Airway response to exercise by forced oscillations in asthmatic children

Abstract

Forced expiratory volume in 1 s (FEV1) detection of exercise-induced bronchoconstriction (EIB) to identify asthma has good specificity but rather low sensitivity. The aim was to test whether sensitivity may be improved by measuring respiratory resistance (Rrs) by the forced oscillation technique (FOT). Forty-seven asthmatic and 50 control children (5-12 y) were studied before and after running 6 min on a treadmill. Rrs in inspiration (Rrsi) and expiration (Rrse), FEV1 and Rrsi response to a deep inhalation (DI) were measured before and after exercise. In asthmatics versus controls, exercise induced significantly larger increases in Rrsi (p < 0.001) and larger decreases in FEV1 (p = 0.004). Asthmatics but not controls showed more bronchodilation by DI after exercise (p = 0.02). At specificity >0.90, sensitivity was 0.53 with 25% increase Rrsi and 0.45 with 27% increase Rrse or 5% decrease FEV1. It is concluded that the FOT improves sensitivity of exercise challenge, and the Rrsi response to DI may prove useful in identifying the mechanism of airway obstruction.