Respiratory parameters in elite athletes--does sport have an influence?

Discipline-specific adaptation patterns in respiratory and lower limb musculotendinous structures: cyclists vs. basketball players

BACKGROUND

This study aimed at assessing how chronic exposure to specific exercise training (high-intensity intervals vs. endurance), comparing experienced basketball-players (BP, N.=16), cyclists (CY, N.=16), and non-specifically trained individuals (CN, N.=16), influences the structural and functional characteristics of both lower limb and respiratory musculotendinous structures.

METHODS

Vastus lateralis, gastrocnemius lateralis, and medialis, diaphragm muscles, as well as patellar tendon and Achilles tendon, were assessed using B-mode ultrasonography. Maximal voluntary isometric and passive torque measurements were conducted in the knee-extensors and plantar-flexors. Additionally, a subset of participants (N.=10 for each group) underwent a fatigue-inducing exercise-till-exhaustion protocol, and the strength of lower limb and respiratory muscles was evaluated immediately before and after the trial.

RESULTS

Athletes had bigger and stronger musculotendinous structures and greater endurance to fatigue than CN (P<0.05). BP had bigger plantar-flexors and diaphragm, greater fascicles length, more explosive plantar-flexors and respiratory muscles and bigger tendons than CY (P<0.05). On the other hand, CY showed greater muscle pennation angle and greater endurance to fatigue for both, lower limb, and respiratory muscles (P<0.05).

CONCLUSIONS

The present study emphasizes that chronic and specific exercise training leads to distinctive adaptations, not only in lower limb musculotendinous structures but also in other components such as respiratory muscles.

Prediction of maximum voluntary ventilation based on forced expiratory volume in athletes

OBJECTIVE

Maximum-voluntary-ventilation (MVV) is the maximal volume of which an individual can move by voluntary effort in one minute. It is possible that the first second forced-expiratory-volume (FEV1) could be more to reliable assess respiratory muscle endurance to estimate MVV.

METHODS

For this aim, 422 athletes (Age 22.9 ± 8.5 years; 98/324 - females/males) were performed a MVV, and FEV1 measurements.

RESULTS

The coefficient of determination was R2 = 0.594 between MVV and FEV1, with a predictive equation for overall participants: MVV = (FEV1 × 33.5)+12.7. The robust regression showed a good multiple correlation coefficient (R = 0.815) with the coefficient of determination R2 = 0.661 for the model including FEV1, age and gender as predictors. These equations MVV = (FEV1 X 27.3)+(Age(y) × 1.1)+20.5 and MVV = (FEV1 × 27.3)+(Age(y) × 1.1) were derived for male and female, respectively.

CONCLUSION

FEV1 can predict MVV in different athletes with greater accuracy when stratified per gender. Therefore, this new approach can be used in a short all-out test without stress of the respiratory muscle to predict MVV in athletes.

Standardised lung function metrics in healthy athletes

The objective of the current review was to identify whether clinically established lung function metrics of ventilatory and diffusion capacity obtained by standardised methodology are consistent with superior lung function in athletes, and whether this is related to maximal oxygen uptake (V̇O2max). Three independent reviewers performed a literature search in PubMed, Scopus, and reference screening. Data was extracted and analysed according to a predefined strategy. Studies published between 1970 and 2023 on athletes reporting V̇O₂max and at least one of the following lung function metrics: predicted forced expiratory volume in the first second of a forced vital capacity manoeuvre (FEV1%pred); predicted forced vital capacity (FVC%pred); predicted total lung capacity (TLC%pred); predicted pulmonary diffusion capacity for carbon monoxide (DL,CO%pred). Data on population size, age, sex, type of sports, as well as FEV1%pred, FVC%pred, TLC%pred, DL,CO%pred, and V̇O2max were extracted. Standardised mean, differences, and 95% CI were calculated when data were sufficient. In total, 13 original studies encompassing 193 individuals across various sports disciplines met the inclusion criteria. Pooled FEV1%pred was 111% (108-113%; 13 studies; n=193), FVC%pred 112% (108-116 %; 7 studies; n=118), TLC%pred 106% (103-108 %; 4 studies; n=60), and DL,CO%pred 121% (120-122 %; 2 studies; n=23). None of the studies provided sufficient data to evaluate the relationship between any of the lung function metrics and V̇O2max. In conclusion, athletes consistently exhibit high ventilatory and diffusing capacity metrics, but it is still unknown whether this is related to V̇O2max.

Association of Physical Fitness and Anthropometric Parameters With Lung Function in 7-Year-Old Children

PURPOSE

Associations between health-related parameters and lung function remain unclear in childhood. The study aims to evaluate the relationship between physical fitness and anthropometric parameters with the lung function of healthy scholar-aged children.

METHOD

A total of 418 children aged 7 years old participated in this study. The associations of physical fitness (handgrip strength, standing broad jump, and 800-m run) and anthropometric (waist circumference and body mass index) parameters with lung function (forced vital capacity and forced expiratory volume in 1 s) were analyzed using a mixed-linear regression model.

RESULTS

Girls had significantly lower forced vital capacity values (P = .006) and physical fitness (P < .030) compared to boys. On mixed-linear regression analyses, waist circumference (P = .003) was independently associated with forced vital capacity, explaining 34.6% of its variance, while handgrip strength (P = .042) and waist circumference (P = .010) were independently associated with forced expiratory volume in 1 second, accounting together for 26.5% of its variance in 7-year-old healthy children.

CONCLUSIONS

Handgrip strength and waist circumference were associated with lung function in healthy children highlighting the influence of upper body muscular strength and trunk dimension on lung function. Our results corroborate the need to promote physical fitness during childhood to protect against lung complications in later on in life.

Effects of Breathing Exercises on Neck Pain Management: A Systematic Review with Meta-Analysis

Background: Given the relationship between reduced pulmonary and respiratory muscle function in neck pain, incorporating breathing exercises into neck pain management may be beneficial. Purpose: The purpose of this study was to investigate the benefits of breathing exercises for treating neck pain. Methods: We searched PubMed (MEDLINE), PEDro, CINAHL, Scopus, and EMBASE databases, up to the 28 of February 2024. Randomized controlled trials evaluating the impact of breathing exercises on reducing pain and disability in both persistent and recent neck pain were selected. A meta-analysis was conducted for each outcome of interest; however, if quantitative methods were not possible, a qualitative synthesis approach was used. The risk of bias was assessed using the Cochrane RoB 2.0 Tool (version 22 August 2019). We used the GRADE approach to judge the certainty of the evidence. Results: Five studies were included. Meta-analysis showed a statistically significant reduction in pain (standardized mean difference (SMD), -10.16; 95% CI: -14.82, -5.50) and disability (SMD, -0.80; 95% CI: -1.49, -0.11), in favor of breathing exercises. Qualitative synthesis for pulmonary functional parameters resulted in a statistically significant improvement for FVC, MIP, MEP, and MVV, in favor of breathing exercises. Conclusions: Breathing exercises showed significant short-term effects in reducing pain and disability for persistent neck pain. They also provided benefits for functional respiratory parameters. However, the evidence certainty is low.

Influence of the breathing pattern on the pulmonary function of endurance-trained athletes

Proper functioning of the respiratory system is one of the most important determinants of human health. According to current knowledge, the diaphragmatic breathing pattern seems to be the most favourable. However, recent reports indicate that athletes often have dysfunctional breathing patterns, which may be associated with an increased risk of musculoskeletal injuries. The influence of the type of breathing pattern on the mechanical airways in athletes has not been investigated. The aim of the present study was to determine the characteristics and relationships between breathing patterns and respiratory function in athletes. This study included 69 Polish elite endurance athletes (♂40, ♀29) in different sports disciplines and 44 (♂17, ♀27) healthy nonathletes as a control group. All participants underwent pulmonary function tests (spirometry, plethysmography, diffusion capacity for carbon monoxide) with assessment of breathing patterns by the Hi-Lo test. Inspiratory and expiratory resistance (R) and reactance (X) of the respiratory system at a given frequency (5 Hz, 11 Hz, and 19 Hz) were measured by a noninvasive forced oscillation technique. In this study, almost half of the athletes (44.92%) had dysfunctional breathing patterns, although at a lower rate than that in the control group. Diaphragmatic breathing patterns were characterized by higher spirometric, plethysmographic and DLCO values compared to thoracic or abdominal breathing patterns. Similarly, lower inspiratory reactance at 5 Hz (X5%pred.) was observed in the diaphragmatic pattern compared to the thoracic pattern. A diaphragmatic breathing pattern is associated with better pulmonary function test results. However, this study revealed a dysfunctional breathing pattern in almost half of the athletes. These results suggest that the assessment of breathing patterns and the implementation of breathing exercises in athletes are essential to promote proper breathing patterns.

Impact of Body Composition Parameters on Lung Function in Athletes

Background: Given the potential risk of unhealthy weight management, the monitoring of body composition in athletes is advised. However, limited data reveal how body composition measurements can benefit athlete health and, in particular, respiratory function. The aim of this study is to evaluate the impact of body composition on pulmonary function in a population of adult athletes. Methods: Data from 435 competitive adult athletes regarding body compositions parameters and spirometry are retrospectively analyzed. Results: Our study population consists of 335 males and 100 female athletes. Muscle mass and fat-free mass are significantly and positively associated with forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) in the male and female population, while waist-to-height ratio is negatively associated with FEV1, FVC, and FEV1/FVC in the male population. In multivariable analysis, muscle mass and fat-free mass show significant association with FEV1 and FVC in both males and females (p < 0.05), and waist-to-height ratio is significantly and inversely associated with FEV1 and FVC in males (p < 0.05). Conclusions: Fat-free mass and muscle mass are positively and independently associated with FEV1 and FVC in athletes of both genders, and waist-to-height ratio is inversely associated with FEV1 and FVC only among male athletes. These findings suggest that body composition in athletes may be helpful in monitoring respiratory function.

Intra-Rater Reliability of Shear Wave Elastography for the Quantification of Respiratory Muscles in Adolescent Athletes

The aim of this study was to assess the intra-rater reliability and agreement of diaphragm and intercostal muscle elasticity and thickness during tidal breathing. The diaphragm and intercostal muscle parameters were measured using shear wave elastography in adolescent athletes. To calculate intra-rater reliability, intraclass correlation coefficient (ICC) and Bland-Altman statistics were used. The reliability/agreement for one-day both muscle measurements (regardless of probe orientation) were at least moderate. During the seven-day interval between measurements, the reliability of a single measurement depended on the measured parameter, transducer orientation, respiratory phase, and muscle. Excellent reliability was found for diaphragm shear modulus at the peak of tidal expiration in transverse probe position (ICC_3.1 = 0.91-0.96; ICC₃.₂ = 0.95), and from poor to excellent reliability for the intercostal muscle thickness at the peak of tidal inspiration with the longitudinal probe position (ICC_3.1 = 0.26-0.95; ICC₃.₂ = 0.15). The overall reliability/agreement of the analysed data was higher for the diaphragm measurements (than the intercostal muscles) regardless of the respiratory phase and probe position. It is difficult to identify a more appropriate probe position to examine these muscles. The shear modulus/thickness of the diaphragm and intercostal muscles demonstrated good reliability/agreement so this appears to be a promising technique for their examination in athletes.

Differences in lung function, bronchial hyperresponsiveness and respiratory health between elite athletes competing in different sports

Objectives: Examine lung function, bronchial hyperresponsiveness (BHR) and exercise-induced respiratory symptoms in elite athletes performing different sports.Methods: Norwegian national-team athletes (30 swimmers, 32 cross-country skiers, 16 speed-skaters, 11 rowers/paddlers, 17 handball players and 23 soccer players) completed a validated questionnaire, measured exhaled nitric oxide (FE_NO), spirometry, methacholine provocation (PD_20met) and skin prick test. Three cut-off levels defined BHR; i.e., PD_20met ≤2µmol, ≤4 µmol and ≤8µmol.Results: Mean forced vital capacity (FVC) was highest in swimmers (Mean z-score[95%CI] =1.16 [0.80, 1.51]), and close to or higher than reference values according to the Global Lung Initiative equation, across all sports. Mean forced expiratory volume in 1 second (FEV₁) was higher than reference values in swimmers (0.48 [0.13, 0.84]), and ball game athletes (0.69 [0.41, 0.97]). Mean forced expiratory flow between 25 and 75% of FVC (FEF_25-75), and/or FEV₁/FVC were lower than reference values in all endurance groups. BHR defined by ≤2 and ≤8 µmol methacholine was observed in respectively 50%-87% of swimmers, 25%-47% of cross-country skiers, 20%-53% of speed-skaters, 18%-36% and of rowers/paddlers, and 0%-17% of the ball game athletes. Exercise-induced symptoms were common in all groups, most frequent in cross-country skiers (88%), swimmers (83%) and speed-skaters (81%).Conclusion: Elite swimmers and ball game athletes had higher mean FVC and FEV₁, compared to reference values. However, FEF_25-75 and/or FEV₁/FVC was lower than the reference values in all endurance groups. The prevalence of BHR was high across all sports, except the ball game athletes, and most of the athletes reported exercise-induced respiratory symptoms.

Association of Leisure Time Physical Activity Types and Risks of All-Cause, Cardiovascular, and Cancer Mortality Among Older Adults

IMPORTANCE

Higher amounts of physical activity are associated with increased longevity. However, whether different leisure time physical activity types are differentially associated with mortality risk is not established.

OBJECTIVES

To examine whether participation in equivalent amounts of physical activity (7.5 to <15 metabolic equivalent of task [MET] hours per week) through different activity types is associated with mortality risk and to investigate the shape of the dose-response association.

DESIGN, SETTING, AND PARTICIPANTS

Participants in this cohort were respondents from the National Institutes of Health-AARP Diet and Health Study who completed the follow-up questionnaire between 2004 and 2005. This questionnaire collected data on weekly durations of different types of physical activities. Mortality was ascertained through December 31, 2019.

EXPOSURES

MET hours per week spent participating in the following activities: running, cycling, swimming, other aerobic exercise, racquet sports, golf, and walking for exercise.

MAIN OUTCOMES AND MEASURES

All-cause, cardiovascular, and cancer mortality. Separate multivariable-adjusted Cox proportional hazards regression models were fitted to estimate hazard ratios (HRs) and 95% CIs of mortality for each of the 7 types of leisure time physical activities, as well as the sum of these activities.

RESULTS

A total of 272 550 participants (157 415 men [58%]; mean [SD] age at baseline, 70.5 [5.4] years [range, 59-82 years]) provided information on types of leisure time activity, and 118 153 (43%) died during a mean (SD) follow-up of 12.4 (3.9) years. In comparison with those who did not participate in each activity, 7.5 to less than 15 MET hours per week of racquet sports (HR, 0.84; 95% CI, 0.75-0.93) and running (HR, 0.85; 95% CI, 0.78-0.92) were associated with the greatest relative risk reductions for all-cause mortality, followed by walking for exercise (HR, 0.91; 95% CI, 0.89-0.93), other aerobic activity (HR, 0.93; 95% CI, 0.90-0.95), golf (HR, 0.93; 95% CI, 0.90-0.97), swimming (HR, 0.95; 95% CI, 0.92-0.98), and cycling (HR, 0.97; 95% CI, 0.95-0.99). Each activity showed a curvilinear dose-response association with mortality risk; low MET hours per week of physical activity for any given activity type were associated with a large reduction in mortality risk, with diminishing returns for each increment in activity thereafter. Associations were similar for cardiovascular and cancer mortality.

CONCLUSIONS AND RELEVANCE

This cohort study of older individuals found differences between different types of leisure time activities and mortality risk, but there were significant associations between participating in 7.5 to less than 15 MET hours per week of any activity and mortality risk.

The Effect of Inspiratory Muscle Training on the Pulmonary Function in Mixed Martial Arts and Kickboxing Athletes

Inspiratory muscle training (IMT) has found its way into athletes’ routine as a promising way of improving pulmonary function in combination with standard training. The objective of the study was to examine the effects of resistive IMT on the pulmonary function variables in athletes of two combat sports, i.e., mixed martial arts (MMA) and kickboxing. Fourteen kickboxing and 12 MMA male athletes qualified for the study. They were randomly assigned into experimental and control groups. While both groups participated in their standard training, the experimental group additionally participated in IMT which consisted of 30 breaths twice a day for 6 weeks. The pulmonary functions were measured at baseline and after 6 weeks of IMT. The addition of IMT to standard training increased significantly the forced expiratory volume in the first second to vital capacity ratio (FEV1/VC), and the maximum voluntary ventilation (MVV) (p < 0.05) with changes of 5.7%, and 28.6%, respectively, in MMA athletes. The kickboxing group showed no significant changes. The interaction of the sport discipline and IMT intervention yielded a strong significant change in the MVV (F(1, 11) = 14.53, p < 0.01), and FEV1/VC (F(1, 11) = 20.67, p < 0.01) to the benefit of MMA athletes in comparison with kickboxing athletes. Combining resistive IMT for 6 weeks with standard training was effective to improve some pulmonary functions in MMA athletes, but did not lead to additional gains in kickboxing athletes.

Effects of a taped filter mask on peak power, perceived breathlessness, heart rate, blood lactate and oxygen saturation during a graded exercise test in young healthy adults: a randomized controlled trial

BACKGROUND

Face masks are an effective, non-pharmacological strategy to reduce the transmission of Severe Acute Respiratory Syndrome Coronavirus-2 and other pathogens. However, it is a challenge to keep masks sealed during exercise, as ventilation can increase from 5 to 10 L/min at rest to up to 200 L/min so that masks may be blown away from the face. To reduce leakage e.g. during exercise, a face mask was developed that is taped onto the face. The aim of this study was to investigate during a graded exercise test the effect of a taped filter mask on the perception of breathlessness, heart rate, blood lactate concentration, and oxygen saturation when compared to a surgical mask and no mask.

METHODS

Eight healthy trained participants (4 females), aged 24.5 ± 3.3 years performed graded exercise test until volitional exhaustion under three conditions: (1) No mask/control, (2) surgical mask or (3) taped filter mask. During these tests, we measured perception of breathlessness, heart rate, blood lactate concentration and peripheral oxygen saturation and analysed the resultant data with one or two-way repeated measures ANOVAs. We also used a questionnaire to evaluate mask comfort and analysed the data with paired t-tests.

RESULTS

When compared to wearing no mask, maximal workload was significantly reduced with a taped filter face mask by 12 ± 6% (p < 0.001) and with a surgical mask by 3 ± 6% (p > 0.05). Moreover, subjects perceive the sensation of "severe breathlessness" at a 12 ± 9% lower workload (p = 0.012) with a taped face mask, and 7 ± 13% lower workload with a surgical mask (p > 0.05) when compared to wearing no mask. Oxygen saturation at 65% of the maximal workload is 1.5% lower (p = 0.018) with a taped mask than no mask. Heart rate and blood lactate concentration are not significantly different in-between no mask, surgical mask and taped mask at any workload. When compared to wearing a surgical mask, wearing a taped filter face mask has a significantly better wearing comfort (p = 0.038), feels better on the skin (p = 0.004), there is a lower sensation of moisture (p = 0.026) and wearers perceive that less heat is generated (p = 0.021). We found no sex/gender differences for any of the measured parameters.

CONCLUSIONS

A taped mask is well tolerated during light and moderate exercise intensity but reduces maximal exercise capacity.

Reference Values of Forced Vital Capacity and Expiratory Flow in High-Level Cyclists

Several studies have demonstrated that spirometric theoretical values may not be applicable to the high-level sports population. No reference values exist for high-level professional cyclists. We aimed to establish predictive spirometric values by reference equations. One hundred and forty-five French Caucasian high-level professional cyclists, aged 18–38, performed basic anthropometric assessment and spirometry during the medical evaluation at the beginning of the sport season. Measured values were compared with theoretical values. Predictive equations were established from anthropometric parameters to explain variations of spirometric parameters. High-level cyclists had significantly higher spirometric values than the theoretical values established from a general population, except for forced expiratory volume in one second (FEV₁), forced vital capacity (FVC) and forced expiratory flow (FEF) at 25% of FVC. Only FVC and FEV₁ were well predicted from body height. The FVC variation of 43.5% is explained by body height and weight. The FEV₁ variation of 25.8% is explained only by body height. High-level cycling is associated with important respiratory adaptations depending on the body height and the sport specificity: intensive and prolonged endurance training. These findings are interesting for clinical individual application to diagnose obstructive disease and test reversibility with bronchodilator drugs.

Respiratory muscle strength in volleyball players suffered from COVID-19

Background

Symptoms related to Coronavirus-19 disease (COVID-19) and quarantine measures have caused pulmonary function abnormality and impaired respiratory mechanics. However, no studies are evaluating pulmonary functions and respiratory muscle strength in female volleyball players according to COVID-19 status in the pandemic.

Aims

This study aims to compare pulmonary functions and respiratory muscle strength in female players with and without COVID-19.

Methods

Seventeen players (23.47 ± 5.89 years) who were recovered from COVID-19 and 25 female volleyball players (20.48 ± 5.05 years) who were not infected by SARS-CoV-2 were included in the study. Maximal inspiratory and expiratory pressure, pulmonary functions, body composition, symptom severity, and perceptions of performance were evaluated.

Results

Measured and predicted percent maximal inspiratory pressure and measured maximal expiratory pressure values of COVID-19 players were statistically significantly lower than non-COVID-19 players (p < 0.05). Dynamic lung volumes were similar in groups (p > 0.05).

Conclusions

Inspiratory and expiratory muscle strength in COVID-19 players were more affected compared with non-COVID-19 players. Pulmonary functions were mostly preserved in COVID-19 players. Respiratory muscle weakening can affect the performance of female players. Therefore, respiratory muscle strength training could be suggested in female players with COVID-19 to increase respiratory muscle strength and prevent deterioration in performance.

Trial registration (ClinicalTrials.gov)

Registration ID: NCT04789512.

Aerobic capacity and respiratory patterns are better in recreational basketball-engaged university students than age-matched untrained males

Study aim: To asses and compare the aerobic capacity and respiratory parameters in recreational basketball-engaged university students with age-matched untrained young adults.

Material and methods: A total of 30 subjects were selected to took part in the study based on recreational-basketball activity level and were assigned to a basketball (BG: n = 15, age 22.86 ± 1.35 yrs., body height 185.07 ± 5.95 cm, body weight 81.21 ± 6.15 kg) and untrained group (UG: n = 15, age 22.60 ± 1.50 yrs., body height 181.53 ± 6.11 cm, body weight 76.89 ± 7.30 kg). Inspiratory vital capacity (IVC), forced expiration volume (FEV1), FEV1/IVC ratio, maximal oxygen consumption (VO2max), ventilatory threshold (VO2VT) and time to exhaustion, were measured in all subjects. Student T-test for independent Sample and Cohen’s d as the measure of the effect size were calculated.

Results: Recreational basketball-engaged students (EG) reached significantly greater IVC (t = 7.240, p < 0.001, d = 1.854), FEV1 (t = 10.852, p < 0.001, d = 2.834), FEV1/IVC ratio (t = 6.370, p < 0.001, d = 3.920), maximal oxygen consumption (t = 9.039, p < 0.001, d = 3.310), ventilatory threshold (t = 9.859, p < 0.001, d = 3.607) and time to exhaustion (t = 12.361, p < 0.001, d = 4.515) compared to UG.

Conclusions: Long-term exposure to recreational basketball leads to adaptive changes in aerobic and respiratory parameters in male university students.

Relationship between pulmonary function, throw distance, and psychological competitive ability of elite highly trained Japanese boccia players via correlation analysis

Background

Boccia players have severe quadriplegia; nonetheless, detailed aspects of the physical function of individual players have not been evaluated.

Aims

This study aimed to detetmine the relationship between pulmonary function, pitching distance, and psychological competitive ability of Japanese boccia players.

Methods

Participants were athletes from the Japan Boccia Association (10 males, 3 females; average age, 32.9 ± 12.0 years) who could independently perform pitching motions. We measured pulmonary function, respiratory muscle force, and diaphragm movement using ultrasonography, pitching distance, and psychological competitive ability.

Outcomes and results

In all participants, pulmonary function, respiratory muscle force, and diaphragm displacement were low, whereas respiratory function was very low compared to the normal range (i.e., the value calculated from the subjects’ height, weight, and age). However, boccia players with high level of competitive ability performed well.

Conclusions and implications

The results raise the question as to whether focusing on the development of boccia players’ competitive ability and physical function will improve their overall performance. This question warrants future investigation.

Asthma among elite athletes, mechanism of occurrence and impact on respiratory parameters: A review of literature

Introduction: It is generally accepted that physical activity benefits every person but athletes diagnosed with asthma face various challenges during their training to keep the symptoms of the disease under control. Prolonged exposure to agents in the environment in which athletes train favors the development of permanent changes in the airways. Their action leads to permanent hyper-reactivity with development of an inflammatory response and the release of mediators (IL-8, leukotrienes, eicosanoids) that lead to damage epithelial cells with breaking connection between them and consequent dysfunction of the respiratory system. This condition is called exercise-induced asthma (EIA). This fact is especially important for athletes who have long endurance training. The best way to check the condition of breathing system is with a diagnostic method which is the " gold" standard spirometry. Aim: The point of this systematic review is to get closer the mechanism occurrence of EIA/(exercise-induced bronchoconstriction)-EIB, prevalence and incidence of EIA/EIB, changes of pulmonary function and quality of life in elite athletes. We searched papers from PubMed and Cochrane database using keywords: 'exercise-induced asthma', 'athletes', 'spirometry', 'bronchoconstriction', 'bronchospasm', 'physical activity', 'physical training', 'prevalence', 'incidence'. We have studied 48 scientific papers in total. Conclusion: The prevalence of asthma among elite athletes, especially endurance athletes is higher than in general population. The explanation of this phenomenon is related to the whole mechanism of occurrence, it is still insufficiently clarified, but one thing is for sure that with good disease control athletes can play and compete undisturbed for many years.

Handgrip strength is associated with improved spirometry in adolescents

Introduction

Pulmonary rehabilitation, including aerobic exercise and strength training, improves function, such as spirometric indices, in lung disease. However, we found spirometry did not correlate with physical activity (PA) in healthy adolescents (Smith ERJ: 42(4), 2016). To address whether muscle strength did, we measured these adolescents’ handgrip strength and correlated it with spirometry.

Methods

In 1846 non-smoking, non-asthmatic Germans (age 15.2 years, 47% male), we modeled spirometric indices as functions of handgrip strength by linear regression in each sex, corrected for factors including age, height, and lean body mass.

Results

Handgrip averaged 35.4 (SD 7.3) kg in boys, 26.6 (4.2) in girls. Spirometric volumes and flows increased linearly with handgrip. In boys each kg handgrip was associated with about 28 mL greater FEV1 and FVC; 60 mL/sec faster PEF; and 38 mL/sec faster FEF2575. Effects were 10–30% smaller in girls (all p<0.0001) and stable when Z-scores for spirometry and grip were modeled, after further correction for environment and/or other exposures, and consistent across stages of puberty.

Conclusions

Grip strength was associated with spirometry in a cohort of healthy adolescents whose PA was not. Thus, research into PA’s relationship with lung function should consider strength as well as total PA. Strength training may benefit healthy lungs; interventions are needed to prove causality.

The training type influence on male elite athletes' ventilatory function

Background/aim

To assess and compare measured ventilatory volumes (forced expiratory volume in 1 s (FEV₁), peak expirium flow (PEF) and maximal voluntary ventilation (MVV)), ventilatory function capacities (forced vital capacity (FVC) and vital capacity (VC)) and FEV₁/VC ratio in a sample of power and endurance elite athletes and their age-matched and sex-matched sedentary control group.

Methods

A cross-sectional study was applied on male elite athletes (n=470) who were classified according to the type of the predominantly performed exercise in the following way: group 1: endurance group (EG=270), group 2: power athletes group (SG=200) and group 3: sedentary control group (CG=100). The lung VC, FVC, FEV₁, FEV₁/FVC ratio, PEF and MVV were measured in all of the observed subjects, who were also classified with regard to body mass index (BMI) and the percentage of the body fat (BF%).

Results

The CG had the highest BF% value, while the endurance group had the lowest BMI and BF% value, which is significantly different from the other two groups (p<0.05). The observed values of VC, FVC and FEV₁ in the EG were significantly higher than those from the other two groups (p<0.05). There were no differences concerning the observed FEV₁/FVC ratio.

Conclusions

A continued endurance physical activity leads to adaptive changes in spirometric parameters (VC, FVC and FEV₁), highlighting the fact that there is a need for specific consideration of different respiratory ‘pattern’ development in different types of sport, which also has to be further evaluated.

Spirometry reference values in the Brazilian population

The aim of the present study was to provide new spirometry reference equations in a sample of the Brazilian population for the following parameters: forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, peak of expiratory flow (PEF), forced expiratory flow at 50% (FEF50%), 75% average vital capacity (FEF25-75%), and average forced expiratory flow time (FEFT). This was a prospective study using results from chest radiographs, electrocardiograms, and questionnaires to investigate the participants' respiratory symptoms, sedentarism, and comorbidities (Charlson comorbidity index). From December 2010 to July 2014, individuals were randomly selected from various locations in the state of Rio de Janeiro. All individuals were examined by a single technician in the morning at the laboratory, and performed the spirometry with the same spirometer. Spirometry values were tabulated for the creation of three equation models: linear regression, logarithmic regression, and logarithms through a method that incorporates the lambda, median, and coefficient of variation (LMS method). Initially, 7003 individuals from both genders were contacted, and 454 were recruited. The data from the new equations were compared with one Brazilian and eight international equations, resulting in a high correlation (r>0.9). The values derived from the LMS method and linear regression were very similar (P>0.5), and both could be used to acquire the reference values for Brazilian spirometry. Data derived from the equations of this study were different from the current Brazilian equation, which could be justified by the different method used.

Sport-specific influences on respiratory patterns in elite athletes

OBJECTIVE:

To examine differences in lung function among sports that are of a similar nature and to determine which anthropometric/demographic characteristics correlate with lung volumes and flows.

METHODS:

This was a cross-sectional study involving elite male athletes (N = 150; mean age, 21 ± 4 years) engaging in one of four different sports, classified according to the type and intensity of exercise involved. All athletes underwent full anthropometric assessment and pulmonary function testing (spirometry).

RESULTS:

Across all age groups and sport types, the elite athletes showed spirometric values that were significantly higher than the reference values. We found that the values for FVC, FEV₁, vital capacity, and maximal voluntary ventilation were higher in water polo players than in players of the other sports evaluated (p < 0.001). In addition, PEF was significantly higher in basketball players than in handball players (p < 0.001). Most anthropometric/demographic parameters correlated significantly with the spirometric parameters evaluated. We found that BMI correlated positively with all of the spirometric parameters evaluated (p < 0.001), the strongest of those correlations being between BMI and maximal voluntary ventilation (r = 0.46; p < 0.001). Conversely, the percentage of body fat correlated negatively with all of the spirometric parameters evaluated, correlating most significantly with FEV₁ (r = −0.386; p < 0.001).

CONCLUSIONS:

Our results suggest that the type of sport played has a significant impact on the physiological adaptation of the respiratory system. That knowledge is particularly important when athletes present with respiratory symptoms such as dyspnea, cough, and wheezing. Because sports medicine physicians use predicted (reference) values for spirometric parameters, the risk that the severity of restrictive disease or airway obstruction will be underestimated might be greater for athletes.