Prevalence of exercise-induced cough in schoolchildren: A pilot study

Abstract

Association between exercise-induced bronchoconstriction (EIB) and physical activity has not been investigated in a natural school environment in a general pediatric population. Our objective was to determine the prevalence of exercise-induced symptoms (cough, wheeze, chest tightness, dyspnea) and bronchospasm among schoolchildren during physical education (PE). A total of 557 schoolchildren from seven public schools were enrolled. Information regarding demographic characteristic, previously diagnosed asthma was obtained. All children attended 45-minute PE lesson with similar exercise intensity. Pulmonary function tests were performed before and immediately after PE lesson. The diagnosis of EIB was defined as a forced expiratory volume in one second (FEV1) decrease from baseline of more than or equal to 10% with exercise. Cough and dyspnea after exercise were recorded. A total of 557 participants were included into the analysis. After PE lesson, 15.3% children suffered from cough, 0.9% reported dyspnea, and 10.1% had more than 10% fall in FEV1 from baseline. Among all participants, 5.9% had doctors' diagnosed asthma, 4.8% of them were treated with inhaled corticosteroids (ICS). Among children with cough, 21.5% had asthma and 17.6% experienced EIB. Among asthmatics, 48.6% suffered from cough and 18.2% had more than 10% fall in FEV1 from baseline after PE lesson. EIB was not affected by age, gender, body mass index, asthma diagnosis, and ICS use. Only cough (odds ratio: 2.21, 95% confidence interval: 1.16-4.23; p = 0.0161) was independently associated with EIB. This study showed a high prevalence of exercise-induced cough and/or 10% fall in FEV1 during activity lesson in a natural school environment in a large urban population of schoolchildren. Our results call for another studies addressing the impact of environment on exercise-induced symptoms.

Influência dos polimorfismos no receptor beta 2 adrenérgico na presença de broncoespasmo induzido pelo exercício em adolescentes

“…The percentage of maximum FEV 1 decrease showed moderate correlation with a history of asthma, which differs from the results found by Cichalewski et al26 The methodological differences in the diagnosis of EIB can explain this discrepancy, as the present study used a bronchial provocation test on treadmill and in the study of Cichalewski et al,26 it was performed 45min after a physical education class. On the other hand, neither study identified an association between EIB and BMI.…”

“…O percentual de queda máxima VEF1 apresentou correlação moderada com histórico de asma, o que difere do resultado encontrado por Cichalewski et al 26. As diferenças metodológicas quanto ao diagnóstico do BIE podem explicar essa discrepância, visto que na presente pesquisa foi feito teste de broncoprovocação em esteira e, no estudo de Cichalewski et al .,26 foi feito 45 minutos após uma aula de educação física.…”

“…As diferenças metodológicas quanto ao diagnóstico do BIE podem explicar essa discrepância, visto que na presente pesquisa foi feito teste de broncoprovocação em esteira e, no estudo de Cichalewski et al .,26 foi feito 45 minutos após uma aula de educação física. Por outro lado, ambas as pesquisas não identificaram relação do BIE com IMC.…”

Down-Regulation of Cough during Exercise Is Less Frequent in Healthy Children than Adults. Role of the Development and/or Atopy?

“…The symptom assessment however is subjective and may be biased by parental perception (Dales et al, 1997; Ioan et al, 2014). Diagnostic of the respiratory condition may benefit identification of a particular trigger such as exercise that is indeed sought by cough questionnaire studies (Suguikawa et al, 2009; Cichalewski et al, 2015; Boulet et al, 2017). Such formulations as “cough with exercise” (Langdeau et al, 2000), “cough during/after exercise” (Stelmach et al, 2016) or exercise-induced cough” (Nair et al, 2017) however do not establish whether cough occurs during or after the physical activity.…”

The asthma‐chronic obstructive pulmonary disease overlap syndrome and its challenge for the allergist‐immunologist

“…14, 15 Cichalewski et al 16 add to the recognition of this burden, reporting the prevalence of exercise-induced symptoms and bronchospasm during physical education in the natural school environment in a study of 557 Polish school children.…”