Prevalence of Exercise Induced Bronchoconstriction in Recreational Adult Hockey Players as determined by Sport Specific Field Exercise Challenge Test

Abstract

BACKGROUND: Exercise induced bronchoconstriction (EIB) is provoked by exercise and results in narrowing of the airways. Studies have shown an EIB prevalence of 11-50% in athletic populations. The diagnosis of EIB is dependent upon objective measurement of respiratory function, as respiratory symptoms are unreliable. Cold and dry ambient conditions contribute to the severity of EIB. The environmental conditions and manner of exertion an athlete is exposed to in ice hockey are significantly different than any current standardized laboratory test to evaluate for EIB. In a prior study of elite women hockey players, 39.5% presented symptoms of asthma and 21% demonstrated EIB. Sport-specific field exercise challenge tests (SSFECT) have been validated for the assessment of EIB, and are more sensitive than laboratory challenges in elite winter athletes. PURPOSE: To use a SSFECT to determine the prevalence of EIB in adult recreational ice hockey players, and the correlation between reported symptoms and diagnosis by this method. METHODS: Participants were 18 males and 2 females (mean age of 34.7 yrs, mean height of 1.78 m); who participated in 1 of 2 recreational ice hockey leagues in Chicago, IL. Using a Piko-1 portable spirometer, FEV1 was measured prior to the hockey game and immediately following periods 1, 2, and 3. All respiratory measurements occurred with hockey equipment adorned. Airway response was expressed as the percent fall in FEV1 from the baseline value. Diagnosis of EIB was given if athletes had a greater than 10% decrease in FEV1 from baseline measured at any time point. Athletes also completed an intake questionnaire prior to testing which included clinical symptoms, exercise history, and past medical history. RESULTS: EIB was diagnosed in 3/20(15%) athletes. A prior diagnosis of asthma or exercise induced asthma was reported in 5/20 (25%) athletes, yet only one of these had a decrease of > 10 % of FEV1 as measured by this test. Of the three EIB+, two were symptomatic (67%); and of the EIB-, 9/17 (53%) reported respiratory symptoms. Diagnosis of EIB was consistent for all three periods in all but one athlete. Mean FEV1 for the three periods was 4.08, 4.07, and 4.07 respectively. CONCLUSIONS: Symptoms remain unreliable for diagnosis of EIB. SSFECT can be utilized for diagnosis of EIB in ice hockey athletes.