Respiratory symptoms of portuguese pediatric athletes
DOI:
https://doi.org/10.34631/sporl.2191Keywords:
Athletes, exercise, allergy, quality of life, AQUA questionnaireAbstract
Introduction - Respiratory diseases and allergic sensitization have a known impact on the daily lives of athletes. These pathologies are often neglected and are not routinely evaluated in sports medicine.
Objectives - The objective of this study is to determine the incidence of nasal/respiratory and allergic symptoms in both pediatric athletes and the non-active population, showing the importance of combining the Allergy Questionnaire for Athletes (AQUA) and Nasal Obstruction Symptom questionnaires. Evaluation (NOSE) in screening these patients.
Material and Methods - A cross-sectional study was carried out using an online self-completed questionnaire by young people between 12 and 18 years old. Participants were recruited during the months of November and December 2023. Both athletes and non-active controls completed a survey consisting of the AQUA and NOSE questionnaires. Of the 436 responses received, 407 were considered complete and included in this study (290 athletes and 117 non-active controls).
Results - The athlete cohort consisted predominantly of male individuals (63.1%, n = 183) with a mean age of 15.2 ± 1.7 years. Both groups coincide in terms of distribution by age and sex. The majority of athletes were rugby players (37.9%, n = 110), followed by football players (12.8%, n = 37) and ballet dancers (10.3%, n = 30). Recurrent upper respiratory tract infections (URTIs) were reported in 71 athletes (24.5%), compared to 14 non-active controls (12.0%), representing a significant increase in the incidence of URTIs in athletes (p = 0.0049). More than 45% of athletes missed training at least once a year due to URTI and 14.5% missed training more than 3 times last year for this reason. With regard to symptoms, there was no significant difference (p = 0.1589) in the number of athletes who reported nasal symptoms (32.8%, n = 95) compared to non-athletes (25.7%, n = 30); however, athletes have significantly higher scores on the NOSE questionnaire (p = 0.0001). Ninety-five athletes (32.8%) report having at least one medically diagnosed allergic disease, as opposed to 35 non-active controls (29.9%), with no significant differences between the groups (p = 0.5776), even with regard to prevalence of asthma (p = 0.4446) or rhinitis (p = 0.4390).
Conclusions - The application of the AQUA and NOSE questionnaires to young athletes could be of great importance in clinical practice as these pathologies have an impact on both training attendance and quality of life.
References
Spence L, Brown WJ, Pyne DB, Nissen MD, Sloots TP, McCormack JG. et al. Incidence, etiology, and symptomatology of upper respiratory illness in elite athletes. Med Sci Sports Exerc. 2007 Apr;39(4):577-86. doi: 10.1249/mss.0b013e31802e851a.
Hox V, Beyaert S, Bullens D, Couto M, Langer D, Hellings PW. et al. Tackling nasal symptoms in athletes: moving towards personalized medicine. Allergy. 2021 Sep;76(9):2716-2729. doi: 10.1111/all.14786.
Dallimore NS, Eccles R. Changes in human nasal resistance associated with exercise, hyperventilation and rebreathing. Acta Otolaryngol. 1977 Nov-Dec;84(5-6):416-21. doi: 10.3109/00016487709123985.
Walker AC, Surda P, Rossiter M, Little SA. Nasal disease and quality of life in athletes. J Laryngol Otol. 2018 Sep;132(9):812-815. doi: 10.1017/S0022215118001408.
Bougault V, Turmel J, Boulet LP. Effect of intense swimming training on rhinitis in high-level competitive swimmers. Clin Exp Allergy. 2010 Aug;40(8):1238-46. doi: 10.1111/j.1365-2222.2010.03551.x.
Bonadonna P, Senna G, Zanon P, Cocco G, Dorizzi R, Gani F. et al. Cold-induced rhinitis in skiers--clinical aspects and treatment with ipratropium bromide nasal spray: a randomized controlled trial. Am J Rhinol. 2001 Sep-Oct;15(5):297-301.
McIntosh C, Clemm HH, Sewry N, Hrubos-Strøm H, Schwellnus MP. Diagnosis and management of nasal obstruction in the athlete. A narrative review by subgroup B of the IOC Consensus Group on "Acute Respiratory Illness in the Athlete". J Sports Med Phys Fitness. 2021 Aug;61(8):1144-1158. doi: 10.23736/S0022-4707.21.12821-X.
Walker A, Surda P, Rossiter M, Little S. Rhinitis in elite and non-elite field hockey players. Int J Sports Med. 2017 Jan;38(1):65-70. doi: 10.1055/s-0042-108200.
Steelant B, Hox V, Van Gerven L, Dilissen E, Dekimpe E, Kasran A. et al. Nasal symptoms, epithelial injury and neurogenic inflammation in elite swimmers. Rhinology. 2018 Sep 1;56(3):279-287. doi: 10.4193/Rhin17.167.
Bonini M, Braido F, Baiardini I, Del Giacco S, Gramiccioni C, Manara M. et al. AQUA: Allergy Questionnaire for Athletes. Development and validation. Med Sci Sports Exerc. 2009 May;41(5):1034-41. doi: 10.1249/MSS.0b013e318193c663.
Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngol Head Neck Surg. 2004 Feb;130(2):157-63. doi: 10.1016/j.otohns.2003.09.016.
Kawai K, Dombrowski N, AuYeung T, Adil EA. Validation of the nasal obstruction symptom evaluation scale in pediatric patients. Laryngoscope. 2021 Sep;131(9):E2594-E2598. doi: 10.1002/lary.29420.
Silva B, Silva C, Ribeiro, J. Cross-cultural adaptation and validation of the NOSE scale in European Portuguese. Repositório Científico da UC. 2020. Jun. Available from: https://hdl.handle.net/10316/97628.
Nieman DC. Exercise, upper respiratory tract infection, and the immune system. Med Sci Sports Exerc. 1994 Feb;26(2):128-39. doi: 10.1249/00005768-199402000-00002.
Reeser JC, Willick S, Elstad M. Medical services provided at the Olympic Village polyclinic during the 2002 Salt Lake City Winter Games. WMJ. 2003;102(4):20-5.
Engebretsen L, Soligard T, Steffen K, Alonso JM, Aubry M, Budgett R. et al. Sports injuries and illnesses during the London Summer Olympic Games 2012. Br J Sports Med. 2013 May;47(7):407-14. doi: 10.1136/bjsports-2013-092380.
Spence L, Brown WJ, Pyne DB, Nissen MD, Sloots TP, McCormack JG. et al. Incidence, etiology, and symptomatology of upper respiratory illness in elite athletes. Med Sci Sports Exerc. 2007 Apr;39(4):577-86. doi: 10.1249/mss.0b013e31802e851a.
Robson-Ansley P, Howatson G, Tallent J, Mitcheson K, Walshe I, Toms C. et al. Prevalence of allergy and upper respiratory tract symptoms in runners of the London marathon. Med Sci Sports Exerc. 2012 Jun;44(6):999-1004. doi: 10.1249/MSS.0b013e318243253d.
Bauchau V, Durham SR. Prevalence and rate of diagnosis of allergic rhinitis in Europe. Eur Respir J. 2004 Nov;24(5):758-64. doi: 10.1183/09031936.04.00013904.
Bonini M, Gramiccioni C, Fioretti D, Ruckert B, Rinaldi M, Akdis C. et al. Asthma, allergy and the Olympics: a 12-year survey in elite athletes. Curr Opin Allergy Clin Immunol. 2015 Apr;15(2):184-92. doi: 10.1097/ACI.0000000000000149.
Kurowski M, Jurczyk J, Krysztofiak H, Kowalski ML. Exercise-induced respiratory symptoms and allergy in elite athletes: allergy and asthma in Polish Olympic Athletes (A(2)POLO) project within GA(2)LEN initiative. Clin Respir J. 2016 Mar;10(2):231-8. doi: 10.1111/crj.12210.
Katelaris CH, Carrozzi FM, Burke TV, Byth K. Effects of intranasal budesonide on symptoms, quality of life, and performance in elite athletes with allergic rhinoconjunctivitis. Clin J Sport Med. 2002 Sep;12(5):296-300. doi: 10.1097/00042752-200209000-00007.
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