Exercise-Induced Asthma in Children

Abstract

Exercise-induced asthma (EIA) is a relatively common problem in children, but may not be recognized because children either do not report their symptoms, or avoid activities that cause it. Clarifying the diagnosis of EIA, in particular separating EIA from other causes of exertional dyspnea, is essential. Treating EIA in children is challenging because of the nature of their physical activities, which are often not planned, and may be prolonged. Keeping children active is an important goal to ensure healthy physical and social development. Many children with EIA are well managed with an inhaled short-acting beta(2)-adrenoceptor agonist before exercise or if symptoms develop. The approach to more troublesome EIA depends on whether the child has persistent asthma and requires better prevention, or the EIA is an isolated clinical problem. The options for treatment also depend on the timing, frequency, and duration of activity that induces EIA. Options include the addition of a cromone, a leukotriene modifier, an inhaled corticosteroid, or switching to use a long-acting beta(2)-adrenoceptor agonist. The use of warm-up exercises has been shown to be helpful by using the refractory period but is not practical for most children with EIA. A final consideration for successful management of EIA in children is that the delivery of medication needs to be age-appropriate.

Prevention of Exercise-induced Asthma by a Fixed Combination of Disodium Cromoglycate plus Reproterol Compared with Montelukast in Young Patients

“…While EIA is not confined to school-children, it is a typical consequence of asthma for this patient group [16]. Current treatment options comprise SABA, MCS, their combination, and leukotriene modifiers [17].…”

Assessment of Asthma in Children Using Electromyography

“…Exercise induced asthma (EIA) is a symptom of asthma that over 80% of asthma patients, children and adults alike, experience [15]. It is diagnosed by means of an exercise challenge test(ECT), combined with lung function testing to determine bronchoconstriction [15,16]. Exercise induced bronchoconstriction (EIB) is more prominently present in children with a sedentary lifestyle [17].…”

“…This is related to the linearity of the conductive medium, together describing the superposition principle. The superposition principle states that the net response to a signal produced by multiple sources is equal to the sum of each individual source (equations 15,16).…”

“…Exclusion criteria Ages: [6][7][8][9][10][11][12][13][14][15][16][17] Children and/or parents that do not speak Dutch Children submitted for an ECT with signs of dyspnea Children with a pacemaker and/or ICD Children born prematurely (< 37 weeks) Children with chronic diseases other than asthma Children with psychomotor retardation with consultation of the researchers.…”

Commentary on Rydström I, Dalheim‐Englund A‐C, Holritz‐Rasmussen B, Möller C & Sandman P‐O (2005) Asthma – quality of life for Swedish children. Journal of Clinical Nursing 14, 739–749

“…2000, van Veldhoven et al. 2001, Carlsen & Carlsen 2002, Massie 2002, Orenstein 2002, Schettler & Gustafson 2004, Welsh et al. 2005).…”