Reported Exercise-Related Respiratory Symptoms and Exercise-Induced Bronchoconstriction in Asthmatic Children

Abstract

BackgroundUnlimited physical activity is one of the key issues of asthma control and management. We investigated how reliable reported exercise-related respiratory symptoms (ERRS) are in predicting exercise-induced bronchoconstriction (EIB) in asthmatic children.MethodsIn this prospective study, 179 asthmatic children aged 7 - 15 years were asked for specific questions on respiratory symptoms related to exercise and allocated into two groups according to whether they complained about symptoms. Group I (n = 134) consisted of children answering “yes” to one or more of the questions and group II (n = 45) consisted of children answering “no” to all of the questions.ResultsSixty-four of 179 children showed a positive exercise challenge test (ECT). There was no difference in the frequency of a positive test between children in group I (n = 48) and group II (n = 12) (P = 0.47). The sensitivity of a positive report for ERRS to predict a positive ECT was only 37%, with a specificity of 0.72.ConclusionAccording to current guidelines, the report or lack of ERRS has direct consequences on treatment decisions. However, the history of ERRS did not predict EIB and one-third of asthmatic children without complaints of ERRS developed EIB during the ECT. This raises the question of the need for objective measures of bronchial hyperresponsiveness (BHR) in pediatric asthma management.

Overweight and exercise‐induced bronchoconstriction – Is there a link?

“…As expected, EIB had an independent association with all three symptoms. However, exercise‐induced cough, wheeze, and shortness of breath have been found to be poor predictors for a diagnostic fall in FEV1 9,10 . Our observations support the concept that the symptoms are not specific for EIB, but also affected by ISO‐BMI and outdoor temperature.…”

“…Overweight has also been associated with poor physical fitness, 1,8 which can be one of the reasons for exercise‐induced respiratory symptoms eliciting asthma investigations. Exercise‐induced cough, wheeze, and shortness of breath are often interpreted as signs of asthma, but the correlation between the symptoms and actual bronchial hyper‐responsiveness has proven to be poor 9,10 …”

Global prevalence of exercise‐induced bronchoconstriction in childhood: A meta‐analysis

“…Thirty‐three studies investigated the prevalence of EIB in general population of children and adolescents. Ten studies reported the prevalence of EIB in child and adolescent athletes, and 23 studies in children and adolescents with asthma.…”

“…Twenty‐three studies involving 2400 participants (1109 cases of EIB) reported the prevalence of EIB in children and adolescents with asthma. The diagnosis of asthma was made by physician in all but four studies, in which the diagnosis was based on symptom questionnaire.…”

Exercise-induced bronchoconstriction and therapeutic modulation in Iraqi girls intermediate school students

“…To determine the incidence rate of exercise induced asthma in Iraqi girls aged between 12-16 years. A fall in PEFR readings greater than or equal to 15% regarded as asthmatic [19][20][21][22][23][24] . The severity of EIB cannot be predicated from the resting level of lung function, for this reason the exercise was chose as the indirect challenge to produce Bronchospasm.…”