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Exercise testing revisited. The response to exercise in normal and atopic children
A Custovic1, N Arifhodzic, A Robinson
1Department of Allergy and Clinical Immunology, University Children's Hospital, Sarajevo, Bosnia-Hercegovina.
Chest
|April 1, 1994
Summary
Exercise-induced bronchospasm (EIB) in atopic children is best diagnosed using multiple spirometry parameters, specifically FEV1 and FEF25-75. This approach identified EIB solely in asthmatic children, not those with allergic rhinitis or dermatitis.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Exercise Physiology
Background:
- Varied criteria for normal airway response to exercise complicate the diagnosis of exercise-induced bronchospasm (EIB) in atopic children.
- This variability leads to wide-ranging estimates of EIB incidence in this population.
Purpose of the Study:
- To establish normative reference ranges for spirometry changes following exercise in children.
- To utilize these established normal values to accurately assess the incidence of EIB in atopic children.
Main Methods:
- Pulmonary function tests were conducted before and at 2, 5, and 10 minutes post-exercise in 48 normal children and 96 atopic children (including asthmatics, allergic rhinitis, and atopic dermatitis/food hypersensitivity).
- Exercise involved 6 minutes of free running.
Main Results:
- EIB was defined using criteria including >10% fall in FEV1, >17.5% fall in PEFR, >26% fall in FEF25-75, and >40% fall in FEF25.
- Sixty-three of 70 asthmatic patients exhibited EIB, most pronounced at 5 minutes post-exercise.
- Combining FEV1 and FEF25-75 criteria detected all EIB cases and excluded subjects with allergic rhinitis or dermatitis.
Conclusions:
- Diagnosis of EIB should incorporate multiple maximum expiratory flow-volume curve parameters, specifically FEV1 and FEF25-75.
- Using these combined criteria, EIB was exclusively observed in asthmatic children, with no instances found in other atopic groups.