Effect of warm-up exercise on exercise-induced bronchoconstriction
Stickland MK, Rowe BH, Spooner CH, Vandermeer B, Dryden DM. Med Sci Sports Exerc. 2012 Mar;44(3):383-91.
Following a warm-up that induces exercise-induced bronchoconstriction (EIB), a temporary airway narrowing associated with exercise, some individuals experience a 1 to 4 hour refractory period during which they have less severe or no EIB after additional vigorous exercise. Numerous warm-up programs have been suggested to induce a refractory period but it is unclear how effective they are. Therefore, Stickland et al conducted a systematic review to evaluate the effectiveness of different warm-up routines to cause a refractory period. In August 2009, the authors searched the literature for randomized clinical trials that assessed the influence of warm-ups on adults or children with EIB. Warm-up routines were classified into four groups: 1) interval high-intensity, 2) continuous low-intensity, 3) continuous high-intensity, and variable intensity warm-ups (e.g., a combination of low and very high intensity). Among the seven studies the authors identified the interval high-intensity and variable intensity warm-ups decreased EIB. In contrast, continuous low-intensity and continuous high-intensity warm-ups did not. The interval protocols involved repetitive sprints of 26 to 30 seconds at 100% maximal oxygen consumption (or higher; the article provides a table giving more details). One of the variable intensity warm-ups included 6-minute treadmill run, a 10-minute rest followed by 7 30-second sprints, and finally a 20-minute rest before the final 6-minute treadmill run.
This systematic review is interesting because it highlights that an appropriate warm-up protocol could function as a short-term nonpharmacological alternative for reducing EIB. The authors note that the interval high-intensity warm-up “may be superior as it is a more easily standardized for the athletes/coach, and there is more evidence for this strategy”. A simple interval program may be particularly valuable because some athletes may be able to perform the 15 to 30 minute warm-up without direct supervision; saving staff time. While this review provides support for interval high-intensity and variable intensity warm-ups (e.g., warm-ups with maximal-exertion sprints) more research in this area may help optimize the benefits of these warm-ups. Furthermore, it will be interesting to see how these warm-ups compare to inhalers. Do you feel that these warm-ups could be beneficial for your athletes? Do you have athletes perform these warm-ups?
Written by: Jeffrey Driban
Reviewed by: Stephen Thomas
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2 comments:
I have EIA and have tried a couple of these to see if they would help. In one case, after an interval warm up, I was able to prevent some of the asthma s/s. However, I still did not feel very well the rest of the time exercising because I induced a little too severe asthma reaction. After this warm up, I felt exhausted the rest of the day in spite of my breathing being relatively normal. In the other instance, I tried to induce with continuous high intensity exercise and either it didn't work or my rest time was not long enough to allow for resolution of symptoms.
Hi Timothy. Thanks for the insight. It is always a plus to hear from someone who has used a program like this on themselves. It was very informative. Thanks!
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