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Ventilatory Demand During Stepping and Running: Implications for Exercise-Induced Bronchoconstriction in Children
Jessyca P Selman1, Fernanda C Lanza1, Gustavo F Wandalsen2
1Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, São Paulo, Brazil.
Respiratory Care
|February 7, 2019
Summary
Single-step tests may not fully diagnose exercise-induced bronchoconstriction (EIB) in children with asthma. While convenient, a negative stepping test result should be confirmed with a treadmill running test for accurate diagnosis.
Area of Science:
- Pediatric Pulmonology
- Exercise Physiology
- Diagnostic Testing
Background:
- Single-step tests are proposed for diagnosing exercise-induced bronchoconstriction (EIB) in children due to their simplicity and low cost.
- However, the lower work and ventilation demands of stepping compared to running may reduce diagnostic accuracy.
Purpose of the Study:
- To compare the diagnostic yield of incremental stepping, constant stepping, and treadmill running tests for EIB in children with asthma.
- To investigate the relationship between test modality, ventilatory demands, and EIB diagnosis.
Main Methods:
- A cross-sectional study involving 53 children (age 6-18) with asthma and exercise-related symptoms.
- Participants completed incremental stepping, constant stepping, and treadmill running tests on separate occasions.
Main Results:
- Stepping tests exhibited lower metabolic, ventilatory, and cardiovascular demands than the treadmill test (P < .05).
- Agreement in EIB diagnosis between tests was poor (kappa 0.217-0.361).
- Treadmill running showed higher EIB prevalence (60%) than constant (53%) and incremental (47%) stepping, though 7 subjects had EIB only with stepping.
Conclusions:
- Lower EIB prevalence in stepping tests is not solely due to reduced ventilation demand.
- Stepping tests can serve as a portable, low-cost screening tool for EIB.
- A negative result from a stepping test in symptomatic children warrants confirmation with a running-based test.
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