Resting Respiratory Resistance in Female Teenage Athletes With and Without Exercise-Induced Laryngeal Obstruction

Abstract

Exercise-induced laryngeal obstruction (EILO) occurs with paradoxical vocal fold motion or supraglottic collapse during moderate to vigorous exercise. Previously, Gallena etal (2015) reported lower-than-normal inspiratory (Ri) and expiratory (Re) resistances during resting tidal breathing (RTB) in female teenage athletes with EILO. This study aimed to replicate that unexpected result. The Airflow Perturbation Device measured Ri and Re during three 1-minute trials of RTB in 16 teenage female athletes with EILO and 16 sex-, age-, and height-matched controls. Multiple linear regression examined group, age, height, and weight as predictors of Ri and Re. Ri and Re tended to be lower in the EILO group than the control group [Ri: F(1,30)=3.58, P=0.068, d=0.686; Re: F(1,30)=3.28, P=0.080, d=0.640], but there was no statistically significant difference in the overall effect [F(2,29)=1.75, P=0.192]. After one outlier for Re from the EILO group and her matched control were removed, the overall difference was statistically significant, F(2,27)=3.38, P=0.049, with Re primarily contributing to the difference [Ri: F(1,28)=3.66, P=0.066, d=0.719; Re: F(1,28)=5.69, P=0.024, d=0.899]. These results did not replicate the robust differences found previously between Ri and Re during RTB in teenage girls with and without EILO, but the results trended in the same direction and met criterion for statistical significance once an outlier was removed from analysis. Overall, the observation that resting respiratory resistances were lower in most teenage girls with EILO suggests that reduced tone of the laryngeal and/or lower airways may predispose young athletes to EILO.