Pulmonary problems and management concerns in youth sports

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Asthma

Asthma is the most common chronic illness of children and adolescents, affecting between 5% and 15% of the population, or some 2.5 million young people in the United States. It is characterized by periodic airways obstruction that is at least partially reversible, either spontaneously or with treatment. The airway obstruction is caused by spasm of bronchial smooth muscle, endobronchial inflammation, or both. There is increased sensitivity of the bronchi to various stimuli [1]. Asthma has a

Scoliosis

In most cases, scoliosis does not influence exercise tolerance, but when the curve is pronounced, somewhere around 60%, it can impinge on chest expansion, causing a restrictive defect, and a reduction of vital capacity. The reduced vital capacity, in turn, reduces exercise tolerance. With more severe curves, exercise tolerance can indeed be extremely limited.

Pectus excavatum

This common problem is often unfairly blamed for reduced exercise tolerance. Pectus excavatum, while occasionally having emotional

Nonpathologic heavy breathing

Most heavy breathing that occurs during athletic competitions and practices is normal. As metabolic demands increase, minute ventilation must increase to supply more oxygen to exercising muscles, and especially to remove carbon dioxide. If the exercise is so intense that the oxygen supply to the exercise muscles is outstripped by the demand, the main source of energy becomes anaerobic metabolism, with the consequent production of lactic acid. With the buffering of lactic acid, excess carbon

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  • Cited by (24)

    • Physical activity and exercise in children with chronic health conditions

      2013, Journal of Sport and Health Science
      Citation Excerpt :

      Parents become apprehensive when their children have difficulty breathing.7 Thus, effective management of the hyper-responsiveness is accomplished either by pharmacological means or as a consequence of improved fitness.39,78 A phenomenon characterized by repeated bouts of exercise interrupted by recovery periods has been shown to result in a “refractory period” which lasts 2–4 h.79 During this refractory period the child can participate in vigorous PA without respiratory problems.

    • Inpatient paediatric rehabilitation in chronic respiratory disorders

      2012, Paediatric Respiratory Reviews
      Citation Excerpt :

      Several studies have implicated lifestyle changes, specifically decreased physical activity, as a contributor to the increase in asthma prevalence and severity.23 Moreover, the capacity for asthmatic subjects to exercise safely and to significantly improve their cardiovascular fitness and quality of life has been demonstrated.24 From this perspective it seems logical to subject asthmatic patients to exercise training to increase fitness and strength.

    • Physical activity and exercise in asthma: Relevance to etiology and treatment

      2005, Journal of Allergy and Clinical Immunology
      Citation Excerpt :

      Several studies have reported that exercise conditioning does not influence inflammation as judged on the basis of preconditioning and postconditioning methacholine challenges.24,25 Orenstein21 suggested that some older studies erroneously concluded that underlying asthma was less severe after exercise conditioning because when challenged with the same preconditioning workload in the fit state, asthmatic patient's minute ventilation was lower, making the stimulus for EIB less intense. Regardless, it seems to us, any measure that makes doing the same workload less asthmogenic seems prudent, irrespective of the mechanism.

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