Exercise Induced Asthma
"Asthma is a pulmonary disease with the following characteristics: 1) airway obstruction that is reversible in most patients either spontaneously or with treatment; 2) airway inflammation; and 3) increased airway responsiveness to a variety of stimuli" (Enright, 1996, p. 375). There presently exist many varieties of asthma that differ in the severity, means of induction, and methods of treatment. One type is exercise-induced asthma. "Exercise-induced asthma (EIA) is a temporary increase in airway resistance and acute narrowing of the airway that occurs after several minutes of strenuous exercise, usually after the exercise had ceased" (Spector, 1993, p. 571). Perfectly healthy individuals with no history of asthma or allergies can experience EIA. EIA can be found in 5.6%-25% of the general population and in 40%-90% of asthmatics (Randolph, 1997). EIA has been recognized for over 300 years, but only recently have it's pathophysiology, diagnosis, and treatment been studied in detail.
EIA was discovered as early as the first century AD when it was observed by Aretaeus the Cappadocian that "if from running, gymnastic exercises, or any other work, the breathing becomes difficult, it is called Asthma" (Randolph, 1997, p. 54). After that, no further research or emphasis was placed on EIA until 1698 when Sir John Floyer, an asthma sufferer, wrote the Treatise on Asthma in which he reported the first delineation of asthmogenic activities. In 1864 Salter recognized that EIA was exacerbated by cold air, and in 1962 Jones determined the pattern of bronchodilation followed by bronchoconstriction that is characteristic of EIA. Such strokes stimulated additional research, and in 1984 and 1988 the Olympic authorities began to screen athletes for EIA before competition. Subsequently, in 1990 the U.S. Olympic Committees published the guidelines for banned and accepted medications for asthma (Randolph, 1997). The results of these studies provided the basis on which to classify EIA. This basis includes airway constriction within the first 6-12 minutes of vigorous exercise, a peak at about 5-10 minutes after exercise, and recovery that is usually spontaneous and within 60 minutes, except in severe cases where it may require up to 3 hours (Enright, 1996; Spector, 1993).
The exact causes of EIA are unknown, but according to Storms (1999), there are two theories of the possible pathogenesis of EIA:
The first is the water loss theory which states that the hyperventilation associated with
strenuous exercise leads to loss of water through the epithelium of the bronchial mucosa.
This loss of water leads to changes in intracellular osmolarity, pH, and temperature through
mechanisms currently unknown, producing the signs and symptoms of EIA. (p. S35)
This theory states that as exercise begins, rate of breathing increases rapidly, and in order for the air to be warmed and...