Return to play following exercise-induced bronchoconstriction.

Objective: To review evidence-based support for return to play criteria following acute exercise-induced bronchoconstriction.

Data Sources: Electronic databases Ovid Medline and PubMed were searched for papers relating to exercise related asthma and bronchoconstriction and return to play criteria. Additional references from the bibliographies of retrieved articles were also reviewed.

Data Synthesis: There is clear evidence that exercise-induced airways narrowing is increasing in prevalence among athletes from school children to Olympians to professionals, yet there have been no studies specifically addressing return to play criteria. Although deaths from exercise associated bronchoconstriction were previously thought to be rare, recent reports of such deaths call for increased awareness by physicians, athletic trainers, and coaches of the potential fatal consequences of unrecognized episodes or of inadequate treatment.

Conclusions: No agreed-upon protocol for safe return to play following an acute episode of exercise induced bronchoconstriction has been published. A specific detailed protocol for return to play would assist physicians and other heath professionals to determine with greater confidence that an athlete is fully recovered and can safely return to play.