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Randomized Controlled Trial
. 2020 Mar;30(3):591-601.
doi: 10.1111/sms.13603. Epub 2019 Dec 6.

Effects of a heat and moisture exchanger on respiratory function and symptoms post-cold air exercise

Clemens Frischhut  1 , Michael D Kennedy  2 , Martin Niedermeier  1 , Martin Faulhaber  1
Affiliations
Randomized Controlled Trial

Effects of a heat and moisture exchanger on respiratory function and symptoms post-cold air exercise

Clemens Frischhut et al. Scand J Med Sci Sports. 2020 Mar.

Abstract

Purpose: Exercise at temperatures below -15°C induces drying and cooling of lung airways which causes exercise-induced bronchoconstriction (EIB) and respiratory symptoms, especially in winter sport athletes. The objective of this study was to evaluate whether a heat and moisture exchanger (HME) worn during intense cold air exercise improves lung function and reduces respiratory symptoms in healthy winter sport athletes.

Methods: Seven active males and six active females (maximum oxygen uptake 61.9 ± 6.9 and 52.2 ± 5.3 mL/kg/min), all active or former winter sport athletes, completed running trials with and without HME in random order on 2 days in an environmental chamber (-20°C temperature, humidity 46.2%). Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1 ), forced expiratory flow at 25%-75% (FEF25%-75% ), and FEF at 50% (FEF50% ) were measured pre- and post-exercise (3, 6, 10, 15, and 20 minutes). Respiratory symptoms were reported after exercise.

Results: Significant interaction effects were observed for FEV1 and FEF25%-75% . Mean decrease of FVC (-5.9%, P ≤ .001) and FEV1 (-4.2%, P = .003) was largest 3 minutes post-exercise without HME. There was an increase of FEV1 , FEF25%-75% , and FEF50% post-exercise compared to pre-exercise with HME. More respiratory symptoms overall were reported without HME (P = .046).

Conclusion: Intense cold air exercise likely causes transient acute bronchoconstriction and symptoms of cough in individuals participating in winter sports. However, this study finds that the application of an HME during intense cold air exercise improves lung function and reduces prevalence of EIB-associated symptoms compared to unprotected intense cold air exercise.

Keywords: cold temperature; cough; exercise-induced asthma; exercise-induced bronchospasm; extreme cold; spirometry.

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Conflict of interest statement

The authors declare no conflict of interest. Thus, the authors declare no role of study sponsors in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or deciding to submit the manuscript for publication.

Figures

Figure 1
Figure 1
The applied heat and moisture exchanger
Figure 2
Figure 2
Change in FEV1 at the time points 3, 6, 10, 15, and 20 minutes post‐exercise for the conditions with and without HME expressed as percent change from pre‐exercise. Data are reported as means ± SD for 13 participants (bars and error bars) and values of each participant (circles and triangles). Significance value was set at P ≤ .05. Interaction contrasts in 6 × 2 repeated‐measures ANOVA as follows: *3‐minute time by condition interaction, P = .011, ηp 2 = 0.430; †10‐minute time by condition interaction, P = .030, ηp 2  = 0.335; ‡15‐minute time by condition interaction, P = .038, ηp 2  = 0.311. Difference contrasts in 6 × 1 repeated‐measures ANOVA as follows: §3 minutes different than pretest without HME, P = .003, ηp 2 = 0.525; ll6 minutes different than pretest without HME, P = .016, ηp 2 = 0.394; 10 minutes different than pretest without HME, P = .038, ηp 2 = 0.31. Abbreviations: FEV1, forced expiratory volume in 1 second; HME, heat and moisture exchanger
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