Management of Exercise-Induced Bronchospasm in NCAA Athletic Programs

Abstract

The prevalence of exercise-induced bronchospasm (EIB) is significantly higher in athletes than that in the general population and can result in significant morbidity in young, competitive athletes. Guidelines emphasize that education and written treatment protocols improve clinical outcomes for asthmatics. Evidence also supports objective testing when EIB is suspected, when there is immediate availability of rescue inhalers, and when there is involvement of asthma specialists in the care of asthmatic athletes. We sought to determine how EIB is managed at the National Collegiate Athletic Association (NCAA) sports medicine programs. A survey consisting of multiple-choice questions related to EIB in athletes was sent electronically to 3200 athletic trainers affiliated with NCAA sports medicine programs. Five hundred and forty-one athletic trainers responded. A minority of athletic trainers surveyed (21%) indicated that an asthma management protocol exists at their institution. Twenty-two percent indicated that pulmonologists are on staff or consultants to the sports medicine department. Many indicated that a short-acting beta-agonist is not required to be available at all practices (39%) and games (41%), and few athletic trainers indicated that their programs use objective testing to diagnose EIB (17%). Regression modeling demonstrated education about EIB, and involvement of pulmonologists significantly improved adherence to current consensus guidelines. On the basis of our data, many NCAA sports medicine programs do not manage athletes with EIB according to current consensus guidelines. This may result in inaccurate diagnoses and may be detrimental to clinical outcomes and overall health of student athletes. Providing education about EIB and involvement of pulmonologists significantly increase adherence to guidelines that likely improves clinical care of athletes and potentially athletic performance.