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PubMed1997

Sweating economy by graded control in well-trained athletes.

Local sweat rates (Msw) at the chest and thigh and the frequency of sweat expulsions (Fsw) were determined in human subjects with (athletes) or without (non-athletes) long-term physical training during moderate bicycle exercise (80 W for 30 min) at ambient thermoneutrality (23 degrees C) and 60% relative humidity. There was a tendency for Msw to be lower in athletes. The rise of Msw with increasing Fsw was significantly less steep and Fsw was also controlled at a significantly lower rate in athletes than in non-athletes. The start of exercise was followed by a temporary decrease in mean skin temperature (Ts) which was less distinct in athletes. The rise in Ts at the end of exercise was significant in athletes (0.80 +/- 0.26 degree C) but not in non-athletes (0.26 +/- 0.33 degree C). The results indicate that long-term physical training leads to improved circulatory heat transfer to the skin and to a more graded nervous control of sweat expulsion and, further, tends to reduce the rate of sweating.

Adult↗
PubMed2006

Treatment of athletes with cardiac disease or arrhythmias.

Ventricular arrhythmias and sudden cardiac death in the athlete are uncommon but extremely visible because of the high profile of amateur and professional athletes. In athletes under the age of 30 years, the incidence of sudden death is low and in most cases occurs in individuals with inherited heart disease. In the older athlete, sudden death is more common and is generally due to arrhythmias in the context of coronary artery disease. Many athletes with aborted sudden death, arrhythmia-related syncope, or high-risk genetic disorders benefit from therapy with implantable cardioverter-defibrillators (ICDs). Although ICD therapy can effectively abort sudden death, implantation of an ICD generally prohibits an individual from all competitive athletics except low-intensity sports. Recommendations for participation in competitive athletics generally follow the recently published 36th Bethesda Conference Eligibility Recommendations for Competitive Athletes with Cardiovascular Abnormalities.

Journal Article↗
PubMed1980

Wenckebach second-degree A-V block in top-ranking athletes: an old problem revisited.

The occurrence of Wenckebach second-degree (Mobitz I) A-V block in apparently normal persons still provides a puzzle for the cardiologist, as the benign nature of this event has been recently questioned. This problem becomes more intriguing when Wenckebach A-V block is encountered in asymptomatic top-ranking athletes, because of medico-legal implications. We report 10 cases of highly-trained athletes, including three with mitral valve prolapse (MVP) features, with a spontaneous or induced Wenckebach second-degree A-V block. Previous ECGs of six subjects, dating from a maximum of 6 years to a minimum of 18 months, were available. Deterioration of A-V conduction has never been documented and all six cases have remained asymptomatic for the whole follow-up period. Athletes have been submitted to a protocol study consisting of ECG recording at rest, during, and after vagal and sympathetic reflex maneuvers, drug administration (isoproterenol and atropine), submaximal and maximal exercise. Nine subjects have been considered to have "normal" responses of the A-V node to provocative tests, since conduction disturbances were improved or normalized by reflex sympathetic stimulations and were completely normalized by autonomic drug administration and exercise. One athlete showed "abnormal" responses to tests. In order to give a conclusive prognostic and medico-legal assessment, we advised him to submit to an invasive electrophysiological investigation. Wenckebach second-degree A-V block in athletes may be a more common finding than so far described, especially when a systematic search is made. In our opinion, this event can still be considered a vagally-induced benign feature of athlete's heart, provided that an immediate improvement of A-V conduction is obtained in response to reflex sympathetic maneuvers, and that a complete normalization after sympathomimetic and vagolytic drug administration and physical exercise is observed. The clinical histories of our athletes and the observed complete disappearance of conduction disturbances after detraining, strongly support this opinion. Wenckebach second-degree A-V block in asymptomatic athletes with MVP features probably does not affect the prognosis if similar favorable responses to the aforesaid tests are observed.

Adolescent↗
PubMed1984

Elevated high-density lipoprotein cholesterol levels in older endurance athletes.

To ascertain whether older (masters) athletes exhibit a more favorable plasma lipoprotein/lipid profile than sedentary men of similar age, 14 endurance-trained masters athletes (mean age 60 +/- 2 years [+/- standard error of the mean]), 12 older, untrained-not lean men (mean age 62 +/- 1 years), 9 older untrained-lean men (mean age 61 +/- 2 years), 15 young endurance-trained athletes (mean age 26 +/- 1 years) and 15 young untrained men (mean age 28 +/- 1 years) were studied. The athletes had higher values for maximal oxygen uptake and lower levels of body fatness compared with the untrained men, regardless of age (p less than 0.05). High-density lipoprotein (HDL) cholesterol was markedly higher in the masters athletes than in the other groups (66 vs 42 to 55 mg/dl, p less than 0.05). The total cholesterol (TC) and low-density lipoprotein cholesterol concentrations of the masters athletes generally were higher than those of the younger groups, similar to those of the older lean men, and lower than those of the older-not lean men (p less than 0.05). The TC/HDL cholesterol ratios were similarly low (2.8 to 3.4) for the athletes and the young untrained men compared with the older untrained men (4.0 to 5.6) (p less than 0.05). Thus, some older endurance athletes exhibit markedly higher HDL cholesterol levels and lower TC/HDL cholesterol ratios compared with their sedentary peers. This favorable plasma lipoprotein profile may indicate a reduced risk of developing coronary artery disease for older men who exercise regularly.

Adult↗
PubMed1989

Preparticipation echocardiographic screening for cardiovascular disease in a large, predominantly black population of collegiate athletes.

Sudden death in young competitive athletes is most commonly due to underlying cardiovascular disease. Echocardiography has the potential to identify structural cardiovascular abnormalities, such as hypertrophic cardiomyopathy (HC), that have been incriminated in such events. In this study, echocardiography (2-dimensional and M-mode) was used as a primary screening test to assess 265 Howard University collegiate athletes for cardiovascular disease; 262 (99%) were black. Most athletes (234, 88%) had no definitive echocardiographic evidence of HC or other major cardiovascular diseases, but 30 (11%) had mitral valve prolapse, and 1 other athlete had a small atrial septal defect. In addition, 4 athletes were identified as having mild systemic hypertension. Most athletes (236 of 265) showed normal left ventricular wall thickness of less than or equal to 12 mm, but an important minority (29, 11%) had maximal ventricular septal thicknesses of greater than or equal to 13 mm that could not always be distinguished (by morphology alone) from mild anatomic expressions of nonobstructive HC. Based on this experience, preparticipation athletic screening using echocardiography as the primary test does not appear to be justified on a cost-effective basis. In addition, the substantial minority of subjects with increased wall thickness made clinical interpretation of the echocardiographic findings difficult in individual athletes.

Adult↗
PubMed1993

Absence of left ventricular wall thickening in athletes engaged in intense power training.

There is a widely held perception that power training increases left ventricular (LV) wall thickness. Consequently, in individual power-trained athletes, confusion may legitimately occur with regard to the differential diagnosis of athlete's heart and nonobstructive hypertrophic cardiomyopathy. To investigate the effects of systematic strength training on cardiac dimensions (particularly absolute LV wall thickness), 100 relatively young and highly conditioned athletes participating in weight and power lifting, wrestling, bobsledding and weight-throwing events for 3 to 24 years (mean 7) were studied by echocardiography. No athlete showed a maximal absolute LV wall thickness that exceeded the generally accepted upper limits of normal (i.e., 12 mm; range 8 to 12). When compared with 26 normal, sedentary control subjects of similar age and body surface area, maximal septal thickness was mildly but significantly greater in athletes (9.6 +/- 0.8 vs 9.0 +/- 0.5 mm; p < 0.001), as was the calculated LV mass index (96 +/- 12 vs 81 +/- 8 g/m2; p < 0.001); LV end-diastolic cavity dimension was similar in athletes and controls (55 +/- 4 and 54 +/- 3, respectively; p > 0.05). Consequently, echocardiographic data in this selected group of purely strength-trained athletes show that whereas this form of conditioning is associated with increased LV mass and a disproportionate increase in wall thickness in relation to cavity dimension, only modest alterations in absolute wall thickness occur (which do not exceed upper normal limits). Therefore, in highly conditioned, strength-trained, competitive athletes, the presence of substantial LV wall thickening (> 13 mm) should suggest alternative explanations, such as the diagnosis of pathologic hypertrophy (i.e., hypertrophic cardiomyopathy).

Adolescent↗
PubMed1990

Altered left ventricular volume and ejection fraction responses to supine dynamic exercise in athletes.

Two-dimensional echocardiography was used to determine the responses of left ventricular volumes, ejection fraction and segmental left ventricular motion to supine dynamic exercise in 22 professional athletes, comparing these responses with those in 22 age- and gender-matched healthy untrained individuals. End-systolic volume was significantly greater at rest and during exercise in the athletes (50 +/- 6 versus 29 +/- 4 ml and 40 +/- 5 versus 17 +/- 4 ml, respectively, p less than 0.001 for both). It decreased during exercise in all the untrained subjects, but did not change or increased in nine athletes (41%). End-diastolic volume was greater in the athletes at rest (143 +/- 12 versus 98 +/- 9 ml) and during exercise (157 +/- 14 versus 121 +/- 13 ml, p less than 0.01 for both). It increased in all the untrained subjects, but decreased or did not change in six athletes (27%). Ejection fraction was significantly lower in the athletes at rest and during exercise (65 +/- 4% versus 70 +/- 5% and 73 +/- 5% versus 86 +/- 5%, p less than 0.01 and 0.001, respectively); the values augmented normally in all the untrained subjects, but increased only by less than 5% units, did not change or decreased in nine athletes (41%). Eight athletes (36.5%) failed to demonstrate the expected symmetric hyperkinetic wall motion changes during exercise, which were seen in all the untrained subjects. No correlation was found between atypical responses to exercise and electrocardiographic patterns.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

A comparison of dynamic coronal plane excursion between matched male and female athletes when performing single leg landings.

BACKGROUND: Despite recent evidence supporting the use of neuromuscular training to reduce anterior cruciate ligament injury risk, female athletes continue to show an increased anterior cruciate ligament injury rate in collegiate basketball and soccer when compared to males. The purpose of the current study was to identify gender and task differences in measures that may increase the risk of anterior cruciate ligament injury in female basketball and soccer athletes. METHODS: Eleven female and 11 male collegiate basketball and soccer athletes were height (female mean 176 (SD 8 cm), male mean 176 (SD 8 cm)) and weight (female mean 73 (SD 7 kg), male mean 74 (SD 6 kg)) matched. Three-dimensional motion analysis was used to calculate differences in total coronal plane angular joint excursion (maximum-minimum) between male and female athletes when performing a series of medially and laterally directed drop landings. FINDINGS: Female athletes demonstrated increased total coronal plane excursion for the hip, knee and ankle (P < 0.05) during the medial drop landing. During the lateral drop landing females displayed increased excursion at the hip and knee. When comparing tasks, the lateral drop landing resulted in greater coronal plane excursion at the hip (P < 0.05) while the knee showed no differences between movements. In contrast, females demonstrated increased ankle excursion during the medial drop task (P < 0.05). INTERPRETATION: Female athletes demonstrate increased lower extremity coronal plane excursion when performing single leg drop landing in both the medial and lateral direction when compared to height/weight matched male athletes. This increased coronal plane oscillation of lower extremity joints may be related to the increased risk of anterior cruciate ligament injury for female basketball and soccer athletes.

Adult↗
PubMed2006

Biventricular myocardial adaptation to different training protocols in competitive master athletes.

BACKGROUND: Conflicting data have been reported about the nature (physiologic versus pathologic) of left ventricular (LV) hypertrophy in master athletes. AIM OF THE STUDY: To analyze LV and right ventricular (RV) myocardial function in master athletes with LV hypertrophy induced by either endurance or strength training. METHODS: Standard Doppler echo and colour Doppler Myocardial Imaging (DMI) of LV and of RV basal lateral walls were performed in 40 competitive master (>45 years) endurance athletes (ATE), in 20 master strength-trained athletes (ATS) and 25 age-matched healthy sedentary subjects, all males. By use of DMI, the following parameters of myocardial function were assessed: systolic peak velocities, precontraction time, contraction time, early (E(m)) and late (A(m)) diastolic peak velocities, E(m)/A(m) ratio, relaxation time. RESULTS: The two groups were comparable for age, but ATS at rest showed higher heart rate, systolic blood pressure, and body surface area. LV mass index did not significantly differ between the two groups of athletes. However, ATS showed increased wall thickness and relative wall thickness, while LV stroke volume and both LV and RV end-diastolic diameters were greater in ATE. All transmitral and transtricuspid Doppler indexes were higher in ATE. DMI analysis showed in ATE higher E(m) and E(m)/A(m) ratio at the level of both RV and LV lateral walls. In the overall population of athletes, linear regression models evidenced independent positive association of RV peak E(m) velocity with both LV stroke volume and maximal workload achieved by bicycle ergometer (both p<0.001). CONCLUSIONS: RV early diastolic myocardial function is positively influenced by preload increase in master athletes and represents an independent determinant of cardiac performance during physical effort. Therefore, colour DMI may be taken into account to distinguish different cardiac adaptation to either endurance or strength sport training in master athletes.

Adaptation, Physiological↗
PubMed2004

Association of fat-free mass and training status with left ventricular size and mass in endurance-trained athletes.

OBJECTIVES: We sought to study the relationship between left ventricular (LV) size and body composition in male endurance athletes and age-matched control subjects. BACKGROUND: Endurance training is associated with increases in both left ventricular mass (LVM) and left ventricular end-diastolic dimension (LVEDD) in athletes. In other populations, LVM is independently predicted by fat-free mass (FFM). We hypothesized that the increase in LV size and mass observed with training may be a normal response to increased FFM. METHODS: Twelve young and 18 older male endurance athletes and 10 young and 18 older untrained men underwent exercise testing, echocardiography, and dual-photon x-ray absorptiometry body composition analysis. Univariate correlates (Spearman) and multivariate determinants of LVM and LVEDD were sought from: height, height(1.4), height(2.7), height(3.0), body surface area (BSA), FFM, weight, and body mass index. Un-indexed and indexed LVM and LVEDD were then compared. RESULTS: Athletes were of a similar age, weight, and height, but had higher FFM and maximum oxygen uptake than untrained men. Both LVM and LVEDD were correlated with body size, including FFM, BSA, weight, and height (all p < 0.05). On multivariate analysis, FFM was the only independent predictor of both LVM (R(2) = 0.36, p < 0.001) and LVEDD (R(2) = 0.35, p < 0.001). Furthermore, LVM and LVEDD (un-indexed and indexed to BSA and height) were different between athletes and non-athletes, but not when indexed to height(2.7) or FFM. CONCLUSIONS: Both LVM and LVEDD are predicted by FFM in endurance athletes, and when indexed to FFM, no training-related differences were observed. Thus, the extent of LV remodeling (athletic heart) in trained individuals may reflect a normal physiologic response to increased FFM induced by training.

Absorptiometry, Photon↗
PubMed2006

Athletic identity and its relationship to sport participation levels.

This study looked at the relationship between athletic identity and three levels of sport participation (elite, recreational, non-participation). Athletic identity was measured using the Athletic Identity Measurement Scale (AIMS) with participants being compared on the total AIMS score and scores on its three factors (social identity, exclusivity, negative affectivity). Results indicated that the male non-participation group scored lower on all three factors and the total AIMS when compared to the two athlete groups. The male elite and recreational groups did not differ on exclusivity and negative affectivity but did differ on the total AIMS and social identity, with elite scoring higher than recreational. For female participants, the non-participation group again scored lower on all three factors and the total AIMS when compared to the two athlete groups. The female elite and recreational groups did not differ on negative affectivity but did differ on the total AIMS, social identity, and exclusivity, with elite scoring higher than recreational. Findings suggest that to assume sport is only important to elite athletes ignores the role that sport may play for less talented sport participants. Whilst not seeing themselves as athletes per se, it is suggested that participation in sport may still impact upon the self-perceptions of recreational sport participants. Therefore, threats to participation may result in similar negative consequences for both elite athletes and recreational sport participants.

Female↗
PubMed2005

Characteristics of glycemic control in elite power and endurance athletes.

A previous study has shown that former elite power athletes exhibited significantly greater relative risk in diabetes than that of former elite endurance athletes. It is unknown whether insulin sensitivity in elite young healthy power athletes is lower than that in elite young endurance athletes. This study includes two parts, part I and part II. In the part I of this study, an oral glucose tolerance test was performed in all of the elite juvenile track athlete subjects, specializing either in short-distance racing (jSD, N = 13, aged 12.5 +/- 0.37 years) or in long-distance racing (jLD, N = 13, aged 12.6 +/- 0.42 years). In the part II of this study, we recruited elite adult swimmers and divided them into two groups according to their specialty in swimming race distance: long-distance (aLD, N = 10, age 20.3 +/- 1.32) and short-distance groups (aSD, N = 10, age 20.2 +/- 1.31). Insulin sensitivity was significantly lower in the jSD group than that in the jLD group, as indicated by the area under the curves of insulin and glucose following a 75-g oral glucose load. Fasting plasma LDL-C and total cholesterol levels in the jSD group were significantly greater than those in the jLD group. The result of the part II of this study, similar to the result of the part I, shows that insulin sensitivity in aSD swimmers was significantly lower than that in aLD swimmers. LDL-C, total cholesterol, and triglyceride levels were also found higher in aSD swimmers than in those of aLD swimmers. These new findings implicate that the genetic makeup associated with exceptional power or endurance performance of elite athletes could also reflect on their metabolic characteristics; elite power athletes appear to be more insulin resistant than elite endurance athletes.

Adult↗
PubMed1998

Exercise-induced silent myocardial ischemia in master athletes.

High-physical activity levels are associated with reduced risk of symptomatic coronary artery disease (CAD). However, there are a number of reports of exercise-related sudden death and myocardial infarction in aerobically trained athletes. This study compared the prevalence of exercise-induced silent myocardial ischemia on maximum graded exercise tests with tomographic thallium scintigraphy in 70 master male athletes (63 +/- 6 years, mean +/- SD) (maximum aerobic capacity, VO2max >40 ml/kg/min) and in 85 healthy untrained men (61 +/- 7 years) with no history of CAD. The prevalence of silent ischemia (exercise-induced ST-segment depression on electrocardiogram and perfusion abnormalities on thallium scintigraphy) was similar in athletes and untrained men; 16% of the athletes (11 of 70) had silent ischemia compared with 21% of the untrained men (chi-square = 0.81, p = 0.36). No athletes had hyperlipidemia, systemic hypertension, or diabetes mellitus. However, the apolipoprotein E4 allele was present in 9 of the 11 athletes with silent ischemia compared with 2 of 32 athletes with normal exercise tests (chi-square = 24, p = 0.0001). These results suggest that older male athletes with the apolipoprotein E4 allele are at increased risk for the development of exercise-induced silent ischemia.

Aged↗
PubMed2000

Comparison of cardiovascular adaptations to long-term arm and leg exercise in wheelchair athletes versus long-distance runners.

The effect of long-term arm exercise on cardiac morphology and function is unknown. To study these effects, highly trained wheelchair athletes were compared with long-distance runners and controls. In addition, the wheelchair athletes were compared with the long-distance runners to determine if long-term leg exercise confers a training effect during the performance of dynamic arm exercise. The study included 31 male subjects (mean age of 33+/-5 years), who comprised 3 groups matched for age and weight: wheelchair athletes (n = 9), long-distance runners (n = 12), and healthy controls (n = 10). All underwent echocardiography at rest and arm ergometry exercise testing with expiratory gas analysis. The peak work rate during arm exercise was highest among the wheelchair athletes, and was significantly higher in both groups of trained athletes compared with the control group (p<0.001). Runners demonstrated a significantly lower submaximal heart rate response to arm exercise compared with wheelchair and control subjects. Wheelchair athletes had increased left ventricular (LV) volume and mass by echocardiography compared with controls, but not to the same degree as that of runners. Although chamber dimensions and wall thickness did not differ among the groups, the LV volume index tended to be largest in the runners. Doppler indexes of diastolic LV filling were similar between the trained and untrained subjects. These data demonstrate that both long-term arm and leg exercise yield increases in LV volume and mass compared with untrained control subjects, although to a lesser degree in arm-trained athletes. Runners demonstrated a transfer of training effect in the performance of dynamic arm exercise, as demonstrated by their ability to achieve a higher peak work rate than controls, and showed a lower heart rate response to submaximal exercise than the wheelchair athletes and control subjects.

Adaptation, Physiological↗
PubMed2002

The pediatric athlete with disabilities.

There have been increased opportunities and sports participation by athletes with disabilities during the past decades. Research on pediatric athletes with disabilities remains limited. Appropriate classification of athletes on the basis of their functional abilities is key to fair participation. Preparticipation evaluation of these athletes is based on similar principles as for able-bodied athletes. The prevalence, nature, evaluation, differential diagnosis, and treatment principles for injuries are similar for athletes with disability and for those without. There are few disability-specific medical and orthopedic issues to be considered in working with these athletes. Sport participation recommendations are based on the specific disability and demands of the sport. The vast majority of athletes with disabilities can participate safely in a number of sports if appropriately matched; such participation should be encouraged and facilitated at all levels because of well-recognized psychological and medical benefits. Significant progress has been made in increasing sports participation opportunities for persons with disabilities; this is especially true for adults and, to a lesser extent, for children and adolescents. Many barriers remain, however: inadequate facilities, exclusion of children with disabilities, medical professional overprotection, lack of trained personnel and volunteers to work with children with disabilities, lack of public knowledge about disabilities, and lack of financial support for sport and physical education in schools [9,12].

Adolescent↗
PubMed1986

Causes of sudden death in competitive athletes.

Cardiovascular diseases responsible for sudden unexpected death in highly conditioned athletes are largely related to the age of the patient. In most young competitive athletes (less than 35 years of age) sudden death is due to congenital cardiovascular disease. Hypertrophic cardiomyopathy appears to be the most common cause of such deaths, accounting for about half of the sudden deaths in young athletes. Other cardiovascular abnormalities that appear to be less frequent but important causes of sudden death in young athletes include congenital coronary artery anomalies, ruptured aorta (due to cystic medial necrosis), idiopathic left ventricular hypertrophy and coronary artery atherosclerosis. Diseases that appear to be very uncommon causes of sudden death include myocarditis, mitral valve prolapse, aortic valve stenosis and sarcoidosis. Cardiovascular disease in young athletes is usually unsuspected during life, and most athletes who die suddenly have experienced no cardiac symptoms. In only about 25% of those competitive athletes who die suddenly is underlying cardiovascular disease detected or suspected before participation and rarely is the correct clinical diagnosis made. In contrast, in older athletes (greater than or equal to 35 years of age) sudden death is usually due to coronary artery disease, and rarely results from congenital heart disease.

Adolescent↗
PubMed2003

Community health and nutrition screening for Special Olympics athletes.

Since 1961, Special Olympics has provided sports training and athletic competition for people with mental retardation. A recent addition to these Olympics has been the Healthy Athletes Program, designed to help the athletes improve their health and fitness, leading to enhanced sports experiences and well being. Original health services included dental and eye screening. In 2002, Special Olympics Delaware piloted a Wellness Park to add nutrition, blood pressure, and flexibility screening. Faculty from a university's health college trained discipline-specific students to conduct the screenings. Thirty nutrition and dietetics students measured height, weight, waist circumference, and calculated body mass index (BMI) for the athletes. Figures and risk-assessments were recorded on a "health report card." Two hundred ten athletes attended the nutrition screening. Ages ranged from 8 to 63 years; 81 percent males and 19 percent females. According to BMI standards, 32 percent of the athletes were overweight; 17 percent were obese. Twenty-five percent of adult males and 73 percent of adult females had a high risk waist circumference. Athletes at high risk for obesity-related diseases were referred to their primary physician for follow up. Nutrition education handouts included a simplified Food Guide Pyramid, tips for healthy eating in restaurants, 5 A Day information, and healthful hydration guides. Approximately 1,250 athletes participate in Special Olympics Delaware each year, providing a great opportunity to do some much needed health screening and improve access to health care for this often neglected population.

Adolescent↗
PubMed2003

Increased airway inflammatory cells in endurance athletes: what do they mean?

BACKGROUND: Inflammatory cells are increased in the airways of endurance athletes, but their role in causing exercise-induced respiratory symptoms and bronchoconstriction, or their possible long-term consequences, are uncertain. AIM: To put the results of athlete studies in perspective, by analysing the pathogenesis of airway cell changes and their impact on respiratory function. RESULTS: Athletes of different endurance sports at rest showed increased airway neutrophils. Elite swimmers and skiers also showed large increases in airway eosinophils and lymphocytes, possibly related to chronic, exercise-related exposure to irritants or cold and dry air, respectively. Post-exercise studies reported variable responses of airway cells to exercise, but found no evidence of inflammatory cell activation in the airways, at variance with exercise-induced neutrophil activation in peripheral blood. The increase in airway inflammatory cells in athletes can result from hyperventilation-induced increase in airway osmolarity stimulating bronchial epithelial cells to release chemotactic factors. Hyperosmolarity may also inhibit activation of inflammatory cells by causing shedding of adhesion molecules, possibly explaining why airway inflammation appears 'frustrated' in athletes. Data on exhaled nitric oxide are few and variable, not allowing conclusions about its usefulness as a marker of airway inflammation in athletes, or its role in modulating bronchial responsiveness. CONCLUSIONS: The acute and long-term effects of exercise on airway cells need further study. Airway inflammatory cells are increased but not activated in athletes, both at rest and after exercise, and airway inflammation appears to regress in athletes quitting competitions. Altogether, these findings do not clearly indicate that habitual intense exercise may be detrimental for respiratory health. Rather, airway changes may represent chronic adaptive responses to exercise hyperventilation. An improved understanding of the effects of exercise on the airways will likely have a clinical impact on sports medicine, and on the current approach to exercise-based rehabilitation in respiratory disease.

Asthma, Exercise-Induced↗