Allergy Asthma Immunol Res.  2018 Jan;10(1):43-51. 10.4168/aair.2018.10.1.43.

Respiratory Function and Symptoms Post Cold Air Exercise in Female High and Low Ventilation Sport Athletes

Affiliations
  • 1Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada. kennedy@ualberta.ca
  • 2Department of Sport Science, Medical Section, University of Innsbruck, Innsbruck, Austria.

Abstract

PURPOSE
Cold weather exercise is common in many regions of the world; however, it is unclear whether respiratory function and symptom worsen progressively with colder air temperatures. Furthermore, it is unclear whether high-ventilation sport background exacerbates dysfunction and symptoms.
METHODS
Seventeen active females (measure of the maximum volume of oxygen [VO(2max)]: 49.6±6.6 mL·kg⁻¹·min⁻¹) completed on different days in random order 5 blinded running trials at 0℃, -5℃, -10℃, -15℃, and -20℃ (humidity 40%) in an environmental chamber. Distance, heart rate, and rating of perceived exertion (RPE) were measured within each trial; forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), forced expiratory flow at 25%-75% (FEF₂₅₋₇₅), and forced expiratory flow at 50% (FEFâ‚…â‚€) were measured pre- and post-test (3, 6, 10, 15, and 20 minutes). Respiratory symptoms and global effort were measured post-test spirometry.
RESULTS
Mean decreases were found in FEV1 (4%-5% at 0℃, -5℃, -10℃, and -15℃; 7% at -20℃). FEF₂₅₋₇₅ and FEF₅₀ decreased 7% and 11% at -15℃ and -20℃, respectively. Post-exertion spirometry results were decreased most at 3 to 6 minutes, recovering back to baseline at 20 minutes. Respiratory symptoms and global effort significantly increased at -15℃ and -20℃ with decreased heart rate. High-ventilation sports decreased function more than low-ventilation participants but had fewer symptoms.
CONCLUSIONS
These results indicate that intense exercise at cold air temperatures up to -20℃ is achievable; however, greater effort along with transient acute bronchoconstriction and symptoms of cough after exercising in temperatures colder than -15℃ are likely. It is recommended that individuals cover their mouth and reduce exercise intensity to ameliorate the effects of cold weather exercise.

Keyword

Exercise-induced asthma; exercise-induced bronchospasm; cold climate; cough; extreme environments; spirometry

MeSH Terms

Asthma, Exercise-Induced
Athletes*
Bronchoconstriction
Cold Climate
Cough
Female*
Forced Expiratory Volume
Heart Rate
Humans
Mouth
Oxygen
Running
Spirometry
Sports*
Ventilation*
Vital Capacity
Weather
Oxygen

Figure

  • Fig. 1 Delta maximum decrease for FEV1 (A), FVC (B), FEF25-75 (C), and FEF50 (D) at GXT (ambient laboratory temperature 23℃; relative humidity 50%), 0℃, -5℃, -10℃, -15℃, and -20℃ (relative humidity 40%). FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; FEF25-75, forced expiratory flow at 25%-75%; FEF50, forced expiratory flow at 50%; GXT, graded exercise test.

  • Fig. 2 Delta change for FEV1 at each time point at each temperature condition expressed as percent change from pre-test baseline. Results are mean±SD (n=17) and significance was set at P<0.05. FEV1, forced expiratory volume in 1 second; SD, standard deviation. A, 3 minutes 0℃ and -20℃ diff; B, -10℃ and -20℃ diff (P<0.05); GXT=0.01, pairwise comparisons with differences as follows. *3 minutes diff than 10, 15, 20 minutes, ‡20 minutes diff than 6, 10 and 15 minutes; 0℃=0.01, pairwise comparisons with differences as follows; β20 minutes diff than 3 and 6 minutes; -5℃=0.08, pairwise comparisons with differences as follows; *3 diff than 20 minutes; α6 minutes diff than 15 and 20 minutes; -10℃=0.00, pairwise comparisons with differences as follows: Δ3, 6, and 10 minutes diff than 15 and 20 minutes; -15℃=0.00, pairwise comparisons with differences as follows: Ω3 minutes diff than 6, 15, and 20 minutes; µ20 minutes diff 15, 10, and 6 minutes; -20℃=0.03, pairwise comparisons with differences as follows: ¥3 minutes diff than 10 and 20 minutes; £6 minutes and 20 minutes diff.


Reference

1. Bergeron MF, Bahr R, Bärtsch P, Bourdon L, Calbet JA, Carlsen KH, et al. International Olympic Committee consensus statement on thermoregulatory and altitude challenges for high-level athletes. Br J Sports Med. 2012; 46:770–779. PMID: 22685119.
Article
2. Carlsen KH. Sports in extreme conditions: the impact of exercise in cold temperatures on asthma and bronchial hyper-responsiveness in athletes. Br J Sports Med. 2012; 46:796–799. PMID: 22906782.
Article
3. Koskela HO. Cold air-provoked respiratory symptoms: the mechanisms and management. Int J Circumpolar Health. 2007; 66:91–100. PMID: 17515249.
Article
4. Quirion A, Laurencelle L, Paulin L, Therminarias A, Brisson GR, Audet A, et al. Metabolic and hormonal responses during exercise at 20 degrees, 0 degrees and -20 degrees C. Int J Biometeorol. 1989; 33:227–232. PMID: 2613366.
5. Larsson K, Tornling G, Gavhed D, Müller-Suur C, Palmberg L. Inhalation of cold air increases the number of inflammatory cells in the lungs in healthy subjects. Eur Respir J. 1998; 12:825–830. PMID: 9817153.
Article
6. Stensrud T, Berntsen S, Carlsen KH. Exercise capacity and exercise-induced bronchoconstriction (EIB) in a cold environment. Respir Med. 2007; 101:1529–1536. PMID: 17317135.
Article
7. Stensrud T, Mykland KV, Gabrielsen K, Carlsen KH. Bronchial hyperresponsiveness in skiers: field test versus methacholine provocation? Med Sci Sports Exerc. 2007; 39:1681–1686. PMID: 17909392.
8. Parsons JP, Kaeding C, Phillips G, Jarjoura D, Wadley G, Mastronarde JG. Prevalence of exercise-induced bronchospasm in a cohort of varsity college athletes. Med Sci Sports Exerc. 2007; 39:1487–1492. PMID: 17805078.
Article
9. Strauss RH, McFadden ER Jr, Ingram RH Jr, Jaeger JJ, Stearns DR. Enhancement of exercise-induced asthma by cold air. N Engl J Med. 1977; 297:743–747. PMID: 895804.
Article
10. Anderson SD, Daviskas E. The mechanism of exercise-induced asthma is …. J Allergy Clin Immunol. 2000; 106:453–459. PMID: 10984363.
Article
11. Turmel J, Bougault V, Boulet LP. Seasonal variations of cough reflex sensitivity in elite athletes training in cold air environment. Cough. 2012; 8:2. PMID: 22449054.
Article
12. Bougault V, Turmel J, Boulet LP. Bronchial challenges and respiratory symptoms in elite swimmers and winter sport athletes: airway hyperresponsiveness in asthma: its measurement and clinical significance. Chest. 2010; 138:31S–37S. PMID: 20363843.
13. Eichner ER. Asthma in athletes: scope, risks, mimics, trends. Curr Sports Med Rep. 2008; 7:118–119. PMID: 18477865.
14. Rundell KW, Im J, Mayers LB, Wilber RL, Szmedra L, Schmitz HR. Self-reported symptoms and exercise-induced asthma in the elite athlete. Med Sci Sports Exerc. 2001; 33:208–213. PMID: 11224807.
Article
15. Rundell KW, Wilber RL, Szmedra L, Jenkinson DM, Mayers LB, Im J. Exercise-induced asthma screening of elite athletes: field versus laboratory exercise challenge. Med Sci Sports Exerc. 2000; 32:309–316. PMID: 10694112.
Article
16. Langdeau JB, Day A, Turcotte H, Boulet LP. Gender differences in the prevalence of airway hyperresponsiveness and asthma in athletes. Respir Med. 2009; 103:401–406. PMID: 19027280.
Article
17. McClaran SR, Harms CA, Pegelow DF, Dempsey JA. Smaller lungs in women affect exercise hyperpnea. J Appl Physiol (1985). 1998; 84:1872–1881. PMID: 9609779.
Article
18. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005; 26:319–338. PMID: 16055882.
19. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982; 14:377–381. PMID: 7154893.
Article
20. Stensrud T, Carlsen KH. Can one single test protocol for provoking exercise-induced bronchoconstriction also be used for assessing aerobic capacity? Clin Respir J. 2008; 2:47–53. PMID: 20298304.
Article
21. Castellani JW, Young AJ, Ducharme MB, Giesbrecht GG, Glickman E, Sallis RE, et al. American College of Sports Medicine position stand: prevention of cold injuries during exercise. Med Sci Sports Exerc. 2006; 38:2012–2029. PMID: 17095937.
22. Heir T, Oseid S. Self-reported asthma and exercise-induced asthma symptoms in high-level competitive cross-country skiers. Scand J Med Sci Sports. 1994; 4:128–133.
Article
23. Herman L, Foster C, Maher MA, Mikat RP, Porcari JP. Validity and reliability of the session RPE method for monitoring exercise training intensity. South Afr J Sports Med. 2006; 18:14–17.
Article
24. Pellegrino R, Viegi G, Brusasco V, Crapo RO, Burgos F, Casaburi R, et al. Interpretative strategies for lung function tests. Eur Respir J. 2005; 26:948–968. PMID: 16264058.
25. Rundell KW, Slee JB. Exercise and other indirect challenges to demonstrate asthma or exercise-induced bronchoconstriction in athletes. J Allergy Clin Immunol. 2008; 122:238–246. PMID: 18678339.
Article
26. Holzer K, Brukner P. Screening of athletes for exercise-induced bronchoconstriction. Clin J Sport Med. 2004; 14:134–138. PMID: 15166901.
Article
27. Cappaert TA, Stone JA, Castellani JW, Krause BA, Smith D, Stephens BA, et al. National Athletic Trainers' Association position statement: environmental cold injuries. J Athl Train. 2008; 43:640–658. PMID: 19030143.
Article
28. Evans TM, Rundell KW, Beck KC, Levine AM, Baumann JM. Airway narrowing measured by spirometry and impulse oscillometry following room temperature and cold temperature exercise. Chest. 2005; 128:2412–2419. PMID: 16236903.
Article
29. Farley RD, Albazzaz MK, Patel KR. Role of cooling and drying in hyperventilation induced asthma. Thorax. 1988; 43:289–294. PMID: 3406916.
Article
30. Helenius IJ, Tikkanen HO, Sarna S, Haahtela T. Asthma and increased bronchial responsiveness in elite athletes: atopy and sport event as risk factors. J Allergy Clin Immunol. 1998; 101:646–652. PMID: 9600502.
31. Rundell KW, Spiering BA, Baumann JM, Evans TM. Effects of montelukast on airway narrowing from eucapnic voluntary hyperventilation and cold air exercise. Br J Sports Med. 2005; 39:232–236. PMID: 15793094.
Article
32. Stensrud T, Berntsen S, Carlsen KH. Humidity influences exercise capacity in subjects with exercise-induced bronchoconstriction (EIB). Respir Med. 2006; 100:1633–1641. PMID: 16446080.
Article
33. Cole P. Further observations on the conditioning of respiratory air. J Laryngol Otol. 1953; 67:669–681. PMID: 13109356.
Article
34. Carlsen KH, Engh G, Mørk M. Exercise-induced bronchoconstriction depends on exercise load. Respir Med. 2000; 94:750–755. PMID: 10955749.
Article
35. McFadden ER Jr, Lenner KA, Strohl KP. Postexertional airway rewarming and thermally induced asthma. New insights into pathophysiology and possible pathogenesis. J Clin Invest. 1986; 78:18–25. PMID: 3722374.
Article
36. Kippelen P, Anderson SD. Airway injury during high-level exercise. Br J Sports Med. 2012; 46:385–390. PMID: 22247295.
Article
37. McFadden ER Jr, Pichurko BM, Bowman HF, Ingenito E, Burns S, Dowling N, et al. Thermal mapping of the airways in humans. J Appl Physiol (1985). 1985; 58:564–570. PMID: 3980358.
Article
38. Parsons JP, Mastronarde JG. Exercise-induced bronchoconstriction in athletes. Chest. 2005; 128:3966–3974. PMID: 16354868.
Article
39. Sylta Ø, Tønnessen E, Seiler S. Do elite endurance athletes report their training accurately? Int J Sports Physiol Perform. 2014; 9:85–92. PMID: 23921186.
Article
40. Esteve-Lanao J, San Juan AF, Earnest CP, Foster C, Lucia A. How do endurance runners actually train? Relationship with competition performance. Med Sci Sports Exerc. 2005; 37:496–504. PMID: 15741850.
Article
41. Stocks JM, Taylor NA, Tipton MJ, Greenleaf JE. Human physiological responses to cold exposure. Aviat Space Environ Med. 2004; 75:444–457. PMID: 15152898.
42. Raven PB, Niki I, Dahms TE, Horvath SM. Compensatory cardiovascular responses during an environmental cold stress, 5 degrees C. J Appl Physiol. 1970; 29:417–421. PMID: 5459907.
Article
43. Sandsund M, Faerevik H, Reinertsen RE, Bjermer L. Effects of breathing cold and warm air on lung function and physical performance in asthmatic and nonasthmatic athletes during exercise in the cold. Ann N Y Acad Sci. 1997; 813:751–756. PMID: 9100966.
Article
Full Text Links
  • AAIR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr