Exercise-induced airway narrowing in army recruits with a history of childhood asthma

Sinclair, D.B.; Sims, MM; Hoad, N A; Winfield, C R

doi:10.1183/09031936.95.08081314

Cited by 19 publications

(10 citation statements)

References 15 publications

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“…Such a diagnosis cannot be made with a methacholine test and EIB cannot be excluded by a negative response to methacholine. When the presence of EIB would impair the ability of a person with a history suggesting asthma to perform demanding or lifesaving work (e.g., military, police, or firefighting work), a test for EIB may be indicated (204,205). Exercise testing is used to determine the effectiveness and optimal dosages of medications prescribed to prevent EIB.…”

Section: A Indicationsmentioning

confidence: 99%

Guidelines for Methacholine and Exercise Challenge Testing—1999

Ro¹,

Casaburi²,

Al³

et al. 2000

Am J Respir Crit Care Med

2,098

455

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This statement provides practical guidelines and suggestions for methacholine and exercise challenging testing. Specifically, it reviews indications for these challenges, details factors that influence the results, presents brief step-by-step protocols, outlines safety measures, describes proper patient preparation and procedures, provides an algorithm for calculating results, and offers guidelines for clinical interpretation of results. The details are important because methacholine and exercise challenge tests are, in effect, dose-response tests and delivery of the dose and measurement of the response must be accurate if a valid test is to be obtained. These guidelines are geared to patients who can perform good-quality spirometry tests; they are not appropriate for infants or preschool children. They are not intended to limit the use of alternative protocols or procedures that have been established as acceptable methods. We do not discuss the general topic of bronchial hyperresponsiveness (BHR). 100 mg 100 mg 6.25 ml A: 16 mg/ml 3 ml of dilution A 9 ml B: 4 mg/ml 3 ml of dilution B 9 ml C: 1 mg/ml 3 ml of dilution C 9 ml D: 0.25 mg/ml 3 ml of dilution D 9 ml E: 0.0625 mg/ml * Schedule obtained from Methapharm (Brantford, ON, Canada). * This list is provided to simplify access to some sources of equipment. It is not a complete list of all possible sources of acceptable equipment.

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Section: A Indicationsmentioning

confidence: 99%

Guidelines for Methacholine and Exercise Challenge Testing—1999

Ro¹,

Casaburi²,

Al³

et al. 2000

Am J Respir Crit Care Med

2,098

455

View full text Add to dashboard Cite

show abstract

“…EIB commonly occurs in people with clinically recognized asthma [8] and has been reported in school children, elite athletes, and military recruits without other clinical signs and symptoms of asthma [9-11]. EIB is often the first indication of asthma [12] so it is important to diagnose and then treat underlying asthma recognized by exercise intolerance.…”

Section: Introductionmentioning

confidence: 99%

Reproducibility of the airway response to an exercise protocol standardized for intensity, duration, and inspired air conditions, in subjects with symptoms suggestive of asthma

Anderson

Pearlman²,

Rundell

et al. 2010

Respir Res

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BackgroundExercise testing to aid diagnosis of exercise-induced bronchoconstriction (EIB) is commonly performed. Reproducibility of the airway response to a standardized exercise protocol has not been reported in subjects being evaluated with mild symptoms suggestive of asthma but without a definite diagnosis. This study examined reproducibility of % fall in FEV1 and area under the FEV1 time curve for 30 minutes in response to two exercise tests performed with the same intensity and duration of exercise, and inspired air conditions.MethodsSubjects with mild symptoms of asthma exercised twice within approximately 4 days by running for 8 minutes on a motorized treadmill breathing dry air at an intensity to induce a heart rate between 80-90% predicted maximum; reproducibility of the airway response was expressed as the 95% probability interval.ResultsOf 373 subjects challenged twice 161 were positive (≥10% fall FEV1 on at least one challenge). The EIB was mild and 77% of subjects had <15% fall on both challenges. Agreement between results was 76.1% with 56.8% (212) negative (< 10% fall FEV1) and 19.3% (72) positive on both challenges. The remaining 23.9% of subjects had only one positive test. The 95% probability interval for reproducibility of the % fall in FEV1 and AUC0-30 min was ± 9.7% and ± 251% for all 278 adults and ± 13.4% and ± 279% for all 95 children. The 95% probability interval for reproducibility of % fall in FEV1 and AUC0-30 min for the 72 subjects with two tests ≥10% fall FEV1 was ± 14.6% and ± 373% and for the 34 subjects with two tests ≥15% fall FEV1 it was ± 12.2% and ± 411%. Heart rate and estimated ventilation achieved were not significantly different either on the two test days or when one test result was positive and one was negative.ConclusionsUnder standardized, well controlled conditions for exercise challenge, the majority of subjects with mild symptoms of asthma demonstrated agreement in test results. Performing two tests may need to be considered when using exercise to exclude or diagnose EIB, when prescribing prophylactic treatment to prevent EIB and when designing protocols for clinical trials.

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“…38 in 1995 reported the results of screening 100 military recruits who were asymptomatic at the time of challenge, but who had a history of asthma in childhood. Each subject underwent two exercise challenges, one in cold, dry air and one at room temperature.…”

mentioning

confidence: 98%

Exercise-Induced Asthma: A Practical Guide to Definitions, Diagnosis, Prevalence, and Treatment

Weiler¹

1996

allergy asthma proc

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Exercise-induced asthma is defined as an intermittent narrowing of the airways, demonstrated by a decrease in some measure of flow, that the patient experiences as wheezing, chest tightness, coughing, and difficulty breathing that is triggered by exercise. Exercise will trigger asthma in most individuals who have chronic asthma, as well as in some who do not otherwise have asthma. Definitive diagnosis requires demonstration of a drop in flow rate, typically > or = 13-15% for forced expiratory volume in one second (FEV1) and > or = 15-20% for peak expiratory flow rate (PEFR), after exercise, associated with symptoms. Prevalence data indicate that this disorder is very common in those who participate in recreational sports as well as in highly competitive athletes, with at least 12-15% of unselected athletes having positive exercise challenges. Treatment of exercise induced asthma involves use of nonpharmacological measures (such as the use of the refractory period after exercise and prewarming air) as well as use of medications (beta-agonists, cromolyn, and nedocromil). With treatment, those who suffer from exercise-induced asthma may be able to participate and compete at the highest levels of performance.

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Exercise-induced airway narrowing in army recruits with a history of childhood asthma

Cited by 19 publications

References 15 publications

Guidelines for Methacholine and Exercise Challenge Testing—1999

Guidelines for Methacholine and Exercise Challenge Testing—1999

Reproducibility of the airway response to an exercise protocol standardized for intensity, duration, and inspired air conditions, in subjects with symptoms suggestive of asthma

Exercise-Induced Asthma: A Practical Guide to Definitions, Diagnosis, Prevalence, and Treatment

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