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Exercise-induced dyspnea is a problem among the general adolescent population
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotherapy.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Otolaryngology and Head and Neck Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
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2014 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 108, no 6, 852-858 p.Article in journal (Refereed) Published
Abstract [en]

Rationale: Respiratory symptoms during exercise are common and might limit adolescents' ability to take part in physical activity. Objective: To estimate the prevalence, determinants and consequences of exercise-induced dyspnea (EID) on daily life in a general population of 12-13 year old adolescents. Methods: A letter was sent to the parents of all 12-13 year old adolescents in the city of Uppsala (n = 3838). Parents were asked to complete a questionnaire together with their child on EID, asthma and allergy, consequences for daily life (wheeze, day time- and nocturnal dyspnea) and physical activity. The response rate was 60% (n = 2309). Results: Fourteen percent (n = 330) reported EID, i.e. had experienced an attack of shortness of breath that occurred after strenuous activity within the last 12 months. Female gender, ever-asthma and rhinitis were independently associated with an increased risk of EID. Ever-asthma was reported by 14.6% (n = 338), and 5.4% (n = 128) had both EID and ever-asthma. Sixty-one percent (n = 202) of the participants with EID did not have a diagnosis of asthma. In addition to rhinitis, participants with EID reported current wheeze and day-time as well as nocturnal dyspnea more often. than the group without EID. No difference was found in the level of physical activity between participants with and without EID. Conclusion: Adolescents with undiagnosed exercise-induced dyspnea have respiratory symptoms and are affected in daily life but have the same level of physical activity as adolescents without exercise-induced respiratory symptoms. 

Place, publisher, year, edition, pages
2014. Vol. 108, no 6, 852-858 p.
Keyword [en]
Exercise-induced dyspnea, Asthma, Exercise, Adolescents, Questionnaire
National Category
Respiratory Medicine and Allergy Physiotherapy
URN: urn:nbn:se:uu:diva-229524DOI: 10.1016/j.rmed.2014.03.010ISI: 000338409500004OAI: oai:DiVA.org:uu-229524DiVA: diva2:737191
Available from: 2014-08-12 Created: 2014-08-11 Last updated: 2015-11-13Bibliographically approved
In thesis
1. Exercise induced breathing problems in adolescents
Open this publication in new window or tab >>Exercise induced breathing problems in adolescents
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Experiencing respiratory symptoms in conjunction with exercise is common in children and adolescents and can have a negative impact on daily life. The aim of the thesis was to estimate the prevalence of exercise-induced dyspnoea, exercise-induced bronchoconstriction (EIB) and exercise-induced laryngeal obstruction (E-ILO) in a general adolescent population, and to explore factors associated with EIB.

Methods: All 12-13-year-old adolescents in the city of Uppsala (n=3,838) participated in a survey on exercise-induced dyspnoea. A subsample of adolescents who answered the survey, 103 randomly selected adolescents reporting exercise-induced dyspnoea and 47 random adolescents who did not report exercise-induced dyspnoea underwent standardised treadmill exercise tests for EIB and E-ILO. The exercise test for EIB was performed while breathing dry air; a positive test was defined as a decrease ≥10% in FEV1 from baseline. E-ILO was investigated using continuous laryngoscopy during exercise. Health related quality of life (HRQoL), and objectively measured daily physical activity were investigated in those with (n=49) and without (n=91) a positive EIB-test.

Results: The prevalence of exercise-induced dyspnoea was 14%, and the estimated prevalence of EIB and E-ILO in the total population was 19.2% and of 5.7%, respectively, with no gender differences. In adolescents with exercise-induced dyspnoea 40% had EIB, 6% had E-ILO, and 5% had both conditions.

An increased baseline level of fraction of nitric oxide in exhaled air (FeNO), female gender, and exercise-induced dyspnoea were associated with a positive EIB test. Female adolescents with EIB had lower HRQoL and lower baseline lung function compared to females without EIB. These differences were not observed in male adolescents. There was no difference in time spent in moderate- to vigorous daily physical activity between adolescents with and without EIB.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 61 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1149
Exercise, dyspnoea, bronchoconstriction, laryngeal obstruction, adolescents, HRQoL, physical activity
National Category
Physiotherapy Respiratory Medicine and Allergy Pediatrics
Research subject
Lung Medicine
urn:nbn:se:uu:diva-264370 (URN)978-91-554-9379-0 (ISBN)
Public defence
2015-12-04, Gunnesalen, Psykiatrins hus, Akademiska sjukhuset, 751 85, Uppsala, 09:00 (Swedish)
Available from: 2015-11-11 Created: 2015-10-10 Last updated: 2015-11-13

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Johansson, HenrikNorlander, KatarinaHedenström, HansJanson, ChristerNordang, LeifNordvall, LennartEmtner, Margareta
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