Exercise-induced dyspnea is a problem among the general adolescent population

Respiratory medicine (Impact Factor: 3.09). 06/2014; 108(6). DOI: 10.1016/j.rmed.2014.03.010


Respiratory symptoms during exercise are common and might limit adolescents' ability to take part in physical activity.

To estimate the prevalence, determinants and consequences of exercise- induced dyspnea (EID) on daily life in a general population of 12-13 year old adolescents.

A letter was sent to the parents of all 12–13 year old adolescents in the city of Uppsala (n=3838). Parents were asked to complete a questionnaire together with their child on EID, asthma and allergy, consequences for daily life (wheeze, day time- and nocturnal dyspnea) and physical activity.The response rate was 60% (n=2309).

Fourteen percent (n=330) reported EID, i.e. had experienced an attack of shortness of breath that occurred after strenuous activity within the last 12 months. Female gender, ever-asthma and rhinitis were independently associated with an increased risk of EID. Ever-asthma was reported by 14.6% (n=338), and 5.4% (n=128) had both EID and ever-asthma. Sixty-one percent (n=202) of the participants with EID did not have a diagnosis of asthma. In addition to rhinitis, participants with EID reported current wheeze and day-time as well as nocturnal dyspnea more often than the group without EID. No difference was found in the level of physical activity between participants with and without EID.

Adolescents with undiagnosed exercise-induced dyspnea have respiratory symptoms and are affected in daily life but have the same level of physical activity as adolescents without exercise-induced respiratory symptoms.

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Available from: Christer Janson, Jul 30, 2015
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    ABSTRACT: The diagnosis of exercise-induced asthma or bronchospasm (EIB) is a complex dare in daily clinical practice. The consensus is that if bronchial hyperresponsiveness (BHR) is demonstrated in a patient with symptoms consistent with EIB, then that patient can be diagnosed with exercise-induced bronchospasm. The aim of this study is to determine which BHR test is the most efficient to diagnose EIB. Children under 16, without previous asthma diagnosis, or with stable asthma, complaining of asthma-like symptoms triggered by exercise were included. Bronchodilator, methacoline, mannitol and exercise tests were performed on all patients, following established protocols. The performance of single and combined tests was determined. 46 patients (median age: 12 years, ranged 8-16 y.o.) were recruited, 30 (70%) previously diagnosed of asthma. BHR was detected in 93.47% of the children. The exercise challenge test detected BHR in 11/46 (23.90%) patients, bronchodilator test in 10/46 (21.70%), mannitol in 36/45 (80%) and methacoline in 41/45 (91.11%). The total number of patients with BHR was detected using a combination of the methacoline and mannitol tests. A combination of the methacoline test performed first, followed by the mannitol test, was able to diagnose BHR in 100% of children with lower number of tests (N=45) than if the order was reversed (N=50). Methacholine and mannitol tests detect BHR in most children with suspected EIB. Bronchodilator and exercise tests show a low positivity rate. A combination of the methacoline test, followed by the mannitol test, gives the highest return to identify BHR in children for the diagnosis of EIB. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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