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Impact of detecting and treating exercise-induced bronchoconstriction in elite footballers

Anna R. Jackson, James H. Hull, James G. Hopker, John W. Dickinson
ERJ Open Research 2018 4: 00122-2017; DOI: 10.1183/23120541.00122-2017
Anna R. Jackson
1School of Sport and Exercise Sciences, University of Kent, Chatham, UK
2English Institute of Sport, London, UK
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James H. Hull
3Dept of Respiratory Medicine, Royal Brompton Hospital, London, UK
4National Heart and Lung Institute, Imperial College, London, UK
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James G. Hopker
1School of Sport and Exercise Sciences, University of Kent, Chatham, UK
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John W. Dickinson
1School of Sport and Exercise Sciences, University of Kent, Chatham, UK
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  • FIGURE 1
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    FIGURE 1

    Maximum fall in forced expiratory volume in 1 s (FEV1) following eucapnic voluntary hyperpnoea (EVH) challenge

  • FIGURE 2
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    FIGURE 2

    a) Exhaled nitric oxide fraction (FeNO) before and after 9 weeks of treatment; b) percentage change in forced expiratory volume in 1 s (FEV1) following eucapnic voluntary hyperpnoea (EVH) challenge before and after 9 weeks of treatment. Data are presented as mean and individual values. #: p<0.05 versus pre-treatment.

  • FIGURE 3
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    FIGURE 3

    Peak oxygen uptake (V′O2peak) before and following 9 weeks of treatment. EVH: eucapnic voluntary hyperpnoea.

Tables

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  • TABLE 1

    Player characteristics and baseline respiratory assessment data for the 97 players who performed the baseline eucapnic voluntary hyperpnoea (EVH) challenge

    All playersEVH+EVH−p-value EVH+ versus EVH−
    Subjects972770
    Age years24±424±424±40.56
    Height cm182.6±6.8183.0±6.7182.5±6.90.77
    Weight kg80.3±7.280.7±6.380.2±7.50.73
    FeNO ppb21.0 (24.6)36.0 (63.0)18.8 (17.3)<0.01#
    FEV1 L4.71±0.654.51±0.554.78±0.680.07
    FVC L5.67±0.765.68±0.645.67±0.810.95
    PEF L·min−1630.0 (135.0)616.0 (102.0)635.0 (148.8)0.29#
    FEV1/FVC82.7±6.879.3±8.084.1±5.80.01
    MVV during EVH % predicted77.68±11.7683.07±10.8875.54±11.48<0.01
    Fall FEV1 from EVH %−8 (5.5)−13 (10.0)−6 (4.0)<0.01#

    Data are presented as n, mean±sd or median (interquartile range), unless otherwise stated. FeNO: exhaled nitric oxide fraction; FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; PEF: peak expiratory flow; MVV: maximal voluntary ventilation. #: data analysed using Mann–Whitney U-tests.

    • TABLE 2

      Respiratory symptoms reported by players

      No symptoms≥1 symptomCoughingExcessive mucus productionChest tightnessDifficulty breathingWheezing
      EVH+19 (70)8 (30)1 (4)1 (4)2 (7)4 (15)1 (4)
      EVH−60 (89)8 (11)4 (6)1 (1)2 (3)4 (6)2 (3)
      p-value0.060.061.000.500.320.221.00

      Data are presented as n (%), unless otherwise stated. n=95; n=2 did not complete questionnaires. EVH: eucapnic voluntary hyperpnoea.

      • TABLE 3

        Differences before and after treatment in eucapnic voluntary hyperpnoea (EVH)+ players on medication

        Pre-treatmentPost-treatmentp-value
        FeNO ppb85.1±60.727.5±10.910.04
        Baseline FEV1 L4.41±0.554.25±0.320.23
        MVV during EVH % predicted85.29±13.6187.81±13.580.38
        Fall in FEV1 post-EVH %14 (28.0)8 (9.0)0.02#

        Data are presented as mean±sd or median (interquartile range), unless otherwise stated. Bold type represents statistical significance. FeNO: exhaled nitric oxide; FEV1: forced expiratory volume in 1 s; MVV: maximal voluntary ventilation. #: data analysed using sign exact tests.

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        Impact of detecting and treating exercise-induced bronchoconstriction in elite footballers
        Anna R. Jackson, James H. Hull, James G. Hopker, John W. Dickinson
        ERJ Open Research Apr 2018, 4 (2) 00122-2017; DOI: 10.1183/23120541.00122-2017

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        Impact of detecting and treating exercise-induced bronchoconstriction in elite footballers
        Anna R. Jackson, James H. Hull, James G. Hopker, John W. Dickinson
        ERJ Open Research Apr 2018, 4 (2) 00122-2017; DOI: 10.1183/23120541.00122-2017
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