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Exercise test using dry air in random adolescents: temporal profile and predictors of bronchoconstriction
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 Medical Sciences, Respiratory Medicine and Allergology.
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 Women's and Children's Health.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
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2016 (English)In: Respirology (Carlton South. Print), ISSN 1323-7799, E-ISSN 1440-1843, Vol. 21, no 2, 289-296 p.Article in journal (Refereed) Published
Abstract [en]

Background and objective

Guidelines recommend exercise tests using dry air to diagnose exercise-induced bronchoconstriction (EIB). Lung function changes subsequent to these tests have not been investigated in a general adolescent population, and it remains unknown whether signs of airway inflammation, measured using exhaled nitric oxide (FeNO), can predict a positive response. The aim of this study was to investigate the temporal aspect of decline in forced expiratory volume in 1 s (FEV1) after an exercise test using dry air, and to investigate predictors of EIB.

Methods

From a cross-sectional study on adolescents aged 13–15 years (n = 3838), a random subsample of 146 adolescents (99 with and 47 without self-reported exercise-induced dyspnoea) underwent standardized treadmill exercise tests for EIB while breathing dry air.

Results

Of the adolescents, 34% had a positive EIB test (decline of ≥10% in FEV1 from baseline) within 30 min. Of the subjects with EIB, 53% showed the greatest decline in FEV1 at 5 to 10 min (mean decline 18.5%), and the remaining 47% of the subjects showed the greatest decline at 15 to 30 min (mean decline 18.9%) after exercise. Increased FeNO (>20 ppb), female gender and self-reported exercise-induced dyspnoea were independently associated with a positive EIB test.

Conclusion

When assessing general adolescents for EIB with exercise test using dry air, there is a temporal variation in the greatest FEV1 decline after exercise. Therefore, lung function should be measured for at least 30 min after the exercise. Increased FeNO, female gender and self-reported exercise-induced dyspnoea can be predictors of a positive EIB test.

Place, publisher, year, edition, pages
2016. Vol. 21, no 2, 289-296 p.
Keyword [en]
adolescents, dry air, exercise induced bronchoconstriction test, exhaled nitric oxide, general population
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:uu:diva-264375DOI: 10.1111/resp.12682ISI: 000373127300011Scopus ID: 26588807OAI: oai:DiVA.org:uu-264375DiVA: diva2:860080
Funder
Swedish Heart Lung Foundation
Available from: 2015-10-10 Created: 2015-10-10 Last updated: 2017-12-01
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.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1149
Keyword
Exercise, dyspnoea, bronchoconstriction, laryngeal obstruction, adolescents, HRQoL, physical activity
National Category
Physiotherapy Respiratory Medicine and Allergy Pediatrics
Research subject
Lung Medicine
Identifiers
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)
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Supervisors
Available from: 2015-11-11 Created: 2015-10-10 Last updated: 2015-11-13

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Johansson, HenrikNorlander, KatarinaAlving, KjellHedenström, HansJanson, ChristerMalinovschi, AndreiNordang, LeifEmtner, Margareta

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PhysiotherapyRespiratory Medicine and AllergologyOtolaryngology and Head and Neck SurgeryDepartment of Women's and Children's HealthClinical Physiology
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