Google Scholar
  • 5 Clark CJ, Cochrane LM. Assessment of work performance in asthma for determination of cardiorespiratory fitness and training capacity. Thorax 1988; 43 (10) 745-749
    CrossrefPubMedSuche in Google Scholar
  • 6 Adams RJ, Wilson DH, Taylor AW. , et al. Psychological factors and asthma quality of life: a population based study. Thorax 2004; 59 (11) 930-935
    CrossrefPubMedSuche in Google Scholar
  • 7 Kullowatz A, Kanniess F, Dahme B, Magnussen H, Ritz T. Association of depression and anxiety with health care use and quality of life in asthma patients. Respir Med 2007; 101 (03) 638-644
    CrossrefPubMedSuche in Google Scholar
  • 8 Lavoie KL, Bacon SL, Barone S, Cartier A, Ditto B, Labrecque M. What is worse for asthma control and quality of life: depressive disorders, anxiety disorders, or both?. Chest 2006; 130 (04) 1039-1047
    CrossrefPubMedSuche in Google Scholar
  • 9 Cluley S, Cochrane GM. Psychological disorder in asthma is associated with poor control and poor adherence to inhaled steroids. Respir Med 2001; 95 (01) 37-39
    CrossrefPubMedSuche in Google Scholar
  • 10 Ram FSF, Robinson SM, Black PN, Picot J. Physical training for asthma. Cochrane Database Syst Rev 2005; 4 (04) CD001116
    PubMedSuche in Google Scholar
  • 11 van Veldhoven NH, Vermeer A, Bogaard JM. , et al. Children with asthma and physical exercise: effects of an exercise programme. Clin Rehabil 2001; 15 (04) 360-370
    CrossrefPubMedSuche in Google Scholar
  • 12 Lucas SR, Platts-Mills TA. Physical activity and exercise in asthma: relevance to etiology and treatment. J Allergy Clin Immunol 2005; 115 (05) 928-934
    CrossrefPubMedSuche in Google Scholar
  • 13 Kitsantas A, Zimmerman BJ. Self-efficacy, activity participation, and physical fitness of asthmatic and nonasthmatic adolescent girls. J Asthma 2000; 37 (02) 163-174
    CrossrefPubMedSuche in Google Scholar
  • 14 Villa F, Castro AP, Pastorino AC. , et al. Aerobic capacity and skeletal muscle function in children with asthma. Arch Dis Child 2011; 96 (06) 554-559
    CrossrefPubMedSuche in Google Scholar
  • 15 Rasmussen F, Lambrechtsen J, Siersted HC, Hansen HS, Hansen NC. Low physical fitness in childhood is associated with the development of asthma in young adulthood: the Odense schoolchild study. Eur Respir J 2000; 16 (05) 866-870
    CrossrefPubMedSuche in Google Scholar
  • 16 Williams B, Powell A, Hoskins G, Neville R. Exploring and explaining low participation in physical activity among children and young people with asthma: a review. BMC Fam Pract 2008; 9: 40
    CrossrefPubMedSuche in Google Scholar
  • 17 Garfinkel SK, Kesten S, Chapman KR, Rebuck AS. Physiologic and nonphysiologic determinants of aerobic fitness in mild to moderate asthma. Am Rev Respir Dis 1992; 145 (4 Pt 1): 741-745
    CrossrefPubMedSuche in Google Scholar
  • 18 Pedersen BK, Saltin B. Exercise as medicine-evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports 2015; 25 (Suppl. 03) 1-72
    CrossrefPubMedSuche in Google Scholar
  • 19 Bougault V, Loubaki L, Joubert P. , et al. Airway remodeling and inflammation in competitive swimmers training in indoor chlorinated swimming pools. J Allergy Clin Immunol 2012; 129 (02) 351-358 , 358.e1
    CrossrefPubMedSuche in Google Scholar
  • 20 Karjalainen EM, Laitinen A, Sue-Chu M, Altraja A, Bjermer L, Laitinen LA. Evidence of airway inflammation and remodeling in ski athletes with and without bronchial hyperresponsiveness to methacholine. Am J Respir Crit Care Med 2000; 161 (06) 2086-2091
    CrossrefPubMedSuche in Google Scholar
  • 21 Sue-Chu M, Karjalainen EM, Altraja A. , et al. Lymphoid aggregates in endobronchial biopsies from young elite cross-country skiers. Am J Respir Crit Care Med 1998; 158 (02) 597-601
    CrossrefPubMedSuche in Google Scholar
  • 22 Centers for Disease Control and Prevention. Current Asthma Prevalence Percent by Age, Sex, and Race/Ethnicity, United States, 2015. Accessed December 16, 2016
    PubMed
  • 23 Storms WW. Review of exercise-induced asthma. Med Sci Sports Exerc 2003; 35 (09) 1464-1470
    CrossrefPubMedSuche in Google Scholar
  • 24 Van Schoor J, Joos GF, Pauwels RA. Indirect bronchial hyperresponsiveness in asthma: mechanisms, pharmacology and implications for clinical research. Eur Respir J 2000; 16 (03) 514-533
    CrossrefPubMedSuche in Google Scholar
  • 25 McFadden Jr ER, Gilbert IA. Exercise-induced asthma. N Engl J Med 1994; 330 (19) 1362-1367
    CrossrefPubMedSuche in Google Scholar
  • 26 Anderson SD, Silverman M, König P, Godfrey S. Exercise-induced asthma. Br J Dis Chest 1975; 69 (01) 1-39
    CrossrefPubMedSuche in Google Scholar
  • 27 Weiler JM, Bonini S, Coifman R. , et al; Ad Hoc Committee of Sports Medicine Committee of American Academy of Allergy, Asthma & Immunology. American Academy of Allergy, Asthma & Immunology Work Group report: exercise-induced asthma. J Allergy Clin Immunol 2007; 119 (06) 1349-1358
    CrossrefPubMedSuche in Google Scholar
  • 28 Gotshall RW. Exercise-induced bronchoconstriction. Drugs 2002; 62 (12) 1725-1739
    CrossrefPubMedSuche in Google Scholar
  • 29 Grzelewski T, Stelmach I. Exercise-induced bronchoconstriction in asthmatic children: a comparative systematic review of the available treatment options. Drugs 2009; 69 (12) 1533-1553
    CrossrefPubMedSuche in Google Scholar
  • 30 Price JF. Choices of therapy for exercise-induced asthma in children. Allergy 2001; 56 (Suppl. 66) 12-17
    PubMedSuche in Google Scholar
  • 31 Cabral ALB, Conceição GM, Fonseca-Guedes CHF, Martins MA. Exercise-induced bronchospasm in children: effects of asthma severity. Am J Respir Crit Care Med 1999; 159 (06) 1819-1823
    CrossrefPubMedSuche in Google Scholar
  • 32 Bonini M, Gramiccioni C, Fioretti D. , et al; AIDA and the Italian Unit of the GA2LEN Olympic Study. Asthma, allergy and the Olympics: a 12-year survey in elite athletes. Curr Opin Allergy Clin Immunol 2015; 15 (02) 184-192
    CrossrefPubMedSuche in Google Scholar
  • 33 Carlsen KH, Anderson SD, Bjermer L. , et al; European Respiratory Society; European Academy of Allergy and Clinical Immunology. Exercise-induced asthma, respiratory and allergic disorders in elite athletes: epidemiology, mechanisms and diagnosis: part I of the report from the Joint Task Force of the European Respiratory Society (ERS) and the European Academy of Allergy and Clinical Immunology (EAACI) in cooperation with GA2LEN. Allergy 2008; 63 (04) 387-403
    CrossrefPubMedSuche in Google Scholar
  • 34 Fitch KD. An overview of asthma and airway hyper-responsiveness in Olympic athletes. Br J Sports Med 2012; 46 (06) 413-416
    CrossrefPubMedSuche in Google Scholar
  • 35 Helenius IJ, Tikkanen HO, Sarna S, Haahtela T. Asthma and increased bronchial responsiveness in elite athletes: atopy and sport event as risk factors. J Allergy Clin Immunol 1998; 101 (05) 646-652
    CrossrefPubMedSuche in Google Scholar
  • 36 Langdeau JB, Turcotte H, Bowie DM, Jobin J, Desgagné P, Boulet LP. Airway hyperresponsiveness in elite athletes. Am J Respir Crit Care Med 2000; 161 (05) 1479-1484
    CrossrefPubMedSuche in Google Scholar
  • 37 Sue-Chu M. Winter sports athletes: long-term effects of cold air exposure. Br J Sports Med 2012; 46 (06) 397-401
    CrossrefPubMedSuche in Google Scholar
  • 38 Turmel J, Poirier P, Bougault V, Blouin E, Belzile M, Boulet LP. Cardiorespiratory screening in elite endurance sports athletes: the Quebec study. Phys Sportsmed 2012; 40 (03) 55-65
    CrossrefPubMedSuche in Google Scholar
  • 39 Larsson K, Ohlsén P, Larsson L, Malmberg P, Rydström PO, Ulriksen H. High prevalence of asthma in cross country skiers. BMJ 1993; 307 (6915): 1326-1329
    CrossrefPubMedSuche in Google Scholar
  • 40 McKenzie DC, Fitch KD. The asthmatic athlete: inhaled Beta-2 agonists, sport performance, and doping. Clin J Sport Med 2011; 21 (01) 46-50
    PubMedSuche in Google Scholar
  • 41 Hallstrand TS, Moody MW, Wurfel MM, Schwartz LB, Henderson Jr WR, Aitken ML. Inflammatory basis of exercise-induced bronchoconstriction. Am J Respir Crit Care Med 2005; 172 (06) 679-686
    CrossrefPubMedSuche in Google Scholar
  • 42 Anderson SD, Kippelen P. Exercise-induced bronchoconstriction: pathogenesis. Curr Allergy Asthma Rep 2005; 5 (02) 116-122
    CrossrefPubMedSuche in Google Scholar
  • 43 Kippelen P, Anderson SD. Pathogenesis of exercise-induced bronchoconstriction. Immunol Allergy Clin North Am 2013; 33 (03) 299-312 , vii
    CrossrefPubMedSuche in Google Scholar
  • 44 Mickleborough TD, Lindley MR, Ray S. Dietary salt, airway inflammation, and diffusion capacity in exercise-induced asthma. Med Sci Sports Exerc 2005; 37 (06) 904-914
    PubMedSuche in Google Scholar
  • 45 Hallstrand TS, Moody MW, Aitken ML, Henderson Jr WR. Airway immunopathology of asthma with exercise-induced bronchoconstriction. J Allergy Clin Immunol 2005; 116 (03) 586-593
    CrossrefPubMedSuche in Google Scholar
  • 46 Crimi E, Balbo A, Milanese M, Miadonna A, Rossi GA, Brusasco V. Airway inflammation and occurrence of delayed bronchoconstriction in exercise-induced asthma. Am Rev Respir Dis 1992; 146 (02) 507-512
    CrossrefPubMedSuche in Google Scholar
  • 47 Gauvreau GM, Ronnen GM, Watson RM, O'Byrne PM. Exercise-induced bronchoconstriction does not cause eosinophilic airway inflammation or airway hyperresponsiveness in subjects with asthma. Am J Respir Crit Care Med 2000; 162 (4 Pt 1): 1302-1307
    CrossrefPubMedSuche in Google Scholar
  • 48 Duong M, Subbarao P, Adelroth E. , et al. Sputum eosinophils and the response of exercise-induced bronchoconstriction to corticosteroid in asthma. Chest 2008; 133 (02) 404-411
    CrossrefPubMedSuche in Google Scholar
  • 49 Hallstrand TS, Altemeier WA, Aitken ML, Henderson Jr WR. Role of cells and mediators in exercise-induced bronchoconstriction. Immunol Allergy Clin North Am 2013; 33 (03) 313-328 , vii
    CrossrefPubMedSuche in Google Scholar
  • 50 Holgate ST, Peters-Golden M, Panettieri RA, Henderson Jr WR. Roles of cysteinyl leukotrienes in airway inflammation, smooth muscle function, and remodeling. J Allergy Clin Immunol 2003; 111 (1, Suppl): S18-S34 , discussion S34–S36
    CrossrefPubMedSuche in Google Scholar
  • 51 Hartert TV, Dworski RT, Mellen BG, Oates JA, Murray JJ, Sheller JR. Prostaglandin E(2) decreases allergen-stimulated release of prostaglandin D(2) in airways of subjects with asthma. Am J Respir Crit Care Med 2000; 162 (2 Pt 1): 637-640
    CrossrefPubMedSuche in Google Scholar
  • 52 Tahan F, Saraymen R, Gumus H. The role of lipoxin A4 in exercise-induced bronchoconstriction in asthma. J Asthma 2008; 45 (02) 161-164
    CrossrefPubMedSuche in Google Scholar
  • 53 Finnerty JP, Holgate ST. The contribution of histamine release and vagal reflexes, alone and in combination, to exercise-induced asthma. Eur Respir J 1993; 6 (08) 1132-1137
    PubMedSuche in Google Scholar
  • 54 Jordan D. Central nervous pathways and control of the airways. Respir Physiol 2001; 125 (1-2): 67-81
    CrossrefPubMedSuche in Google Scholar
  • 55 Canning BJ, Fischer A. Neural regulation of airway smooth muscle tone. Respir Physiol 2001; 125 (1-2): 113-127
    CrossrefPubMedSuche in Google Scholar
  • 56 Barnes PJ. Neural control of human airways in health and disease. Am Rev Respir Dis 1986; 134 (06) 1289-1314
    PubMedSuche in Google Scholar
  • 57 Crimi E, Milanese M, Pingfang S, Brusasco V. Allergic inflammation and airway smooth muscle function. Sci Total Environ 2001; 270 (1-3): 57-61
    CrossrefPubMedSuche in Google Scholar
  • 58 Molfino NA, Slutsky AS, Julià-Serdà G. , et al. Assessment of airway tone in asthma. Comparison between double lung transplant patients and healthy subjects. Am Rev Respir Dis 1993; 148 (05) 1238-1243
    CrossrefPubMedSuche in Google Scholar
  • 59 Stang J, Stensrud T, Mowinckel P, Carlsen KH. Parasympathetic Activity and Bronchial Hyperresponsiveness in Athletes. Med Sci Sports Exerc 2016; 48 (11) 2100-2107
    CrossrefPubMedSuche in Google Scholar
  • 60 Langdeau JB, Turcotte H, Desagné P, Jobin J, Boulet LP. Influence of sympatho-vagal balance on airway responsiveness in athletes. Eur J Appl Physiol 2000; 83 (4-5): 370-375
    CrossrefPubMedSuche in Google Scholar
  • 61 Knöpfli BH, Bar-Or O. Vagal activity and airway response to ipratropium bromide before and after exercise in ambient and cold conditions in healthy cross-country runners. Clin J Sport Med 1999; 9 (03) 170-176
    CrossrefPubMedSuche in Google Scholar
  • 62 Knöpfli BH, Bar-Or O, Araújo CGS. Effect of ipratropium bromide on EIB in children depends on vagal activity. Med Sci Sports Exerc 2005; 37 (03) 354-359
    CrossrefPubMedSuche in Google Scholar
  • 63 Freed AN. Models and mechanisms of exercise-induced asthma. Eur Respir J 1995; 8 (10) 1770-1785
    CrossrefPubMedSuche in Google Scholar
  • 64 Zeitoun M, Wilk B, Matsuzaka A, KnOpfli BH, Wilson BA, Bar-Or O. Facial cooling enhances exercise-induced bronchoconstriction in asthmatic children. Med Sci Sports Exerc 2004; 36 (05) 767-771
    PubMedSuche in Google Scholar
  • 65 Mountjoy M, Fitch K, Boulet LP, Bougault V, van Mechelen W, Verhagen E. Prevalence and characteristics of asthma in the aquatic disciplines. J Allergy Clin Immunol 2015; 136 (03) 588-594
    CrossrefPubMedSuche in Google Scholar
  • 66 Rundell KW, Anderson SD, Sue-Chu M, Bougault V, Boulet LP. Air quality and temperature effects on exercise-induced bronchoconstriction. Compr Physiol 2015; 5 (02) 579-610
    PubMedSuche in Google Scholar
  • 67 McFadden Jr ER. Hypothesis: exercise-induced asthma as a vascular phenomenon. Lancet 1990; 335 (8694): 880-883
    CrossrefPubMedSuche in Google Scholar
  • 68 Anderson SD, Schoeffel RE, Follet R, Perry CP, Daviskas E, Kendall M. Sensitivity to heat and water loss at rest and during exercise in asthmatic patients. Eur J Respir Dis 1982; 63 (05) 459-471
    PubMedSuche in Google Scholar
  • 69 Anderson SD, Daviskas E. The mechanism of exercise-induced asthma is…. J Allergy Clin Immunol 2000; 106 (03) 453-459
    CrossrefPubMedSuche in Google Scholar
  • 70 Spooner CH, Spooner GR, Rowe BH. Mast-cell stabilising agents to prevent exercise-induced bronchoconstriction. Cochrane Database Syst Rev 2003; (04) CD002307
    PubMedSuche in Google Scholar
  • 71 Kippelen P, Larsson J, Anderson SD. , et al. Acute effects of beclomethasone on hyperpnea-induced bronchoconstriction. Med Sci Sports Exerc 2010; 42 (02) 273-280
    PubMedSuche in Google Scholar
  • 72 Pfleger A, Eber E, Weinhandl E, Zach MS. Effects of nedocromil and salbutamol on airway reactivity in children with asthma. Eur Respir J 2002; 20 (03) 624-629
    CrossrefPubMedSuche in Google Scholar
  • 73 Carlsen KH. Sports in extreme conditions: the impact of exercise in cold temperatures on asthma and bronchial hyper-responsiveness in athletes. Br J Sports Med 2012; 46 (11) 796-799
    CrossrefPubMedSuche in Google Scholar
  • 74 Tsushima K, Yasuo M, Tanabe T, Yoshikawa S, Yamazaki Y, Kubo K. Airway inflammation in employees involved in cultivating Japanese mushrooms (bunashimeji). Respirology 2008; 13 (04) 546-552
    CrossrefPubMedSuche in Google Scholar
  • 75 Helenius I, Lumme A, Haahtela T. Asthma, airway inflammation and treatment in elite athletes. Sports Med 2005; 35 (07) 565-574
    CrossrefPubMedSuche in Google Scholar
  • 76 Helenius I, Rytilä P, Sarna S. , et al. Effect of continuing or finishing high-level sports on airway inflammation, bronchial hyperresponsiveness, and asthma: a 5-year prospective follow-up study of 42 highly trained swimmers. J Allergy Clin Immunol 2002; 109 (06) 962-968
    CrossrefPubMedSuche in Google Scholar
  • 77 Bougault V, Turmel J, Boulet LP. Airway hyperresponsiveness in elite swimmers: is it a transient phenomenon?. J Allergy Clin Immunol 2011; 127 (04) 892-898
    CrossrefPubMedSuche in Google Scholar
  • 78 Haahtela T, Malmberg P, Moreira A. Mechanisms of asthma in Olympic athletes--practical implications. Allergy 2008; 63 (06) 685-694
    CrossrefPubMedSuche in Google Scholar
  • 79 Hewitt M, Estell K, Davis IC, Schwiebert LM. Repeated bouts of moderate-intensity aerobic exercise reduce airway reactivity in a murine asthma model. Am J Respir Cell Mol Biol 2010; 42 (02) 243-249
    CrossrefPubMedSuche in Google Scholar
  • 80 Silva RA, Vieira RP, Duarte AC. , et al. Aerobic training reverses airway inflammation and remodelling in an asthma murine model. Eur Respir J 2010; 35 (05) 994-1002
    CrossrefPubMedSuche in Google Scholar
  • 81 Vieira RP, Claudino RC, Duarte AC. , et al. Aerobic exercise decreases chronic allergic lung inflammation and airway remodeling in mice. Am J Respir Crit Care Med 2007; 176 (09) 871-877
    CrossrefPubMedSuche in Google Scholar
  • 82 Vieira RP, de Andrade VF, Duarte AC. , et al. Aerobic conditioning and allergic pulmonary inflammation in mice. II. Effects on lung vascular and parenchymal inflammation and remodeling. Am J Physiol Lung Cell Mol Physiol 2008; 295 (04) L670-L679
    CrossrefPubMedSuche in Google Scholar
  • 83 Chen Y, Dales R, Krewski D. Leisure-time energy expenditure in asthmatics and non-asthmatics. Respir Med 2001; 95 (01) 13-18
    CrossrefPubMedSuche in Google Scholar
  • 84 Eijkemans M, Mommers M, de Vries SI. , et al. Asthmatic symptoms, physical activity, and overweight in young children: a cohort study. Pediatrics 2008; 121 (03) e666-e672
    CrossrefPubMedSuche in Google Scholar
  • 85 Corbo GM, Forastiere F, De Sario M. , et al; Sidria-2 Collaborative Group. Wheeze and asthma in children: associations with body mass index, sports, television viewing, and diet. Epidemiology 2008; 19 (05) 747-755
    CrossrefPubMedSuche in Google Scholar
  • 86 Carson KV, Chandratilleke MG, Picot J, Brinn MP, Esterman AJ, Smith BJ. Physical training for asthma. Cochrane Database Syst Rev 2013; (09) CD001116
    PubMedSuche in Google Scholar
  • 87 Eichenberger PA, Diener SN, Kofmehl R, Spengler CM. Effects of exercise training on airway hyperreactivity in asthma: a systematic review and meta-analysis. Sports Med 2013; 43 (11) 1157-1170
    PubMedSuche in Google Scholar
  • 88 Mendes FA, Gonçalves RC, Nunes MP. , et al. Effects of aerobic training on psychosocial morbidity and symptoms in patients with asthma: a randomized clinical trial. Chest 2010; 138 (02) 331-337
    Suche in Google Scholar
  • 89 Turner S, Eastwood P, Cook A, Jenkins S. Improvements in symptoms and quality of life following exercise training in older adults with moderate/severe persistent asthma. Respiration 2011; 81 (04) 302-310
    Suche in Google Scholar
  • 90 Chandratilleke MG, Carson KV, Picot J, Brinn MP, Esterman AJ, Smith BJ. Physical training for asthma. Cochrane Database Syst Rev 2012; (05) CD001116
    PubMedSuche in Google Scholar
  • 91 Wanrooij VH, Willeboordse M, Dompeling E, van de Kant KD. Exercise training in children with asthma: a systematic review. Br J Sports Med 2014; 48 (13) 1024-1031
    CrossrefPubMedSuche in Google Scholar
  • 92 Moreira A, Delgado L, Haahtela T. , et al. Physical training does not increase allergic inflammation in asthmatic children. Eur Respir J 2008; 32 (06) 1570-1575
    CrossrefPubMedSuche in Google Scholar
  • 93 Mendes FA, Almeida FM, Cukier A. , et al. Effects of aerobic training on airway inflammation in asthmatic patients. Med Sci Sports Exerc 2011; 43 (02) 197-203
    PubMedSuche in Google Scholar
  • 94 Bonsignore MR, La Grutta S, Cibella F. , et al. Effects of exercise training and montelukast in children with mild asthma. Med Sci Sports Exerc 2008; 40 (03) 405-412
    CrossrefPubMedSuche in Google Scholar
  • 95 Fanelli A, Cabral AL, Neder JA, Martins MA, Carvalho CR. Exercise training on disease control and quality of life in asthmatic children. Med Sci Sports Exerc 2007; 39 (09) 1474-1480
    CrossrefPubMedSuche in Google Scholar
  • 96 Baquet G, van Praagh E, Berthoin S. Endurance training and aerobic fitness in young people. Sports Med 2003; 33 (15) 1127-1143
    CrossrefPubMedSuche in Google Scholar
  • 97 Foglio K, Bianchi L, Bruletti G, Battista L, Pagani M, Ambrosino N. Long-term effectiveness of pulmonary rehabilitation in patients with chronic airway obstruction. Eur Respir J 1999; 13 (01) 125-132
    CrossrefPubMedSuche in Google Scholar
  • 98 Wipfli BM, Rethorst CD, Landers DM. The anxiolytic effects of exercise: a meta-analysis of randomized trials and dose-response analysis. J Sport Exerc Psychol 2008; 30 (04) 392-410
    CrossrefPubMedSuche in Google Scholar
  • 99 Mead GE, Morley W, Campbell P, Greig CA, McMurdo M, Lawlor DA. Exercise for depression. Cochrane Database Syst Rev 2008; (04) CD004366
    PubMedSuche in Google Scholar
  • 100 Basaran S, Guler-Uysal F, Ergen N, Seydaoglu G, Bingol-Karakoç G, Ufuk Altintas D. Effects of physical exercise on quality of life, exercise capacity and pulmonary function in children with asthma. J Rehabil Med 2006; 38 (02) 130-135
    CrossrefPubMedSuche in Google Scholar
  • 101 Neder JA, Nery LE, Silva AC, Cabral AL, Fernandes AL. Short-term effects of aerobic training in the clinical management of moderate to severe asthma in children. Thorax 1999; 54 (03) 202-206
    CrossrefPubMedSuche in Google Scholar
  • 102 van Gent R, van Essen LEM, Rovers MM, Kimpen JL, van der Ent CK, de Meer G. Quality of life in children with undiagnosed and diagnosed asthma. Eur J Pediatr 2007; 166 (08) 843-848
    CrossrefPubMedSuche in Google Scholar
  • 103 Juniper EF. Quality of life in adults and children with asthma and rhinitis. Allergy 1997; 52 (10) 971-977
    CrossrefPubMedSuche in Google Scholar
  • 104 Hallstrand TS, Bates PW, Schoene RB. Aerobic conditioning in mild asthma decreases the hyperpnea of exercise and improves exercise and ventilatory capacity. Chest 2000; 118 (05) 1460-1469
    CrossrefPubMedSuche in Google Scholar
  • 105 Onur E, Kabaroğlu C, Günay O. , et al. The beneficial effects of physical exercise on antioxidant status in asthmatic children. Allergol Immunopathol (Madr) 2011; 39 (02) 90-95
    CrossrefPubMedSuche in Google Scholar
  • 106 Zietkowski Z, Skiepko R, Tomasiak-Lozowska MM, Mroczko B, Szmitkowski M, Bodzenta-Lukaszyk A. Changes in high-sensitivity C-reactive protein in serum and exhaled breath condensate after intensive exercise in patients with allergic asthma. Int Arch Allergy Immunol 2010; 153 (01) 75-85
    CrossrefPubMedSuche in Google Scholar
  • 107 Nikolaidis MG, Kyparos A, Vrabas ISF. F2-isoprostane formation, measurement and interpretation: the role of exercise. Prog Lipid Res 2011; 50 (01) 89-103
    CrossrefPubMedSuche in Google Scholar
  • 108 Price OJ, Hull JH, Backer V, Hostrup M, Ansley L. The impact of exercise-induced bronchoconstriction on athletic performance: a systematic review. Sports Med 2014; 44 (12) 1749-1761
    CrossrefPubMedSuche in Google Scholar
  • 109 Simpson AJ, Romer LM, Kippelen P. Self-reported Symptoms after Induced and Inhibited Bronchoconstriction in Athletes. Med Sci Sports Exerc 2015; 47 (10) 2005-2013
    CrossrefPubMedSuche in Google Scholar
  • 110 Aaron SD, Vandemheen KL, FitzGerald JM. , et al; Canadian Respiratory Research Network. Reevaluation of Diagnosis in Adults With Physician-Diagnosed Asthma. JAMA 2017; 317 (03) 269-279
    CrossrefPubMedSuche in Google Scholar
  • 111 Langdeau JB, Boulet LP. Is asthma over- or under-diagnosed in athletes?. Respir Med 2003; 97 (02) 109-114
    CrossrefPubMedSuche in Google Scholar
  • 112 Rundell KW, Im J, Mayers LB, Wilber RL, Szmedra L, Schmitz HR. Self-reported symptoms and exercise-induced asthma in the elite athlete. Med Sci Sports Exerc 2001; 33 (02) 208-213
    PubMedSuche in Google Scholar
  • 113 Bougault V, Turmel J, Boulet LP. Bronchial challenges and respiratory symptoms in elite swimmers and winter sport athletes: Airway hyperresponsiveness in asthma: its measurement and clinical significance. Chest 2010; 138 (2, Suppl): 31S-37S
    CrossrefPubMedSuche in Google Scholar
  • 114 Anderson SD, Brannan JD. Methods for “indirect” challenge tests including exercise, eucapnic voluntary hyperpnea, and hypertonic aerosols. Clin Rev Allergy Immunol 2003; 24 (01) 27-54
    CrossrefPubMedSuche in Google Scholar
  • 115 Boulet LP, Turmel J, Côté A. Asthma and exercise-induced respiratory symptoms in the athlete: new insights. Curr Opin Pulm Med 2017; 23 (01) 71-77
    PubMedSuche in Google Scholar
  • 116 Weiler JM, Anderson SD, Randolph C. , et al; American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. Pathogenesis, prevalence, diagnosis, and management of exercise-induced bronchoconstriction: a practice parameter. Ann Allergy Asthma Immunol 2010; 105 (6, Suppl): S1-S47
    CrossrefPubMedSuche in Google Scholar
  • 117 Walsh NP, Gleeson M, Shephard RJ. , et al. Position statement. Part one: Immune function and exercise. Exerc Immunol Rev 2011; 17: 6-63
    PubMedSuche in Google Scholar
  • 118 Exercise and febrile illnesses. Paediatr Child Health 2007; 12 (10) 885-892
    CrossrefPubMedSuche in Google Scholar
  • 119 Elkins MR, Brannan JD. Warm-up exercise can reduce exercise-induced bronchoconstriction. Br J Sports Med 2013; 47 (10) 657-658
    CrossrefPubMedSuche in Google Scholar
  • 120 Koh MS, Tee A, Lasserson TJ, Irving LB. Inhaled corticosteroids compared to placebo for prevention of exercise induced bronchoconstriction. Cochrane Database Syst Rev 2007; (03) CD002739
    PubMedSuche in Google Scholar
  • 121 Hancox RJ, Subbarao P, Kamada D, Watson RM, Hargreave FE, Inman MD. Beta2-agonist tolerance and exercise-induced bronchospasm. Am J Respir Crit Care Med 2002; 165 (08) 1068-1070
    CrossrefPubMedSuche in Google Scholar
  • 122 Lougheed MD, Leniere C, Ducharme FM. , et al; Canadian Thoracic Society Asthma Clinical Assembly. Canadian Thoracic Society 2012 guideline update: Diagnosis and management of asthma in preschoolers, children and adults: executive summary. Can Respir J 2012; 19 (06) e81-e88
    PubMedSuche in Google Scholar
  • 123 Subbarao P, Duong M, Adelroth E. , et al. Effect of ciclesonide dose and duration of therapy on exercise-induced bronchoconstriction in patients with asthma. J Allergy Clin Immunol 2006; 117 (05) 1008-1013
    CrossrefPubMedSuche in Google Scholar
  • 124 Duong M, Amin R, Baatjes AJ. , et al. The effect of montelukast, budesonide alone, and in combination on exercise-induced bronchoconstriction. J Allergy Clin Immunol 2012; 130 (02) 535-539.e3
    CrossrefPubMedSuche in Google Scholar
  • 125 Rundell KW, Spiering BA, Baumann JM, Evans TM. Effects of montelukast on airway narrowing from eucapnic voluntary hyperventilation and cold air exercise. Br J Sports Med 2005; 39 (04) 232-236
    CrossrefPubMedSuche in Google Scholar
  • 126 Rundell KW, Spiering BA, Baumann JM, Evans TM. Bronchoconstriction provoked by exercise in a high-particulate-matter environment is attenuated by montelukast. Inhal Toxicol 2005; 17 (02) 99-105
    CrossrefPubMedSuche in Google Scholar
  • 127 Larsson J, Perry CP, Anderson SD, Brannan JD, Dahlén SE, Dahlén B. The occurrence of refractoriness and mast cell mediator release following mannitol-induced bronchoconstriction. J Appl Physiol (1985) 2011; 110 (04) 1029-1035
    CrossrefPubMedSuche in Google Scholar
  • 128 Stickland MK, Rowe BH, Spooner CH, Vandermeer B, Dryden DM. Effect of warm-up exercise on exercise-induced bronchoconstriction. Med Sci Sports Exerc 2012; 44 (03) 383-391
    CrossrefPubMedSuche in Google Scholar
  • 129 Anderson SD, Brannan JD. Long-acting beta 2-adrenoceptor agonists and exercise-induced asthma: lessons to guide us in the future. Paediatr Drugs 2004; 6 (03) 161-175
    CrossrefPubMedSuche in Google Scholar
  • 130 Helenius IJ, Tikkanen HO, Haahtela T. Occurrence of exercise induced bronchospasm in elite runners: dependence on atopy and exposure to cold air and pollen. Br J Sports Med 1998; 32 (02) 125-129
    CrossrefPubMedSuche in Google Scholar
  • 131 Millqvist E, Bengtsson U, Löwhagen O. Combining a beta2-agonist with a face mask to prevent exercise-induced bronchoconstriction. Allergy 2000; 55 (07) 672-675
    CrossrefPubMedSuche in Google Scholar
  • 132 Kippelen P, Fitch KD, Anderson SD. , et al. Respiratory health of elite athletes - preventing airway injury: a critical review. Br J Sports Med 2012; 46 (07) 471-476
    CrossrefPubMedSuche in Google Scholar
  • 133 Cutrufello PT, Smoliga JM, Rundell KW. Small things make a big difference: particulate matter and exercise. Sports Med 2012; 42 (12) 1041-1058
    CrossrefPubMedSuche in Google Scholar
  • 134 Del Giacco SR, Firinu D, Bjermer L, Carlsen KH. Exercise and asthma: an overview. Eur Clin Respir J 2015; 2: 27984
    PubMedSuche in Google Scholar
  • 135 Smoliga JM, Weiss P, Rundell KW. Exercise induced bronchoconstriction in adults: evidence based diagnosis and management. BMJ 2016; 352: h6951
    PubMedSuche in Google Scholar
  • 136 World Anti-Doping Agency. International Standards. List of Prohibited Substances and Methods (2017). Available at: https://www.wada ama.org/sites/default/files/resources/files/2016-09-29_-_wada_prohibited_list_2017_eng_final.pdf . Accessed December 16, 2016
  • 137 Anderson SD. Exercise-induced asthma in children: a marker of airway inflammation. Med J Aust 2002; 177 (Suppl): S61-S63
    PubMedSuche in Google Scholar
  • 138 Sue-Chu M, Karjalainen EM, Laitinen A, Larsson L, Laitinen LA, Bjermer L. Placebo-controlled study of inhaled budesonide on indices of airway inflammation in bronchoalveolar lavage fluid and bronchial biopsies in cross-country skiers. Respiration 2000; 67 (04) 417-425
    CrossrefPubMedSuche in Google Scholar
  • 139 Hoshino Y, Koya T, Kagamu H. , et al. Effect of inhaled corticosteroids on bronchial asthma in Japanese athletes. Allergol Int 2015; 64 (02) 145-149
    CrossrefPubMedSuche in Google Scholar
  • 140 Couto M, Stang J, Horta L. , et al. Two distinct phenotypes of asthma in elite athletes identified by latent class analysis. J Asthma 2015; 52 (09) 897-904
    CrossrefPubMedSuche in Google Scholar
  • 141 Price OJ, Ansley L, Menzies-Gow A, Cullinan P, Hull JH. Airway dysfunction in elite athletes--an occupational lung disease?. Allergy 2013; 68 (11) 1343-1352
    CrossrefPubMedSuche in Google Scholar
  • 142 Kippelen P, Anderson SD. Airway injury during high-level exercise. Br J Sports Med 2012; 46 (06) 385-390
    CrossrefPubMedSuche in Google Scholar
  • 143 Bougault V, Turmel J, St-Laurent J, Bertrand M, Boulet LP. Asthma, airway inflammation and epithelial damage in swimmers and cold-air athletes. Eur Respir J 2009; 33 (04) 740-746
    CrossrefPubMedSuche in Google Scholar
  • 144 Belda J, Ricart S, Casan P. , et al. Airway inflammation in the elite athlete and type of sport. Br J Sports Med 2008; 42 (04) 244-248 , discussion 248–249
    CrossrefPubMedSuche in Google Scholar
  • 145 Anderson SD, Kippelen P. Airway injury as a mechanism for exercise-induced bronchoconstriction in elite athletes. J Allergy Clin Immunol 2008; 122 (02) 225-235 , quiz 236–237
    CrossrefPubMedSuche in Google Scholar