Abstract
Purpose
The aim of this study was to evaluate the respiratory function and symptom perception in professional cyclists completing a Grand Tour (GT).
Methods
Nine male cyclists completed La Vuelta or Tour de France (2018/19). At study entry, airway inflammation was measured via fractional exhaled nitric oxide (FeNO). Respiratory symptoms and pulmonary function were assessed prior to the first stage (Pre-GT), at the second rest day (Mid-GT) and prior to the final stage of the GT (Late-GT). Sniff nasal inspiratory pressure (SNIP) was assessed at pre and late-GT timepoints.
Results
Seven cyclists reported respiratory symptoms during the race (with a prominence of upper airway issues). Symptom severity increased either mid or late-GT for most cyclists. A decline in FEV1 from pre-to-mid GT (− 0.27 ± 0.24 l, − 5.7%) (P = 0.02) and pre-to-late GT (− 0.27 ± 0.13 l, − 5.7%) (P < 0.001) was observed. Similarly, a decline in FVC (− 0.22 ± 0.17 l, − 3.7%) (P = 0.01) and FEF25-75 (− 0.49 ± 0.34 l/s, − 11%) (P = 0.02) was observed pre-to-late GT. Overall, eight (89%) and six (67%) demonstrated a clinically meaningful decline (> 200 ml) in FEV1 and FVC during the GT follow-up, respectively. SNIP remained unchanged pre-to-late GT (n = 5), however, a positive correlation was observed between ΔSNIP and ΔFVC (r = 0.99, P = 0.002).
Conclusion
GT competition is associated with a high prevalence of upper respiratory symptoms and a meaningful decline in lung function in professional cyclists. Further research is now required to understand the underpinning physiological mechanisms and determine the impact on overall respiratory health and elite cycling performance and recovery.
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Abbreviations
- EIB:
-
Exercise-induced bronchoconstriction
- FEF25-75 :
-
Mean forced expiratory flow between 25 and 75% of forced vital capacity
- FeNO:
-
Fractional exhaled nitric oxide
- FEV1 :
-
Forced expiratory volume in one second
- FVC:
-
Forced vital capacity
- GT:
-
Grand tour
- ICS:
-
Inhaled corticosteroid
- IQR:
-
Interquartile range
- LTRA:
-
Leukotriene receptor antagonist
- PEF:
-
Peak expiratory flow
- PPB:
-
Parts per billion
- RMF:
-
Respiratory muscle fatigue
- SABA:
-
Short-acting beta-2 agonist
- SNIP:
-
Sniff nasal inspiratory pressure
- TDF:
-
Tour de France
- UCI:
-
Union Cycliste International
- VAS:
-
Visual Analogue Scale
- VO2max :
-
Maximal Oxygen Uptake
- Vuelta:
-
Vuelta a España
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Acknowledgements
The authors would like to acknowledge the commitment and support of the World Tour professional cyclists and team staff involved in the completion of this study.
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OP, JG, JH were involved in the conception and design of the study. HA and JG acquired the data. All authors were involved with drafting and critical revision of manuscript and final approval of the version to be published. The results of the study are presented clearly, honestly, and without fabrication or falsification.
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Allen, H., Price, O.J., Greenwell, J. et al. Respiratory impact of a grand tour: insight from professional cycling. Eur J Appl Physiol 121, 1027–1036 (2021). https://doi.org/10.1007/s00421-020-04587-z
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DOI: https://doi.org/10.1007/s00421-020-04587-z