[Asthma and sport--risk and chance]

Not only asthmatic subjects can suffer from exercise induced airway obstruction, but also healthy persons. Symptoms are various. Exercise induced asthma is a nonspecific airway - reaction of asthmatic patients after a period of exercise, especially a reaction on hyperventilation. This can prevent asthmatic subjects from playing sports or attempting to keep fit. In a Danish co-twin control study physical activity was identified as a risk factor for asthma. Becker et al. presented a report of a 7-year experience with regard to asthma deaths during sports. The subjects who had fatal asthma exacerbations were usually between the ages of 10 and 21 years. Most of them had no long-term control medications. In a review of 13 randomised controlled studies of asthmatic subjects undertaking physical training Ram et al. concluded that physical training improved cardiopulmonary fitness as measured by an increase in maximum oxygen uptake and maximum expiratory ventilation. A number of studies in the effects of physical conditioning on children and adolescents with asthma have reported some reductions in hospitalisations, wheeze frequency, school absenteeism, doctor consultations and medication usage. Guidelines recommend physical training in the treatment of asthma. To take the chances of sport it is necessary to explain the risks to asthmatic subjects. It must be sure that patients with asthma are properly medicated and rescue medication must be immediately available during any sports activity.