Impact of detecting and treating exercise-induced bronchoconstriction in elite footballers

Our aim was to evaluate the prevalence of exercise-induced bronchoconstriction (EIB) in elite football players and assess subsequent impact of therapy on airway health and exercise performance. 97 male professional football players completed an airway health assessment with a eucapnic voluntary hyperpnoea (EVH) challenge to diagnose EIB. Players demonstrating a positive result (EVH⁺) were prescribed inhaler therapy depending on severity, including inhaled corticosteroids and inhaled short-acting β₂-agonists, and underwent repeat assessment after 9 weeks of treatment. Eight players (EVH⁺ n=3, EVH^- n=5) completed a peak oxygen uptake (V'_O) test at initial and follow-up assessment. Out of the 97 players, 27 (28%) demonstrated a positive EVH result. Of these, 10 had no prior history (37%) of EIB or asthma. EVH outcome was not predictable by respiratory symptoms. Seven (24%) of the 27 EVH⁺ players attended follow-up and demonstrated improved post-challenge spirometry (forced expiratory volume in 1 s pre-test -22.9±15.4%, post-test -9.0±1.6%; p=0.018). At follow-up V'_O improved by 3.4±2.9 mL·kg^-1·min^-1 in EVH⁺ players compared to 0.1±2.3 mL·kg^-1·min^-1 in EVH^- players. Magnitude of inference analysis indicated treatment was possibly beneficial (74%) for exercise capacity. Elite football players have a high EIB prevalence. Treatment with inhaler therapy reduces EIB severity.