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Exercise-induced bronchoconstriction in athletes - a qualitative assessment of symptom perception

Exercise-induced bronchoconstriction in athletes - a qualitative assessment of symptom perception
Exercise-induced bronchoconstriction in athletes - a qualitative assessment of symptom perception
Background: A poor relationship between perceived respiratory symptoms and objective evidence of exercise-induced bronchoconstriction (EIB) in athletes is often reported; however, the reasons for this disconnect remain unclear. The primary aim of this study was to utilise a qualitative-analytical approach to compare respiratory symptoms in athletes with and without objectively confirmed EIB.

Methods: Endurance athletes who had previously undergone bronchoprovocation test screening for EIB were divided into sub-groups, based on the presence or absence of EIB ± heightened self-report of dyspnoea: (i) EIB-Dys- (ii) EIB þ Dysþ (iii) EIB þ Dys- (iv) EIB-Dysþ. All athletes underwent a detailed
semi-structured interview.

Results: Twenty athletes completed the study with an equal distribution in each sub-group (n=5).Thematic analysis of individual narratives resulted in four over-arching themes: 1) Factors aggravating dyspnoea, 2) Exercise limitation, 3) Strategies to control dyspnoea, 4) Diagnostic accuracy. The
anatomical location of symptoms varied between EIB + Dys + athletes and EIB-Dys + athletes. All EIB-Dys + reported significantly longer recovery times following high-intensity exercise in comparison to all other sub-groups. Finally, EIB + Dys + reported symptom improvement following beta-2 agonist therapy,whereas EIB-Dys + deemed treatment ineffective.

Conclusion: A detailed qualitative approach to the assessment of breathlessness reveals few features that distinguish between EIB and non-EIB causes of exertional dyspnoea in athletes. Important differencesthat may provide value in clinical work-up include (i) location of symptoms, (ii) recovery time following exercise and (iii) response to beta-2 agonist therapy. Overall these findings may inform clinical evaluation and development of future questionnaires to aid clinic-based assessment of athletes with
dyspnoea.
36-43
Price, Oliver J.
874ebdc9-52f8-4c23-a933-87cfbb5ba540
Hull, James H.
86c481ad-5f14-401c-a9a3-b71a21008061
Ansley, Les
7ce69ec2-9ed6-4636-9009-b1fe1b89b682
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Eyles, Caroline
f8518cbb-669f-4cf6-bacb-4a174e385483
Price, Oliver J.
874ebdc9-52f8-4c23-a933-87cfbb5ba540
Hull, James H.
86c481ad-5f14-401c-a9a3-b71a21008061
Ansley, Les
7ce69ec2-9ed6-4636-9009-b1fe1b89b682
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Eyles, Caroline
f8518cbb-669f-4cf6-bacb-4a174e385483

Price, Oliver J., Hull, James H., Ansley, Les, Thomas, Mike and Eyles, Caroline (2016) Exercise-induced bronchoconstriction in athletes - a qualitative assessment of symptom perception. Respiratory Medicine, 120, 36-43. (doi:10.1016/j.rmed.2016.09.017).

Record type: Article

Abstract

Background: A poor relationship between perceived respiratory symptoms and objective evidence of exercise-induced bronchoconstriction (EIB) in athletes is often reported; however, the reasons for this disconnect remain unclear. The primary aim of this study was to utilise a qualitative-analytical approach to compare respiratory symptoms in athletes with and without objectively confirmed EIB.

Methods: Endurance athletes who had previously undergone bronchoprovocation test screening for EIB were divided into sub-groups, based on the presence or absence of EIB ± heightened self-report of dyspnoea: (i) EIB-Dys- (ii) EIB þ Dysþ (iii) EIB þ Dys- (iv) EIB-Dysþ. All athletes underwent a detailed
semi-structured interview.

Results: Twenty athletes completed the study with an equal distribution in each sub-group (n=5).Thematic analysis of individual narratives resulted in four over-arching themes: 1) Factors aggravating dyspnoea, 2) Exercise limitation, 3) Strategies to control dyspnoea, 4) Diagnostic accuracy. The
anatomical location of symptoms varied between EIB + Dys + athletes and EIB-Dys + athletes. All EIB-Dys + reported significantly longer recovery times following high-intensity exercise in comparison to all other sub-groups. Finally, EIB + Dys + reported symptom improvement following beta-2 agonist therapy,whereas EIB-Dys + deemed treatment ineffective.

Conclusion: A detailed qualitative approach to the assessment of breathlessness reveals few features that distinguish between EIB and non-EIB causes of exertional dyspnoea in athletes. Important differencesthat may provide value in clinical work-up include (i) location of symptoms, (ii) recovery time following exercise and (iii) response to beta-2 agonist therapy. Overall these findings may inform clinical evaluation and development of future questionnaires to aid clinic-based assessment of athletes with
dyspnoea.

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Accepted/In Press date: 23 September 2016
e-pub ahead of print date: 25 September 2016
Published date: November 2016
Organisations: Primary Care & Population Sciences

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Local EPrints ID: 403904
URI: https://eprints.soton.ac.uk/id/eprint/403904
PURE UUID: 50fc7b9a-f77b-49a0-b57a-786afc1af026

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Date deposited: 16 Dec 2016 09:40
Last modified: 20 Jul 2019 05:32

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