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The capacity of children with and without asthma to detect external resistive loads on breathing
S Rietveld1, P J Prins, A M Kolk
1Department of Clinical Psychology, University of Amsterdam, The Netherlands.
Insights
Children with asthma struggle to accurately perceive airflow changes, a key factor in managing their condition. This study found asthmatic children were less accurate than healthy peers in detecting breathing resistance.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Subjective asthma symptoms in adults often do not correlate with objective measures of airway obstruction.
- Inaccurate symptom perception complicates asthma management and medication adherence.
Purpose of the Study:
- To investigate the accuracy of airflow detection in children with and without asthma.
- To determine if children with asthma have impaired perception of respiratory load stimuli.
Main Methods:
- 46 children with asthma and 46 healthy children (aged 7-18) participated.
- Participants breathed through a facemask and responded to varying intensity load stimuli.
- Two experiments assessed detection thresholds (just noticeable difference) for airflow changes.
Main Results:
- Children, in general, demonstrated poor perception of load stimuli.
- Children with asthma showed significantly less accuracy in detecting airflow changes compared to healthy controls.
- Asthmatic children's detection thresholds correlated with a substantial fall in forced expiratory volume in 1 second (FEV1).
Conclusions:
- Children with asthma exhibit impaired perception of respiratory load.
- This reduced sensory accuracy may contribute to difficulties in self-monitoring and managing asthma effectively.
- Findings highlight the need for objective monitoring in pediatric asthma management.
Abstract:
Clinical observations and research with adults consistently showed that subjective symptoms of asthma poorly reflect actual airway obstruction. The lack of accurate symptom perception poses a problem for medication and management of asthma. The accuracy of airflow detection was studied in 46 children with and 46 without asthma (aged 7-18 years). They breathed through a facemask and responded to load stimuli of different intensity. Sessions consisted of 10 blocks of 5 min, each with 10 stimuli presented. Experiment 1: Loads of increasing intensity presented to 36 children with and 36 without asthma. Seven asthmatics had a reliable detection threshold (just noticeable difference, jnd) analogous to approximately equal to 64% fall in forced expiratory volume in 1 sec (FEV1). Ten normal controls had a jnd of approximately 39% fall. Experiment 2: Loads randomly presented to 10 children with and 10 without asthma. Four asthmatics had a jnd of approximately equal to 64% fall in FEV1. Six normal controls had a jnd of approximately equal to 39% fall. The results demonstrated that children generally were poorly perceiving load stimuli and that asthmatics were less accurate.