Exercise performance after salbutamol inhalation in non-asthmatic, non-athlete individuals: a randomised, controlled, cross-over trial

Filip Eckerström, Christian Emil Rex, Marie Maagaard, Sune Rubak, Vibeke Elisabeth Hjortdal, Johan Heiberg, Filip Eckerström, Christian Emil Rex, Marie Maagaard, Sune Rubak, Vibeke Elisabeth Hjortdal, Johan Heiberg

Abstract

Background: Asthma is a frequent diagnosis in competitive sports, and inhaled β2-agonists are commonly used by athletes. Although inhaled β2-agonists do not seem to improve performance in athletes, it has remained uncertain whether they can increase exercise performance in non-athletes.

Objective: To investigate the effect of inhaled β2-agonists on exercise performance in healthy non-athlete individuals.

Methods: In a double-blinded, placebo-controlled, cross-over trial, healthy, non-asthmatic, non-athlete individuals were randomised to inhalation of either 900 µg of salbutamol or placebo. Cardiopulmonary exercise testing, dynamic spirometry and impulse oscillometry were performed. The primary outcome was the effect from salbutamol on peak oxygen uptake, whereas secondary outcomes were breathing reserve and ventilation efficiency, and workload, heart rate, breath rate and minute ventilation at peak exercise under influence of salbutamol.

Results: A total of 36 healthy subjects with a mean age of 26±5 years were included. Salbutamol had no effect on peak oxygen uptake compared with placebo, 46.8±1.3 mL/kg/min versus 46.6±1.2 mL/kg/min, p=0.64. Salbutamol had no effect on workload, p=0.20, heart rate, p=0.23, breath rate, p=0.10, or minute ventilation, p=0.26, at peak exercise compared with placebo. Salbutamol lowered oxygen uptake, p=0.04, and workload, p=0.04, at anaerobic threshold compared with placebo. Forced expiratory volume in 1 s, 116%±13% of predicted, and peak expiratory flow, 122%±16% of predicted, increased after inhalation of salbutamol compared with placebo; 109%±13% and 117%±17%, respectively, p<0.01. Breathing reserve was found to be higher, 22%±2%, after salbutamol inhalation than after placebo, 16%±2%, p<0.01.

Conclusion: Inhaled salbutamol did not improve peak oxygen uptake in healthy, non-asthmatic, non-athlete individuals compared with placebo.

Trial registration number: NCT02914652.

Keywords: Sports & exercise medicine; doping; endurance; performance; randomised controlled trial.

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of investigations performed at first and second visits. The red and blue lines represent the randomisation order.
Figure 2
Figure 2
Exercise parameters related to workload during bicycle ergometry after salbutamol and placebo intervention in healthy, non-asthmatic individuals. (A) Oxygen uptake. (B) Oxygen pulse. (C) Heart rate. (D) Carbon dioxide excretion.
Figure 3
Figure 3
Exercise parameters related to workload during bicycle ergometry after salbutamol and placebo intervention in healthy, non-asthmatic individuals. (A) Breath rate. (B) Ventilation. (C) Ventilatory efficiency.

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