loss causes the bronchial vasculature to dilate and engorge in order to rewarm the epithelium. This engorgement, in turn, causes the airways to be impinged and narrowed, causing the symptoms of EIA. Support for this theory comes from the observation that inhaling warm air after exercise worsens the bronchoconstriction and inhaling cold air, lessens it (Tan & Spector, 1998). EIA follows the typical pattern of bronchodilation at the beginning of exercise, followed by bronchoconstriction, and then recovery. During the first 2 to 3 minutes of strenuous exercise bronchodilation occurs, however, after 5 minutes of exercise at 80% or more of maximal heart rate, bronchoconstriction occurs. “Pulmonary function classically declines 8-15 minutes after exercise has ceased” (Spector, 1993, p. 572). Recovery is usually spontaneous and occurs within 60 minutes. “Factors influencing EIA severity include the type, intensity, duration of exercise, environmental conditions (temperature, humidity, and air pollution) and the interval since the last attack” (Enright, 1996, p. 377). According to Hansen-Flaschen and Schotland (1998), “the greater the ventilatory response and the colder and dryer the inspired air, the more likely and severe is the resulting bronchoconstriction” (p. 192). EIA may or may not be classified by a refractory period ranging from between 40 minutes to 3 hours after the initial exercise challenge (Smith & LaBotz, 1998; Tan & Spector, 1998). “Approximately 40% to 50% of patients with EIA experience a 2-hour to 4-hour refractory period after an initial exercise task” (Spector, 1993, p. 575). As stated by Tan and Spector (1998), “if the individual attempts to exercise again after the symptoms subside, he or she will experience fewer symptoms the second time. This has been referred to as the refractory period” (p. 4). During this period, the effects of the ...
