Physical Activity and Asthma

Abstract

Postoji suglasje znanstvene i stručne međunarodne javnosti da djecu i odrasle osobe s astmom treba poticati na sudjelovanje u redovitoj tjelesnoj aktivnosti jer ona povoljno djeluje na aktivnost bolesti te kvalitetu života. Astmatični napad, međutim, mogu izazvati brojni čimbenici, a među njima i tjelesno opterećenje. Uvriježen naziv za astmatični napad uzrokovan tjelesnim opterećenjem je “exercise-induced” astma (EIA). Taj fenomen može ometati astmatične osobe pri uključenju u školske, rekreativne i natjecateljske sportske aktivnosti te ograničiti njihova sportska postignuća. U ovom su radu opisani patofiziološki, klinički, dijagnostički i terapijski aspekti EIA. Prikazane su nefarmakološke mjere prevencije EIA, s posebnim osvrtom na pravilan odabir sportske discipline te prilagodbu trenažnog procesa kod astmatičara. Opisana su naša istraživanja pogodnosti hrvanja grčko-rimskim stilom i karatea za kondicioniranje školske djece s alergijskim bolestima, uključujući i astmu. Prikazane su specifičnosti uključenja osoba s astmom u sportske aktivnosti na međunarodnoj razini uz osvrt na antiastmatske lijekove koji se nalaze na listi zabranjenih supstancija Svjetske antidopinške agencije (WADA - World Anti-Doping Agency). Opisan je poseban oblik astme koja se pojavljuje u vrhunskih sportaša koji su respiratorno zdravi ušli u trenažni proces. Uzimajući u obzir navedene specifi čnosti EIA te današnje mogućnosti dijagnostike i liječenja tog poremećaja, astmatičar se, bez obzira na dob, može bez većih poteškoća uključiti u sportske aktivnosti, uz mogućnost za ostvarenje vrhunskih sportskih rezultata. Pri tome je nužna suradnja prosvjetnih, kinezioloških i medicinskih stručnjaka te redoviti zdravstveni nadzor astmatičnog sportaša uz prikladno liječenje, pravilan odabir sportske discipline te prilagodbu trenažnoga procesa.There is general agreement among experts that children and adults with asthma should be encouraged to participate in regular physical activity due to its benefi cial effects on disease activity and the patient’s quality of life. However, asthma attack can be provoked by exercise and the accepted term for this type of asthma attack is exercise-induced asthma (EIA). This phenomenon can interfere with involvement in school, recreational or top level sport activities, and limit achievements of asthmatic athletes. This article describes patophysiology, clinical features, diagnostic procedures, and therapy of EIA. We presented nonpharmacological preventive measures of EIA with particular attention to the selection of adequate sport discipline and adjustments of the training process for asthmatics. Furthermore, we reviewed our previous studies assessing Greco-Roman wrestling and non-contact karate in terms of their suitability for conditioning children with allergic diseases including asthma. We described the specifi cities of asthmatic top athletes participating in international competitions and we included the list of prohibited antiasthmatic drugs according to the World Anti-Doping Agency. We also presented a separate asthma phenotype which developed in top athletes who were respiratory healthy upon entry into training. With respect to all described specifi cities of EIA, modern diagnostic and therapeutic possibilities allow asthmatic persons to participate in various sport activities, even on top international level. Physical activities of asthmatics should be closely monitored and undertaken in cooperation with experts of kinesiology, education and sport medicine. They should also include regular health checkups, adequate asthma therapy, selection of appropriate sport discipline, and adjustments of training process