Related Experiment Video
Updated: Dec 16, 2025
Acquisition and Semi-Automated Analysis of Respiratory Muscle Surface Electromyography
Published on: January 24, 2025
Assessing paediatric exercise-induced bronchoconstriction using electromyography
Pascal B Keijzer1,2, Mattiènne R van der Kamp1,3, Boony J Thio1
1Medisch Spectrum Twente, Enschede, the Netherlands.
Insights
Surface electromyography (EMG) of the diaphragm can accurately identify exercise-induced bronchoconstriction (EIB) in children. This less invasive method offers a promising alternative to traditional exercise challenge tests for assessing asthma control.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Diagnostic Tools
Background:
- Childhood asthma affects up to 10% of children.
- Exercise-induced bronchoconstriction (EIB) indicates uncontrolled asthma.
- Current EIB assessment (exercise challenge test) requires difficult breathing maneuvers.
Purpose of the Study:
- To evaluate diaphragm surface electromyography (EMG) as an alternative EIB assessment.
- To investigate the relationship between diaphragm EMG and FEV1 changes post-exercise.
Main Methods:
- 42 children with suspected EIB underwent an exercise challenge test (ECT) with portable EMG.
- EIB defined as >13% fall in FEV1.
- Spirometry and EMG recorded before, during, and after exercise.
Main Results:
- 20/42 children diagnosed with EIB.
- Diaphragm EMG peak amplitude significantly higher in children with EIB (4.85 μV) vs. without (0.20 μV).
- EMG accurately distinguished EIB with 95% sensitivity and 91% specificity at a 1.15 μV cutoff.
Conclusions:
- Diaphragm EMG strongly correlates with FEV1 and accurately identifies EIB.
- EMG is a less invasive, effort-independent alternative to spirometry for EIB assessment.
- EMG may be valuable when spirometry is not feasible.
Background:
Asthma is one of the most common chronic diseases in childhood, occurring in up to 10% of all children. Exercise-induced bronchoconstriction (EIB) is indicative of uncontrolled asthma and can be assessed using an exercise challenge test (ECT). However, this test requires children to undergo demanding repetitive forced breathing manoeuvres. We aimed to study the electrical activity of the diaphragm using surface electromyography (EMG) as an alternative measure to assess EIB.
Methods:
Forty-two children suspected of EIB performed an ECT wearing a portable EMG amplifier. EIB was defined as a fall in FEV of more than 13%. Children performed spirometry before exercise, and at 1, 3 and 6 min after exercise until the nadir FEV1 was attained and after the use of a bronchodilator. EMG measurements were obtained between spirometry measurements.
Results:
Twenty out of 42 children were diagnosed with EIB. EMG peak amplitudes measured at the diaphragm increased significantly more in children with EIB; 4.85 μV (1.82-7.84), compared to children without EIB; 0.20 μV (-0.10-0.54), (p<0.001) at the lowest FEV post-exercise. Furthermore, the increase in EMG peak amplitude could accurately distinguish between EIB and non-EIB using a cut-off of 1.15 μV (sensitivity 95%, specificity 91%).
Conclusion:
EMG measurements of the diaphragm are strongly related to the FEV1 and can accurately identify EIB. EMG measurements are a less invasive, effort-independent measure to assess EIB and could be an alternative when spirometry is not feasible.
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