A simple "step-test" protocol for identifying suspected unrecognized exercise-induced asthma (EIA) in children.
R A Feinstein1, C S Hains, M P Hemstreet
1Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, USA.
Allergy and Asthma Proceedings
|July 2, 1999
Summary
A simple school-based step-test effectively identifies elementary students with undiagnosed asthma. This exercise challenge, using spirometry, confirmed asthma in 88.89% of diagnosed students, enabling early intervention.
Area of Science:
- Pediatric Pulmonology
- Exercise Physiology
- Epidemiology
Background:
- Undiagnosed asthma in elementary school children presents a challenge for identification.
- Early diagnosis and intervention are crucial for managing childhood asthma.
- Standard diagnostic methods may not always capture exercise-induced asthma in young children.
Purpose of the Study:
- To validate a simple submaximal step-test as an exercise challenge for identifying undiagnosed asthma in elementary students.
- To establish a reproducible exercise testing protocol for epidemiological evaluations in schools.
- To assess the efficacy of a school-based exercise test in detecting potential asthma cases.
Main Methods:
- A 12-item parental questionnaire identified students (grades 1-4) with suspected asthma.
- Eligible students underwent baseline spirometry and a 5-minute step-test with continuous heart rate monitoring (150-200 bpm).
- Pulmonary function (FEV1, FEF25-75) was measured pre- and post-exercise; a significant decline indicated possible asthma.
Main Results:
- Out of 548 students with suspected asthma, 30 (6%) showed exercise-induced pulmonary function changes.
- Of 30 students with positive tests, 26 were evaluated by specialists.
- Asthma was diagnosed in 23 (88.89%) of the evaluated students, with no reported complications.
Conclusions:
- A simple, school-based step-test protocol is a feasible and effective method for identifying elementary students with suspected undiagnosed asthma.
- This exercise challenge can aid in early detection and facilitate timely medical evaluation.
- The protocol is safe and reproducible for use in school settings for epidemiological purposes.
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