Reduction of exercise-induced asthma in children by short, repeated warm ups.

Abstract

Aim-To study the eVect of a warm up schedule on exercise-induced asthma in asthmatic children to enable them to engage in asthmogenic activities. Method-In the first study, peak flows during and after three short, repeated warm up schedules (SRWU 1, 2, and 3), identical in form but diVering in intensity, were compared in 16 asthmatic children. In the second study the eYciency of the best of these SRWU schedules was tested on 30 young asthmatic children. Children performed on diVerent days a 7 minute run alone (EX1) or the same run after an SRWU (EX2). Results-The second study showed that for most children (24/30) the fall in peak flow after EX2 was less than that after EX1. The percentage fall in peak flow after EX2 was significantly correlated with the percentage change in peak flow induced by SRWU2 (r=0.68). The children were divided into three subgroups according to the change in peak flow after SRWU2: (G1: increase in peak flow; G2: < 15% fall in peak flow; G3: > 15% fall in peak flow). Only the children in the G3 subgroup did not show any gain in peak flow after EX2 compared with EX1. Conclusion-The alteration in peak flow at the end of the SRWU period was a good predictor of the occurrence of bronchoconstriction after EX2. An SRWU reduced the decrease in peak flow for most of the children (24/30) in this series, thus reducing subsequent post-exercise deep bronchoconstriction. (Br J Sports Med 1999;33:100-104) Keywords: bronchoconstriction; children; asthma; warm up Physical activity including the practice of many sports tends to be limited in children with post-exercise bronchospasm 1 2 unless they take appropriate medication before exercise. However, physical activity in sports and games contributes to the physical and psychological growth of asthmatic children.3-5 Apart from premedication, various training schedules and warm up periods have been proposed to attenuate the post-exercise bronchospasm seen in these children.6 7 A continuous warm up of three minutes had no beneficial eVect on the bronchospasm induced by treadmill, 8 though short, repeated warm up periods (SRWU) have been shown to reduce the bronchospasm induced by a subsequent long run.9 10 In our study three SRWU schedules were evaluated in 16 children with asthma, and the eYciency of the best of these SRWU was then examined in a further series of 30 asthmatic children. MethodsThe tests were conducted outdoors in a centre for the treatment of asthmatic children in the Pyrenees mountains at an altitude of 1800 m. This centre is dedicated to improving the asthmatic status of the children through physical activity in a non-polluted environment. Ambient mean (SD) temperature was 4 (5)°C with a low humidity (1.5 (0.5) mm Hg). FIRST STUDYThe first study aimed at selecting an optimum SRWU schedule. Sixteen children, aged 11 (2) years, with post-exercise asthma were included. All were tested in the laboratory and showed a fall in FEV 1 of at least 15% after completion of a short 7 minute maximal exercise performed on an ergometric bicycle...

Asthma as a Barrier to Children's Physical Activity: Implications for Body Mass Index and Mental Health

“…This is despite evidence that proper therapeutic management of asthma should allow most children to participate fully in vigorous physical activity, 36 particularly if a thorough warm-up is allowed. 37 If parents discourage exercise in children with asthma, the consequences may be secondary deconditioning as a result of inactivity. 38 This study provides some support for previous work, suggesting that asthma negatively impacts on mental health.…”

3-Min step test and treadmill exercise for evaluating exercise-induced asthma

“…Although physical training increases the aerobic capacity similarly in asthmatic patients and in healthy subjects, it has no detectable influence on the degree of EIA [39]. Conversely, a prolonged warm-up period of submaximal exercise can induce refractoriness of EIA without inducing bronchoconstriction [40,41].…”

Pre-Exercise Hyperpnea Attenuates Exercise-Induced Bronchoconstriction Without Affecting Performance

“…However, whole-body warm-up as well as hyperpnea warm-up exercises bear the risk of inducing EIB by itself [6,7,9,11,14] which might compromise preparation for the subsequent competition. Interestingly, one study showed that exercising with warm and humid air did not induce substantial EIB but this exercise was still effective in preventing EIB in the following exercise challenge [17].…”