Cough in the Athlete: CHEST Guideline and Expert Panel Report.

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Clinical Guidelines
Authored By
Boulet LP, Turmel J, Irwin RS
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Interests
Pulmonology
Speciality
Pulmonology
Book Detail
volume
151
ISSN
1931-3543
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{"article_title":"Cough in the Athlete: CHEST Guideline and Expert Panel Report.","author":"Boulet LP, Turmel J, Irwin RS","journal_title":"Chest","issn":"1931-3543","isbn":"","publication_date":"2017-02-01","volume":"151","issue":"2","first_page":"441","page_count":"","accession_number":"27865877","doi":"10.1016\/j.chest.2016.10.054","publisher":"Elsevier","doctype":"Journal Article","subjects":"Asthma, Exercise-Induced complications; Athletes; Cough etiology; Environmental Exposure adverse effects; Respiratory Tract Infections complications; Rhinitis complications; Vocal Cord Dysfunction complications; Adolescent; Adult; Asthma complications; Asthma diagnosis; Asthma, Exercise-Induced diagnosis; Bronchial Provocation Tests; Consensus; Cough therapy; Disease Management; Exercise; Humans; Young Adult","interest_area":["Pulmonology"],"abstract":"Background: Cough is a common symptom experienced by athletes, particularly after exercise. We performed a systematic review to assess the following in this population: (1) the main causes of acute and recurrent cough, either exercise-induced or not, (2) how cough is assessed, and (3) how cough is treated in this population. From the systematic review, suggestions for management were developed. Methods: This review was performed according to the CHEST methodological guidelines and Grading of Recommendations Assessment, Development and Evaluation framework until April 2015. To be included, studies had to meet the following criteria: participants had to be athletes and adults and adolescents aged \u2265 12 years and had to complain of cough, regardless of its duration or relationship to exercise. The Expert Cough Panel based their suggestions on the data extracted from the review and final grading by consensus according to a Delphi process. Results: Only 60 reports fulfilled the inclusion criteria, and the results of our analysis revealed only low-quality evidence on the causes of cough and how to assess and treat cough specifically in athletes. Although there was no formal evaluation of causes of cough in the athletic population, the most common causes reported were asthma, exercise-induced bronchoconstriction, respiratory tract infection (RTI), upper airway cough syndrome (UACS) (mostly from rhinitis), and environmental exposures. Cough was also reported to be related to exercise-induced vocal cord dysfunction among a variety of less common causes. Although gastroesophageal reflux disease (GERD) is frequent in athletes, we found no publication on cough and GERD in this population. Assessment of the causes of cough was performed mainly with bronchoprovocation tests and suspected disease-specific investigations. The evidence to guide treatment of cough in the athlete was weak or nonexistent, depending on the cause. As data on cough in athletes were hidden in a set of other data (respiratory symptoms), evidence tables were difficult to produce and were done only for cough treatment in athletes. Conclusions: The causes of cough in the athlete appear to differ slightly from those in the general population. It is often associated with environmental exposures related to the sport training environment and occurs predominantly following intense exercise. Clinical history and specific investigations should allow identification of the cause of cough as well as targeting of the treatment. Until management studies have been performed in the athlete, current guidelines that exist for the general population should be applied for the evaluation and treatment of cough in the athlete, taking into account specific training context and anti-doping regulations. Copyright \u00a9 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=27865877","isPdfLink":false,"isSAML":false,"an":"27865877","number_other":"","type_pub":"","issn_electronic":"1931-3543","languages":"English","language":"eng","date_entry":"Date Created: 20161121 Date Completed: 20170524 Latest Revision: 20240210","date_update":"20240210","titleSource":"Chest [Chest] 2017 Feb; Vol. 151 (2), pp. 441-454. Date of Electronic Publication: 2016 Nov 16.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2017-02-01","description":"Background: Cough is a common symptom experienced by athletes, particularly after exercise. We performed a systematic review to assess the following in this population: (1) the main causes of acute and recurrent cough, either exercise-induced or not, (2) how cough is assessed, and (3) how cough is treated in this population. From the systematic review, suggestions for management were developed.<br \/>Methods: This review was performed according to the CHEST methodological guidelines and Grading of Recommendations Assessment, Development and Evaluation framework until April 2015. To be included, studies had to meet the following criteria: participants had to be athletes and adults and adolescents aged \u2265 12 years and had to complain of cough, regardless of its duration or relationship to exercise. The Expert Cough Panel based their suggestions on the data extracted from the review and final grading by consensus according to a Delphi process.<br \/>Results: Only 60 reports fulfilled the inclusion criteria, and the results of our analysis revealed only low-quality evidence on the causes of cough and how to assess and treat cough specifically in athletes. Although there was no formal evaluation of causes of cough in the athletic population, the most common causes reported were asthma, exercise-induced bronchoconstriction, respiratory tract infection (RTI), upper airway cough syndrome (UACS) (mostly from rhinitis), and environmental exposures. Cough was also reported to be related to exercise-induced vocal cord dysfunction among a variety of less common causes. Although gastroesophageal reflux disease (GERD) is frequent in athletes, we found no publication on cough and GERD in this population. Assessment of the causes of cough was performed mainly with bronchoprovocation tests and suspected disease-specific investigations. The evidence to guide treatment of cough in the athlete was weak or nonexistent, depending on the cause. As data on cough in athletes were hidden in a set of other data (respiratory symptoms), evidence tables were difficult to produce and were done only for cough treatment in athletes.<br \/>Conclusions: The causes of cough in the athlete appear to differ slightly from those in the general population. It is often associated with environmental exposures related to the sport training environment and occurs predominantly following intense exercise. Clinical history and specific investigations should allow identification of the cause of cough as well as targeting of the treatment. Until management studies have been performed in the athlete, current guidelines that exist for the general population should be applied for the evaluation and treatment of cough in the athlete, taking into account specific training context and anti-doping regulations.<br \/> (Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&scope=site&db=mdl&AN=27865877&authtype=shib&custid=ns346513&group=main&profile=eds","no_of_pages":"","authored_by":"Boulet LP, Turmel J, Irwin RS"}
ISSN
1931-3543
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true
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