Volunteer soccer coaches have limited knowledge on how to manage asthma in young players, a large-scale study finds.

Canadian researchers found 93% of coaches who responded to a 22-question online survey had not received any asthma-related training,

Of the 513 coaches who responded from a pool of 2300, the majority knew how to treat an asthma attack with a quick -relief inhaler and what to do with an asthmatic player who was out of breath while on the field.

However, far fewer coaches knew how to prevent an asthma attack and the majority “never” or “rarely” discussed an asthma emergency action plan with players and their families.

“Based on our results, since there is currently no specific asthma education protocol in place for soccer coaches, developing and testing the efficacy of an asthma education program would be the logical next step,” researchers wrote in the Open Access Journal of Sports Medicine.

On average, the respondents were inexperienced coaches, coached younger aged groups and around one-third had personal experience of asthma (either they or their child had the condition), the researchers noted, saying this could indicate a bias in the sample.

Experienced coaches were better at identifying the number of players with asthma on their team and the number of asthma-related incidents they had encountered as coaches.

“… a worrying trend is that coaches at younger age groups, particularly U5 and U7, tend to have quite poor knowledge regarding how to prevent an asthma attack,” researchers wrote.

 “It could be beneficial if coaches were able to recognise and manage symptoms at least at a preliminary level in these younger children.”

Over 90% of coaches believed asthma training would be beneficial and 69% said it should be mandatory.

Commenting on the study, consultant respiratory physician Dr James Hull of London’s Royal Brompton Hospital, said a campaign to upskill youth sport coaches could be beneficial.

“But it is about understanding the impact of asthma – not simply pulling a child out or sitting them out due to fear,” he told the limbic.

Dr Hull, who has a special interest in exercise-induced breathlessness, also called for education around exercised-induced laryngeal obstruction (EILO) – a largely under-detected and under-recognised condition where the voice box closes inappropriately during vigorous exercise.

In Scandinavia, where the condition is on the radar, a large study has shown a prevalence of between 5-7% of all adolescents.

“Yet whenever I talk to coaches or watch youth sports events, it is evident that any wheeze or breathlessness that a child develops during sport is assumed to be exercise-induced asthma,” Dr Hull said.

“From the best data available, it seems likely that most coaches of youth teams will have at least 1-2 children with EILO and yet have no idea how this impacts breathing during vigorous exercise and how it can respond so well to specialist breathing techniques to ease the breathlessness.”

Open Access Journal of Sports Medicine 2019: 10 17-31