Here are some highlights from this Session at the 2015 ACSM Fall Summit.
Asthma- chronic inflamation of the airway, variable airflow obstruction, and airway hyper-responsiveness.
Asthma is more prevent in males than females in regards to children under 10.
Asthma is the only single chronic disease in the federal budget with a budget of 2.7 billion dollars.
It is hypothesized that due to the reduction in early environmental infections over the years and the recent overuse of antibiotics, there is an increase in asthma occurence.
Early exposure - Such as majority living on farm lands in the past or Daycare exposure
Wheeze Early= Stronger as an adult
Vitamin D hypothesis
Vitamin D elicits anti-inflammatory response
Deficiency of Vitamin D is associated with worse asthma severity and Vitamin D has decreased since the 1980s
Acetaminophen Tylenol Hypothesis
Aspirin use has decreased with the historic APAP Reyes Sydnrome Epidemic
Many studied found association with APAP and Asthma
Asthma can come and go without treatment
Symptoms: coughing, wheeze, Shortness of breath, chest tightness (can have all or none)
Many times you have periods with/without symptoms years in between
- I had it yesterday but not today ( Did you know if you see 1 roach there are a minimum of 1000 there)
-Smoking doesn't bother me or my child's asthma
Frequent symptoms, Daily Therapy required, airway hyper-responsiveness and exacerbation
Exercise Inducted Asthma (EIA)
Can be part of chronic asthma
Can occur in isolation such as only with exercise; not associated with airway hypersensitivity
Symptoms can occur 6-8 minutes after physical activity (vigorous)
Epidemiology of EIA
50% of those with negative history of EIA have a positive response to exercise
Individuals with allergy: 40% have allergic rhinitis
Individual without asthma/allergy: 9% have EIA in high school and !2% have positive response to EIA overall
Olympians: 9-16% in Summer; 17-50% Winter
EIA IS FREQUENTLY UNDIAGNOSED!
Exercise increases our aerobic capacity and with greater activity can lead to less ventilation
Hypermolar- Water loss from airway surface
Airway Rewarming- Exercise hyperventilation leads to heat exchange from pulmonary vascular bed & cooling of airway service cells
-polluted indoor out door - continuous hard exercise - cold enviroments (during infection) - pollen season
High- Long distance running, cycling, soccer, rugby, basketball, ice hockey
Less- Team games, swimming, tennis, gymnastics, golf, karate, wrestling, boxing, downhill skiing, water polo, intermittent exercise, warm humid air
Swimming and Asthma
+high humidity +prone position +slow exhalation & Rhythmic breathing +immersion of water (chlorine may exacerbate symptoms)
Skiers/Hockey & Asthma
-very high prevelance -extreme cold may damage epithelium
-even asymptote tic have evidence
Challenge Testing for Diagnosis
Step Testing, outdoor running (parking lot? B/c its polluted), treadmill tests, athletic-specific tests, dry air breathing on bike
Change to less Asthmogenic activity
Avoid exercise in cold or high pollen
Warm up before could hold of symptoms upwards 45 minutes
Cool down after - Mask/Scarf over mouth when running
Most effective- Short acting beta agonist 15minutes before
Leukotriene modifiers hours after
LABAS- protect up to 12hrs, not available for asthmotherapy in US
Failure to Respond
Vocal cord dysfunction, Exercise Induced Broncospasm
YOU SHOULD NOT LIMIT VIGOROUS ACTIVITY, JUST MUST FIND THE RIGHT TREATMENT
Presented by Michelle Cloutier MD. Please share with someone you know who has Asthma and like this and my website of course :) !