Facial Cooling Enhances Exercise-Induced Bronchoconstriction in Asthmatic Children

ZEITOUN, MONA1; WILK, BOGUSLAW1; MATSUZAKA, AKIRA1; KNÖPFLI, BRUNO H.2; WILSON, BRIAN A.3; BAR-OR, ODED1

Medicine & Science in Sports & Exercise:
CLINICAL SCIENCES: Clinically Relevant
Abstract

ZEITOUN, M., B. WILK, A. MATSUZAKA, B. H. KNÖPFLI, B. A. WILSON, and O. BAR-OR. Facial Cooling Enhances Exercise-Induced Bronchoconstriction in Asthmatic Children. Med. Sci. Sports Exerc., Vol. 36, No. 5, pp. 767–771, 2004.

Purpose: Exercising in cold air enhances bronchial responsiveness (BR) as compared with exercising in warm air. This may be due to intrathoracic cooling or to increased vagal activity caused by facial cooling. The purpose of this study was to compare the effects on BR of cold air inhalation and of facial exposure to cold air, as well as the combined effect of both.

Methods: Fourteen children with asthma (eight girls) performed four exercise challenge tests in a climatic chamber, under one of the following conditions: 1) inhaling warm air while the face was exposed to warm air (WW, 21°C, 25% relative humidity (RH)); 2) inhaling warm air while the face was exposed to cold air (WC, 0°C, 80% RH); 3) inhaling cold air while the face was exposed to cold air (CC); and 4) inhaling cold air while the face was exposed to warm air (CW). The study was analyzed, using a one- and two-way ANOVA.

Results: Postexercise forced expiratory volume in the first second (FEV1) and maximal mid-expiratory flow (MMEF) values as percent predicted (% pred) showed significant reductions over time (P < 0.001), significant differences among the four experimental conditions (P < 0.001) and a significant condition × time interaction (FEV1:P < 0.001, MMEF:P < 0.01). FEV1 was significantly lower for CC and WC, as compared with WW and CW at 5 and 10 min postexercise. The lowest postexercise values for FEV1 occurred in the CC and WC sessions (76% predicted in both). A similar pattern was obtained for MMEF.

Conclusion: Facial cooling combined with either cold or warm air inhalation causes the greatest EIB, as compared with the isolated challenge with cold air inhalation. We suggest that vagal mechanisms play a major role in exercise and cold-induced bronchoconstriction.

Author Information

1Children’s Exercise and Nutrition Centre, McMaster University, Hamilton, Ontario, CANADA; 2Alpine Children’s Hospital Davos, Davos, SWITZERLAND; and 3School of Human Biology and Nutritional Science, University of Guelph, Ontario, CANADA

Address for correspondence: Oded Bar-Or, M.D. Director, Children’s Exercise and Nutrition Centre, Chedoke Hospital Division, Evel Building, Hamilton, Ontario, L8N 3Z5, Canada; E-mail: baror@mcmaster.ca.

Submitted for publication September 2003.

Accepted for publication December 2003.

©2004The American College of Sports Medicine