Spirometry in sports medicine is essential for tracking the lung health of athletes over time in their chosen sport, with their changing training regimes or during rehabilitation programs. There are several factors that may affect recorded lung health values for athletes and it is important for sports medicine physicians to consider the difference and variability in lung health parameters of elite athletes.
Training/sports type: Different sports cause respiratory patterns
Each sports have their own characteristic impact on lung health. It is known that each sport may produce different expected spirometric outcomes for each sports type. For example, it is now known that endurance athletes have higher VC, FVC, FEV1 values than power athletes or to non-athlete individuals (1). Power athletes may in fact have no significant difference in ventilatory capacity compared to non-athlete individuals (1). Significant comparisons also exist between individuals involved in water-based (i.e. water-polo) and those in land-based sports (2). Between specific sports, it has been reported that PEF is generally lower in individuals in boxing, kayaking, taekwondo, rugby, handball and tennis, whereas VC and FEV1 is statistically significantly higher in basketball players, water polo players and rowers (3). The documented differences in spirometric parameters recorded for people with different sporting backgrounds is therefore important to consider by sports physicians who interpret spirometry testing in such individuals.
Individual Physical Characteristics: Effects on predicted values
Aside from the general parameters such as height, weight, age, gender and ethnicity, there may be other factors which influence respiratory function in elite athletes. Posture, the equilibrium between chest elasticity and strength of thoracic and abdominal muscles, and other body composition parameters such as fat free mass or waist measurement can affect predicted values (1). For example, it has been shown that there is a significant correlation between FVC and BMI, waist measurement and body fat mass (4). It is therefore important to consider, particularly for athletes who can undergo drastic change with training, body composition factors that might be contributing to the pulmonary function test results and trends.
Declining lung values: Possible in long-term athletes
High-level sports involving frequent and prolonged periods of hyperpnoea (increased depth and rate of breathing) may actually have negative long-term effects on lung health. A study found airway obstruction in up to 50% of athletes who were neither with atopic nor had asthmatic constitution (5). It is known, for example, that endurance athletes such as water polo players have higher prevalence of asthma, compared to non-athletic individuals or power athletes. A declining trend in spirometric measurements should be assessed within the context of the sport, training frequency and training type to understand the full impact of the sport versus the presence of a clinical respiratory condition.
Reference Values: Elite athletes should have their own reference values
Reference values in spirometry are largely derived from the general population. The lack of predictive values for normative respiratory parameters in the elite athlete population may affect proper clinical evaluation for respiratory disorders in such individuals. Care must be taken to remember that even mild exercise has a more prominent effect in elite athletes than the general population, and underestimation of lung health parameters in athletes of both sexes has previously occurred (6).
SpiroHome Ultrasonic Spirometers in Sports Medicine
SpiroHome Personal ultrasonic spirometers are ultra-portable high accuracy spirometers that can record and track an athletes lung health parameters both on and off the ‘field’. Customised to the athletes personal data, personal progress or decline in pulmonary function can be reported directly to physicians through the tap of a button. Personal data can be updated and logged to ensure that spirometry data is interpreted in light of changing physical or exercise conditions that the athlete is experiencing. Flow and Volume data can provide deeper insight into any underlying lung condition that may be affecting performance.
Alternatively, the SpiroHome Clinic can be used by sports physicians to test and track lung health in all of the athletes that they take care of. The athlete management dashboard centralises data across clinics or sporting groups. With session quality grading and trend data, physicians are supported through the interpretation of changing lung conditions in an individual.
Most importantly, SpiroHome Personal and SpiroHome Clinic data can unified and integrated over the SpiroHome Web Dashboard. This means that athletes and their physicians can pool pulmonary data from their respective devices. This not only allows physicians to verify the quality of data obtained by athletes on their personal device, but it also liberates the athletes who have busy training schedules from clinic visits.
- Durmic, T. et al., “The training type influence on male elite athletes' ventilatory function.” BMJ open sport & exercise medicine vol. 3,1, 2017, doi:10.1136/bmjsem-2017-000240
- Durmic, T. et al. ,‘'Sport-specific influences on respiratory patterns in elite athletes.’' J Bras Pneumol. vol.41,6, pg. 516-522, 2015, http://dx.doi.org/10.1590/s1806-37562015000000050
- Mazic, S. et al. , ‘'Respiratory parameters in elite athletes – does sport have an influence?.’' Pulmonology Journal vol.21,4, pg.192-197, 2015, DOI: 10.1016/j.rppnen.2014.12.003
- Park, J.E. et al., ‘'The Effect of Body Composition on Pulmonary Function.'’ Tuberc Respir Dis (Seoul), vol.72,5, pg. 433–440, 2012, doi: 10.4046/trd.2012.72.5.433
- Leischik, R. and Dworrak, B., ‘'Ugly duckling or Nosferatu? Cardiac injury in endurance sport - screening recommendations.’', Eur Rev Med Pharmacol Sci., vol.18,21, pg.3274-90, 2014
- Myrianthefs, P., ‘'Spirometry may underestimate airway obstruction in professional Greek athletes.’', Clin Respir vol.8,2, pg.240-247, 2014, doi: 10.1111/crj.12066. Epub 2013 Dec 16.