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Monitoring pulmonary function during exercise in children with asthma
  1. Janneke C van Leeuwen1,
  2. Jean M M Driessen1,
  3. Frans H C de Jongh2,3,
  4. Wim M C van Aalderen3,
  5. Boony J Thio1
  1. 1Department of Pediatrics, Medisch Spectrum Twente, Enschede, The Netherlands
  2. 2Department of Pulmonology, Medisch Spectrum Twente, Enschede, The Netherlands
  3. 3Department of Pediatric Respiratory Medicine and Allergy, Emma Children's Hospital, AMC, Amsterdam, The Netherlands
  1. Correspondence to Janneke C van Leeuwen, Medisch Spectrum Twente, VKC Poli 17, Haaksbergerstraat 55, 7513 ER Enschede, The Netherlands; vanleeuwen.janneke{at}


Objective Exercise-induced bronchoconstriction (EIB) is defined as acute, reversible bronchoconstriction induced by physical exercise. It is widely believed that EIB occurs after exercise. However, in children with asthma the time to maximal bronchoconstriction after exercise is short, suggesting that the onset of EIB in such children occurs during exercise.

Aim In this study the authors investigate pulmonary function during exercise in cold air in children with asthma.

Methods 33 Children with asthma with a mean age of 12.3 years and a clinical history of exercise induced symptoms, underwent a prolonged, submaximal, exercise test of 12 min duration at approximately 80% of the predicted maximum heart rate. Pulmonary function was measured before and each minute during exercise. If EIB occurred (fall in forced expiratory volume in 1 s >15% from baseline), exercise was terminated and salbutamol was administered.

Results 19 Children showed EIB. In 12 of these children bronchoconstriction occurred during exercise (breakthrough EIB), while seven children showed bronchoconstriction immediately after exercise (non-breakthrough EIB). Breakthrough EIB occurred between 6 and 10 min of exercise (mean 7.75 min).

Conclusion In the majority of children with EIB in this study (ie, 12 out of 19), bronchoconstriction started during, and not after, a submaximal exercise test.

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  • Funding This study was supported by an unrestricted grant from the Stichting Pediatrisch Onderzoek Enschede.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Medisch Ethische Toetsingscommissie Medisch Spectrum Twente, Enschede.

  • Provenance and peer review Not commissioned; externally peer reviewed.