Eucapnic Voluntary Hyperpnea Challenge Research Articles

The role of the bronchial provocation challenge tests in the diagnosis of exercise-induced bronchoconstriction in elite swimmers

BackgroundThe International Olympic Committee–Medical Commission (IOC-MC) accepts a number of bronchial provocation tests for the diagnosis of exercise-induced bronchoconstriction (EIB) in elite athletes, none of which have been studied in...

Inspiratory muscle training: a simple cost-effective treatment for inspiratory stridor

This case study describes the support given to a British elite athlete in the build up to the 2004 Athens Olympic Games. The athlete had complained of breathing symptoms during...

Screening of athletes for exercise-induced bronchoconstriction.

Exercise-induced bronchoconstriction (EIB) has a high prevalence in elite athletes, particularly endurance athletes, winter athletes and swimmers. Recent studies have shown that a clinical diagnosis of EIB has only a moderate sensitivity and specificity for EIB. This finding in conjunction with a recent ruling by the IOC-medical commission that all athletes competing in initially the 2003 Winter Olympic Games in Salt Lake City, and now the 2004 Summer Olympic Games in Athens require objective evidence of EIB, support the need for bronchial provocation challenge tests in the diagnosis of EIB. The recommended bronchial provocation challenge test is the eucapnic voluntary hyperpnea (EVH) challenge; this challenge test has been shown to have both a high sensitivity and specificity for EIB. Pharmacological challenge tests, such as the methacholine challenge test, have been shown to have only a low sensitivity but high specificity for EIB in elite athletes, and are thus not recommended in the athlete with pure EIB. Exercise challenge tests performed both in the laboratory and field have a high specificity for EIB; however those in the laboratory have only a moderate sensitivity for EIB in elite athletes, whilst those in the field are limited by problems with standardization. The osmotic challenge tests, such as the hypertonic saline and newer inhaled dry powder mannitol challenge have both a high sensitivity and specificity for EIB, and may be used as an alternative to the EVH challenge.

Airways Hyperresponsiveness in High School Athletes

Adult athletes have a higher prevalence (11%–50%) of exercise‐induced bronchoconstriction (EIB) and airways hyperresponsiveness (AHR) than the population at large (7%–11%): reports describing EIB/AHR in adolescent athletes are scant. Hypotheses: 1) a minimum AHR prevalence of 20% would be revealed in a group of high school athletes; 2) demographic data would predict AHR; 3) AHR‐positive athletes would preferentially choose low ventilation sports. Eucapnic voluntary hyperpnea (EVH) was used to test for AHR in 23% of all athletes (79 of 343) of a midwestern high school. The AHR was defined by at least a 10%, 20%, or 25% decline in FEV1, FEF25–75, or PEFR at 1, 5, 10, or 15‐min post‐EVH, respectively. Results: 30 of 79 (38%) tested positive for AHR; demographic data tended to predict AHR, as correlations between the total number of years exercised with the greatest decline in FEV1 and the total number of days exercised with the greatest decline in FEV1 following the EVH challenge tended to be significant (r = 0.354; p = 0.055 and r = 0.314; p = 0.091, respectively); and 69% of AHR‐positive students played only low ventilation sports. Conclusion: AHR prevalence was 38% in athletes of a midwestern high school; demographic data tended to predict AHR; those with AHR preferentially play low ventilation sports.