Development and validation of the Exercise-Induced Laryngeal Obstruction Dyspnea Index (EILODI)

Olin, J. Tod; Shaffer, Monica; Nauman, Emily; Durso, Catherine; Fan, Elizabeth M.; Staudenmayer, Herman; Christopher, Kent L.; Gartner‐Schmidt, Jackie

doi:10.1016/j.jaci.2021.09.027

Cited by 18 publications

(4 citation statements)

References 28 publications

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“…Recent advances in translaryngeal pressure measurements may guide diagnostic and therapeutic decision-making in the future 74. In terms of monitoring the severity of previously-diagnosed EILO over time and in response to interventions in clinics and clinical trials, a patient-reported outcome measure is available 76…”

Section: Observationsmentioning

confidence: 99%

Exercise-induced laryngeal obstruction (EILO) in athletes: a narrative review by a subgroup of the IOC Consensus on ‘acute respiratory illness in the athlete’

Clemm

Olin

McIntosh³

et al. 2022

Br J Sports Med

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Exercise-induced laryngeal obstruction (EILO) is caused by paradoxical inspiratory adduction of laryngeal structures during exercise. EILO is an important cause of upper airway dysfunction in young individuals and athletes, can impair exercise performance and mimic lower airway dysfunction, such as asthma and/or exercise-induced bronchoconstriction. Over the past two decades, there has been considerable progress in the recognition and assessment of EILO in sports medicine. EILO is a highly prevalent cause of unexplained dyspnoea and wheeze in athletes. The preferred diagnostic approach is continuous visualisation of the larynx (via laryngoscopy) during high-intensity exercise. Recent data suggest that EILO consists of different subtypes, possibly caused via different mechanisms. Several therapeutic interventions for EILO are now in widespread use, but to date, no randomised clinical trials have been performed to assess their efficacy or inform robust management strategies. The aim of this review is to provide a state-of-the-art overview of EILO and guidance for clinicians evaluating and treating suspected cases of EILO in athletes. Specifically, this review examines the pathophysiology of EILO, outlines a diagnostic approach and presents current therapeutic algorithms. The key unmet needs and future priorities for research in this area are also covered.

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Section: Observationsmentioning

confidence: 99%

Exercise-induced laryngeal obstruction (EILO) in athletes: a narrative review by a subgroup of the IOC Consensus on ‘acute respiratory illness in the athlete’

Clemm

Olin

McIntosh³

et al. 2022

Br J Sports Med

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“…Speech pathology management of VCD/ILO includes an initial evaluation followed by three to four therapy sessions. The evaluation includes case history, patient reported outcome measures, 48 , 49 , 50 , 51 , 52 , 53 voice assessment and observation of coughing and breathing at rest and during tasks. Some patients may present to speech pathologists with a confirmed diagnosis of VCD/ILO.…”

Section: Treatmentmentioning

confidence: 99%

Vocal cord dysfunction/inducible laryngeal obstruction—2022 Melbourne Roundtable Report

et al. 2023

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Vocal cord dysfunction/inducible laryngeal obstruction (VCD/ILO), is a common condition characterized by breathlessness associated with inappropriate laryngeal narrowing. Important questions remain unresolved, and to improve collaboration and harmonization in the field, we convened an international Roundtable conference on VCD/ILO in Melbourne, Australia. The aims were to delineate a consistent approach to VCD/ILO diagnosis, appraise disease pathogenesis, outline current management and model(s) of care and identify key research questions. This report summarizes discussions, frames key questions and details recommendations. Participants discussed clinical, research and conceptual advances in the context of recent evidence. The condition presents in a heterogenous manner, and diagnosis is often delayed. Definitive diagnosis of VCD/ILO conventionally utilizes laryngoscopy demonstrating inspiratory vocal fold narrowing >50%. Computed tomography of the larynx is a new technology with potential for swift diagnosis that requires validation in clinical pathways. Disease pathogenesis and multimorbidity interactions are complex reflecting a multi‐factorial, complex condition, with no single overarching disease mechanism. Currently there is no evidence‐based standard of care since randomized trials for treatment are non‐existent. Recent multidisciplinary models of care need to be clearly articulated and prospectively investigated. Patient impact and healthcare utilization can be formidable but have largely escaped inquiry and patient perspectives have not been explored. Roundtable participants expressed optimism as collective understanding of this complex condition evolves. The Melbourne VCD/ILO Roundtable 2022 identified clear priorities and future directions for this impactful condition.

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“…The apparent effect mainly on glottic closure suggests a mechanism of action similar to that of laryngeal control techniques, rather than a benefit from increased respiratory muscle strength. The exercise‐induced laryngeal obstruction dyspnoea index (EILODI) is a recently validated patient‐reported outcome measure that can be employed to evaluate the efficacy of treatment interventions and change in clinical status over time 111 …”

Section: Diagnosis and Management Of Respiratory Disordersmentioning

confidence: 99%

Diagnosis and management of allergy and respiratory disorders in sport: An EAACI task force position paper

Price

Walsted

Bonini

et al. 2022

Allergy

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Allergy and respiratory disorders are common in young athletic individuals. In the context of elite sport, it is essential to secure an accurate diagnosis in order to optimize health and performance. It is also important, however, to consider the potential impact or consequences of these disorders, in recreationally active individuals engaging in structured exercise and/or physical activity to maintain health and well-being across the lifespan. This EAACI Task Force was therefore established, to develop an up-to-date, research-informed position paper, detailing the optimal approach to the diagnosis and management of common exercise-related allergic and respiratory con- ditions. The recommendations are informed by a multidisciplinary panel of expertsThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Development and validation of the Exercise-Induced Laryngeal Obstruction Dyspnea Index (EILODI)

Cited by 18 publications

References 28 publications

Exercise-induced laryngeal obstruction (EILO) in athletes: a narrative review by a subgroup of the IOC Consensus on ‘acute respiratory illness in the athlete’

Exercise-induced laryngeal obstruction (EILO) in athletes: a narrative review by a subgroup of the IOC Consensus on ‘acute respiratory illness in the athlete’

Vocal cord dysfunction/inducible laryngeal obstruction—2022 Melbourne Roundtable Report

Diagnosis and management of allergy and respiratory disorders in sport: An EAACI task force position paper

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