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Nasal function and dysfunction in exercise

Published online by Cambridge University Press:  17 February 2016

A Walker ,
P Surda ,
M Rossiter  and
S Little
A Walker*
Affiliation:
Department of ENT Surgery, St George's Hospital, London, UK
P Surda
Affiliation:
Department of ENT Surgery, St George's Hospital, London, UK
M Rossiter
Affiliation:
All Sports Medicine, Candover Clinic, Basingstoke and North Hampshire Hospital, Basingstoke, UK
S Little
Affiliation:
Department of ENT Surgery, St George's Hospital, London, UK
*
Address for correspondence: Ms Abigail Walker, Department of ENT Surgery, St George's Hospital, Blackshaw Road, London SW17 0QT, UK E-mail: [email protected]
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Abstract

Background:

There have been recent advances in our appreciation of the functional complementarity of the upper and lower airways. The unified airway begins at the nose: rather than acting merely as a conduit for air to the lungs, the nose and nasal cavity perform an important role in filtering, humidification and immune surveillance.

Methods:

The physiological and pathological responses of the nasal cavity to exercise and regular training are examined in this narrative review, with specific reference to the relation of nasal health to quality of life, lower airway health and upper respiratory tract infections. Relevant literature is examined and placed in clinical context.

Results:

There is considerable published evidence to support nasal dysfunction associated with exercise, and a link to lower airway dysfunction. Evidence also supports the role of upper and lower airway dysfunction in the development of upper respiratory tract infection symptoms.

Conclusion:

Nasal dysfunction in exercise may be a source of considerable morbidity to the regular exerciser, and further research into exercise-induced rhinitis is recommended.

Keywords

RhinitisExerciseNoseAthletesPhysiologySports MedicineNasal Obstruction
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 5 , May 2016 , pp. 431 - 434
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 Anderson, I, Proctor, DF. The fate and effects of inhaled materials. In: Anderson, I, Proctor, DF, eds. The Nose: Upper Airway Physiology and the Atmospheric Environment. New York: Elsevier Biomedical, 1982;423–43Google Scholar
2 Schultz, EL, Horvath, SM. Control of extrathoracic airway dynamics. J Appl Physiol 1989;66:2839–43Google Scholar
3 Bridger, GP, Proctor, DF. Maximum nasal inspiratory flow and nasal resistance. Ann Otol Rhinol Laryngol 1970;79:481–8CrossRefGoogle ScholarPubMed
4 Fregosi, RF, Lansing, RW. Neural drive to nasal dilator muscles: influence of exercise intensity and oronasal flow partitioning. J Appl Physiol 1995;79:1330–7CrossRefGoogle ScholarPubMed
5 Overend, T, Barrios, J, McCutcheon, B, Sidon, J. External nasal dilator strips do not affect treadmill performance in subjects wearing mouthguards. J Athl Train 2000;35:60–4Google Scholar
6 O'Kroy, JA. Oxygen uptake and ventilatory effects of an external nasal dilator during ergometry. Med Sci Sports Exerc 2000;32:1491–5CrossRefGoogle ScholarPubMed
7 Baker, KM, Behm, DG. The ineffectiveness of nasal dilator strips under aerobic exercise and recovery conditions. J Strength Cond Res 1999;13:206–9Google Scholar
8 Gómez-Hervás, J, García-Valdecasas Bernal, J, Fernández-Prada, M, Palomeque-Vera, JM, García-Ramos, A, Fernández-Castanys, BF. Effects of oxymetazoline on nasal flow and maximum aerobic exercise performance in patients with inferior turbinate hypertrophy. Laryngoscope 2015;125:1301–6Google Scholar
9 Meir, R, Zhao, GG, Zhou, S, Beavers, R, Davie, A. The acute effect of mouth only breathing on time to completion, heart rate, rate of perceived exertion, blood lactate, and ventilatory measures during a high-intensity shuttle run sequence. J Strength Cond Res 2014;28:950–7CrossRefGoogle ScholarPubMed
10 Saketkhoo, K, Kaplan, I, Sackner, MA. Effect of exercise on nasal mucous velocity and nasal airflow resistance in normal subjects. J Appl Physiol 1979;46:369–71CrossRefGoogle ScholarPubMed
11 Stanford, CF, Stanford, RL. Exercise induced rhinorrhoea (athlete's nose). BMJ 1988;297:660 Google Scholar
12 Mackinnon, LT, Hooper, S. Mucosal (secretory) immune system responses to exercise of varying intensity and during overtraining. Int J Sports Med 1994;15:S179–83Google Scholar
13 Pyne, DB, Gleeson, M. Effects of intensive exercise training on immunity in athletes. Int J Sports Med 1998;19:S183–91Google Scholar
14 Tomasi, TB, Trudeau, FB, Czerwinski, D, Erredge, S. Immune parameters in athletes before and after strenuous exercise. J Clin Immunol 1982;2:173–8Google Scholar
15 Hopkins, C, Gillett, S, Slack, R, Lund, VJ, Browne, JP. Psychometric validity of the 22-item Sinonasal Outcome Test. Clin Otolaryngol 2009;34:447–54Google Scholar
16 Meltzer, EO. Quality of life in adults and children with allergic rhinitis. J Allergy Clin Immunol 2001;108:S45–53CrossRefGoogle ScholarPubMed
17 Schwartz, LB, Delgado, L, Craig, T, Bonini, S, Carlsen, KH, Casale, TB et al. Exercise-induced hypersensitivity syndromes in recreational and competitive athletes: a PRACTALL consensus report (what the general practitioner should know about sports and allergy). Allergy 2008;63:953–61CrossRefGoogle ScholarPubMed
18 Katelaris, CH, Carrozzi, FM, Burke, TV, Byth, K. A springtime Olympics demands special consideration for allergic athletes. J Allergy Clin Immunol 2000;106:260–6Google Scholar
19 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;12:296–300 CrossRefGoogle ScholarPubMed
20 Thomas, S, Wolfarth, B, Wittmer, C, Nowak, D, Radon K;, GA2LEN-Olympic Study Team. Self-reported asthma and allergies in top athletes compared to the general population–results of the German part of the GA2LEN-Olympic study 2008. Allergy Asthma Clin Immunol 2010;6:31 CrossRefGoogle Scholar
21 Kurowski, M, Jurczyk, J, Jarzębska, M, Moskwa, S, Makowska, JS, Krysztofiak, H et al. Association of serum Clara cell protein CC16 with respiratory infections and immune response to respiratory pathogens in elite athletes. Respir Res 2014;15:45 CrossRefGoogle ScholarPubMed
22 Katelaris, CH, Carrozzi, FM, Burke, TV, Byth, K. Patterns of allergic reactivity and disease in Olympic athletes. Clin J Sport Med 2006;16:401–5Google Scholar
23 Alaranta, A, Alaranta, H, Heliövaara, M, Alha, P, Palmu, P, Helenius, I. Allergic rhinitis and pharmacological management in elite athletes. Med Sci Sports Exerc 2005;37:707–11CrossRefGoogle ScholarPubMed
24 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;15:297–301 Google Scholar
25 Alves, A, Martins, C, Delgado, L, Fonseca, J, Moreira, A. Exercise-induced rhinitis in competitive swimmers. Am J Rhinol Allergy 2010;24:e114–17CrossRefGoogle ScholarPubMed
26 Gelardi, M, Ventura, MT, Fiorella, R, Fiorella, ML, Russo, C, Candreva, T et al. Allergic and non-allergic rhinitis in swimmers: clinical and cytological aspects. Br J Sports Med 2012;46:54–8Google Scholar
27 Brożek, JL, Bousquet, J, Baena-Cagnani, CE, Bonini, S, Canonica, GW, Casale, TB et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol 2010;126:466–76Google Scholar
28 Carlsen, KH, Anderson, SD, Bjermer, L, Bonini, S, Brusasco, V, Canonica, W et al. Exercise-induced asthma, respiratory and allergic disorders in elite athletes: epidemiology, mechanisms and diagnosis. Part I of the report from the Joint Task Force of the European Respiratory Society (ERS) and the European Academy of Allergy and Clinic Immunology (EAACI) in cooperation with GA2LEN. Allergy 2008;63:387–403 Google Scholar
29 Moreira, A, Delgado, L, Carlsen, KH. Exercise-induced asthma: why is it so frequent in Olympic athletes? Expert Rev Respir Med 2011;5:1–3 Google Scholar
30 Fitch, KD. An overview of asthma and airway hyper-responsiveness in Olympic athletes. Br J Sports Med 2012;46:413–16Google Scholar
31 Hallstrand, TS, Moody, MW, Wurfel, MM, Schwartz, LB, Henderson, WR Jr, Aitken, ML. Inflammatory basis of exercise-induced bronchoconstriction. Am J Respir Crit Care Med 2005;172:679–86CrossRefGoogle ScholarPubMed
32 Anderson, SD, Kippelen, P. Exercise-induced bronchoconstriction: pathogenesis. Curr Allergy Asthma Rep 2005;5:116–22Google Scholar
33 Nieman, DC. Exercise, upper respiratory tract infection, and the immune system. Med Sci Sport Exerc 1994;26:128–39Google Scholar
34 Reeser, JC, Willick, S, Elstad, M. Medical services provided at the Olympic Village polyclinic during the 2002 Salt Lake City Winter Games. WMJ 2003;102:20–2Google Scholar
35 Robinson, D, Milne, C. Medicine at the 2000 Sydney Olympic Games: the New Zealand health team. Br J Sports Med 2002;36:229 Google Scholar
36 Gleeson, M. Immune function in sport and exercise. J Appl Physiol 2007;103:693–9CrossRefGoogle ScholarPubMed
37 Nieman, DC, Johanssen, LM, Lee, JW, Arabatzis, K. Infectious episodes in runners before and after the Los Angeles Marathon. J Sports Med Phys Fitness 1990;30:316–28Google ScholarPubMed
38 Peters, EM, Bateman, ED. Ultramarathon running and upper respiratory tract infections. An epidemiological survey. S Afr Med J 1983;64:582–4Google Scholar
39 Peters, EM, Goetzsche, JM, Grobbelaar, B, Noakes, TD. Vitamin C supplementation reduces the incidence of postrace symptoms of upper-respiratory-tract infection in ultramarathon runners. Am J Clin Nutr 1993;57:170–4Google Scholar
40 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;39:577–86Google Scholar
41 Cox, AJ, Gleeson, M, Pyne, DB, Callister, R, Hopkins, WG, Fricker, PA. Clinical and laboratory evaluation of upper respiratory symptoms in elite athletes. Clin J Sport Med 2008;18:438–45CrossRefGoogle ScholarPubMed
42 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;44:999–1004 Google Scholar