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Abstract
This study aimed at determining the frequency of respiratory symptoms in high-level athletes and whether respiratory questionnaires are reliable predictors of airway hyperresponsiveness (AHR) in this population compared with control subjects. One hundred high-level athletes exercising in different conditions of ambient air (dry, humid, cold or mixed dry and humid) and 50 sedentary control subjects answered four question sets on exercise-induced symptoms of postnasal drip (Q1), breathlessness, chest tightness and wheezing (Q2), and cough (Q3). Another question set (Q4) evaluated the self-description of nociceptive sensations associated with respiratory symptoms. Methacholine inhalation tests were performed in all subjects to obtain a 20% fall in forced expiratory volume in 1 second (PC20). AHR could be detected by questionnaires in 37 of 44 (84%) subjects with a PC20<8 mg/mL. Sensitivity to detect AHR varied between the different subgroups of athletes with each of the question sets; however, no significant differences in sensitivity were observed between the groups of athletes and controls except for Q3 (P = .007), in which athletes exercising in cold air reported more exercise-induced cough. Q2 had a better specificity (83%) than Q3 (77%) and Q4 (64%). Combined question sets revealed that three swimmers, two triathletes, and two controls, who answered negatively to all question sets, had a PC20<8 mg/mL. Questionnaires on symptoms and on associated nociceptive sensations may help to detect AHR as well in athletes and controls, although for some subgroups of athletes such as swimmers and triathletes and in some controls, false negative questionnaires can be observed and AHR underreported.
| Abbreviations | ||
| AHR: | = | Airway hyperresponsiveness |
| FEV1: | = | Forced expiratory volume in one second |
| CA: | = | Cold air |
| DA: | = | Dry air |
| DHA: | = | Dry and humid air |
| HA: | = | Humid air |
| MIT: | = | Methacholine inhalation test |
| PC20: | = | Concentration of methacholine inducing a 20% fall in FEV1 |
| Q1: | = | Question set 1 (on exercise-induced symptoms of post-nasal drip) |
| Q2: | = | Question set 2 (on exercise-induced breathlessness, chest tightness and wheeze) |
| Q3: | = | Question set 3 (on exercise-induced cough) |
| Q4: | = | Question set 4 (on self-description of the nociceptive sensations associated with respiratory symptoms |