What do Nancy Hogshead, Jackie Joyner-Kersee, Bill Koch, Greg Louganis, and Dominique Wilkins all have in common? Each is a famous athlete who has asthma. They come from diverse fields: swimming, track and field, cross-country skiing, diving, basketball, and long-distance running. Following their asthma management plans helped these athletes become winners.

Students who follow their asthma management plans and keep their asthma under control can usually participate vigorously in the full range of sports and physical activities. Activities that are more intense and sustained -- such as long periods of running, basketball, and soccer -- are more likely to provoke asthma symptoms or an asthma episode. However, Olympic medalists with serious asthma have demonstrated that these activities are possible with good asthma management.

When a student experiences asthma symptoms or is just recovering from a recent asthma episode, exercise should be temporarily modified in type, length, or frequency to help reduce the risk of further symptoms. The student needs convenient access to his or her medications.

Actions for school staff to consider:

• Include adequate warm-up and cool-down periods. These help prevent or lessen episodes of exercise-induced asthma.
• Consult the student's asthma management plan, parent/guardian, or health care provider on the type and length of any limitations. Assess the student and school resources to determine how the student can participate most fully.
• Remember that a student who experiences symptoms or who has just recovered from an asthma episode is at an even greater risk for additional asthma problems. Take extra care. Observe for asthma symptoms, and check the student's peak flow if he or she uses a peak flow meter. Review the student's asthma management plan if there are any questions.
• Monitor the environment for potential allergens and irritants, for example, a recently mowed field or refinished gym floor. If an allergen or irritant is present, consider a temporary change in location.
• Make exercise modifications as necessary to get appropriate levels of participation. For example, if running is scheduled, the student could walk the whole distance, run part of the distance, or alternate running and walking.
• Keep the student involved when any temporary but major modification is required. Ask the student to act, for example, as a scorekeeper, timer, or equipment handler until he or she can return to full participation. Dressing for a physical education class and participating at any level is better than being left out or left behind.

Created by the National Heart, Lung, and Blood Institute.