Role of Impulse Oscillometry in Assessing Asthma Control in Children
Related Experiment Video
Updated: Dec 28, 2025
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Lesa Dawman1, Aparna Mukherjee1, Tavpritesh Sethi2
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Insights
Impulse oscillometry and spirometry are comparable for assessing childhood asthma control. Impulse oscillometry is a valuable, effort-independent tool for monitoring asthma in children, particularly younger ones.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Asthma Management
Background:
- Impulse oscillometry (IOS) is an effort-independent method to assess airway resistance and reactance.
- It is suitable for children who cannot perform spirometry.
Purpose of the Study:
- To evaluate the utility of impulse oscillometry and spirometry in assessing asthma control in children.
- To compare the effectiveness of these methods in differentiating between controlled and uncontrolled asthma.
Main Methods:
- A prospective cohort study involving children aged 5-15 years with persistent asthma.
- Clinical assessments, impulse oscillometry, and spirometry were conducted every 3 months.
- Receiver operating characteristic (ROC) curves and generalized estimating equation models were used for analysis.
Main Results:
- In 2616 visits across 256 children, asthma symptoms were controlled in 48.9% of visits.
- FEV1 (0.58) and Area of Reactance (AX) (0.55) showed comparable ability to discriminate controlled vs. uncontrolled asthma.
- Both FEV1 and AX were significantly associated with controlled asthma over time.
Conclusions:
- Spirometry and impulse oscillometry parameters are comparable in assessing asthma control.
- Impulse oscillometry's effort-independent nature makes it suitable for monitoring childhood asthma control, especially in younger children.
Background:
Impulse oscillometry is an effort-independent technique of assessment of airway resistance and reactance, and can be performed in children unable to complete spirometry.
Objective:
To evaluate the utility of impulse oscillometry and spirometry for assessing asthma control in children.
Study Design:
Prospective cohort study.
Participants:
Children aged 5-15 years, with mild to severe persistent asthma.
Intervention:
On each 3-monthly follow-up visit, clinical assessment, classification of control of asthma, impulse oscillometry and spirometry were performed.
Outcome:
Utility of impulse oscillometry parameters [impedance (Z5), resistance (R5), reactance (X5) at 5 Hz, and R5-20 (resistance at 20Hz -5Hz) (% predicted), and area of reactance (AX, actual values)] and FEV1 (% predicted) to discriminate between controlled and uncontrolled asthma was assessed by receiver operating characteristic (ROC) curve. Association of FEV1 and impulse oscillometry parameters over time with controlled asthma was evaluated by generalized estimating equation model.
Results:
Number of visits in 256 children [mean (SD) age, 100 (41.6) mo; boys: 198 (77.3%)], where both impulse oscillometry and spirometry were performed was 2616; symptoms were controlled in 48.9% visits. Area under the curve for discrimination between controlled and uncontrolled asthma by FEV1, AX, R5-20, Z5, R5, and X5 were 0.58, 0.55, 0.55, 0.52, 0.52 and 0.52, respectively. FEV1 [OR (95% CI): 1.02 (1.01-1.03)] and AX [OR (95% CI): 0.88 (0.81-0.97)] measured over the duration of follow-up were significantly associated with controlled asthma.
Conclusions:
Spirometry and impulse oscillometry parameters are comparable in ascertaining controlled asthma. Impulse oscillometry being less effort-dependent may be performed for monitoring control of childhood asthma, especially in younger children.
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