ABSTRACT
This chapter evaluates the available diagnostic methodology for exercise-induced bronchoconstriction (EIB) and provides practical recommendations concerning clinical assessment, diagnostic test selection and interpretation. The eucapnic voluntary hyperpnoea (EVH) challenge was developed on the premise that the ventilation reached and sustained, and the water content of the air inspired, are the most important determinants of EIB. Indirect bronchoprovocation challenges also provide value in the investigation of drugs employed to treat clinical asthma and EIB. Furthermore, pharmacotherapy effective in attenuating EIB has been shown to inhibit the airway response to both EVH and mannitol. Studies investigating inhaled corticosteroid therapy have demonstrated that higher doses appear to be more effective at inhibiting EIB when treatment is initially introduced. The athlete’s EIB now appears well managed and they are encouraged to maintain inhaler therapy. EVH has been observed to identify more cases of EIB than laboratory exercise tests, and it is as sensitive as field-based exercise testing for athletes.
