J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 9, Number 5, May 2017, pages 410-415

Reported Exercise-Related Respiratory Symptoms and Exercise-Induced Bronchoconstriction in Asthmatic Children

Figure 1. Box plots show the maximum fall in FEV₁ after exercise challenge test between symptomatic and asymptomatic children. The median is the line bisecting the box, the box limits represent 25th and 75th percentiles, and whiskers extend to the 10th and 90th percentile. The black dots represent outliers. FEV₁: forced expiratory volume in 1 s.

**Table 1.** Questions That Were Asked to the Children for Exercise-Related Symptoms
Q1	Do you have cough during or after exercise?
Q2	Do you have wheezing during or after exercise?
Q3	Do you have dyspnea during or after exercise?
Q4	Do you have chest tightness during or after exercise?
Q5	Do you have chest pain during or after exercise?

Table 1. Questions That Were Asked to the Children for Exercise-Related Symptoms

Do you have cough during or after exercise?

Do you have wheezing during or after exercise?

Do you have dyspnea during or after exercise?

Do you have chest tightness during or after exercise?

Do you have chest pain during or after exercise?

**Table 2.** Clinical Characteristics of the Two Groups
	Group I (n = 134)	Group II (n = 45)	P value
*Mean ± standard deviation. ^#Chi-square. ICS: inhaled corticosteroids; BMI: body mass index; FEV₁: forced expiratory volume in 1 s; LTRA: leukotriene receptor antagonist.
Age (years)	10.6 ± 2.46*	10.3 ± 2.03	0.5
Gender (female/male)	57/77	16/29	0.4^#
Baseline FEV_{1 (%pred)}	96.5 ± 12.7	95.8 ± 11.05	0.7
Regular ICS	41 (30.1%)	7 (15.5%)	0.08^#
LTRA treatment	14 (10.4%)	3 (6.6%)	0.16^#
Allergic sensitization	114 (85.1%)	28 (62.2%)	0.7^#
BMI (kg/m²)	18.8 ± 3.5*	17.9 ± 3.1*	0.31

Table 2. Clinical Characteristics of the Two Groups

Group I (n = 134)

Group II (n = 45)

P value

*Mean ± standard deviation. ^#Chi-square. ICS: inhaled corticosteroids; BMI: body mass index; FEV₁: forced expiratory volume in 1 s; LTRA: leukotriene receptor antagonist.

Age (years)

10.6 ± 2.46*

10.3 ± 2.03

0.5

Gender (female/male)

57/77

16/29

0.4^#

Baseline FEV_{1 (%pred)}

96.5 ± 12.7

95.8 ± 11.05

0.7

Regular ICS

41 (30.1%)

7 (15.5%)

0.08^#

LTRA treatment

14 (10.4%)

3 (6.6%)

0.16^#

Allergic sensitization

114 (85.1%)

28 (62.2%)

0.7^#

BMI (kg/m²)

18.8 ± 3.5*

17.9 ± 3.1*

0.31

**Table 3.** Changes in FEV₁ Values After Exercise Challenge, Frequency of Symptoms and Positive ECT in Two Groups
	Group I (n = 131)	Group II (n = 43)	P value
*Mean ± standard deviation. ^#Chi-square. ICS: inhaled corticosteroids; ECT: exercise challenge test. ^§Fall in post-exercise FEV₁ of ≥ 15% from baseline. ^$Breathlessness, cough, wheezing, chest pain or tiredness.
Maximum % fall of FEV₁	-11.09 ± 10.5*	-8.11 ± 7.7	0.123
Positive^§	-22.1 ± 8.5	-16.9 ± 5.64	0.055
Negative	-4.72 ± 4.73	-4.3 ± 4.6	0.54
ECT
Positive^§	48 (36.6%)	12 (27.9%)	0.34^#
Negative	83 (63.4%)	31 (72.1%)
Time to maximum fall FEV₁
1 - 5 min	29 (58%)	5 (31.1%)
10 - 15 min	10 (20%)	7 (35.7%)	0.24^#
30 - 60 min	11 (22%)	2 (14.3%)
Symptoms during ECT^$	15 (11.4%)	5 (11.6%)	0.8^#

Table 3. Changes in FEV₁ Values After Exercise Challenge, Frequency of Symptoms and Positive ECT in Two Groups

Group I (n = 131)

Group II (n = 43)

P value

*Mean ± standard deviation. ^#Chi-square. ICS: inhaled corticosteroids; ECT: exercise challenge test. ^§Fall in post-exercise FEV₁ of ≥ 15% from baseline. ^$Breathlessness, cough, wheezing, chest pain or tiredness.

Maximum % fall of FEV₁

-11.09 ± 10.5*

-8.11 ± 7.7

0.123

Positive^§

-22.1 ± 8.5

-16.9 ± 5.64

0.055

Negative

-4.72 ± 4.73

-4.3 ± 4.6

0.54

ECT

Positive^§

48 (36.6%)

12 (27.9%)

0.34^#

Negative

83 (63.4%)

31 (72.1%)

Time to maximum fall FEV₁

1 - 5 min

29 (58%)

5 (31.1%)

10 - 15 min

10 (20%)

7 (35.7%)

0.24^#

30 - 60 min

11 (22%)

2 (14.3%)

Symptoms during ECT^$

15 (11.4%)

5 (11.6%)

0.8^#

**Table 4.** Asthma Questionnaires for Exercise Limitation or Exercise-Related Symptoms [20, 23, 24, 26, 27]
Questionnaire	Number of items	Question specific to exercise
Asthma control questionnaire (ACQ) [23]	6	In general, during the past week, how limited were you in your activities because of your asthma
Asthma control scoring system (ACSS) [24]	3 + 3 + 1	Limitation of physical activity: none, very few, few, moderate, severe
Asthma control test for children (C-ACT) [26]	4 + 3	How much of a problem is your asthma when you run, exercise or play sports?
Asthma therapy assessment questionnaire (ATAQ) [27]	3	In the past 4 weeks, did your child have wheezing or difficulty breathing when exercising?
GINA [20]	5	Limitations of activities: none, any

Table 4. Asthma Questionnaires for Exercise Limitation or Exercise-Related Symptoms [20, 23, 24, 26, 27]

Questionnaire

Number of items

Question specific to exercise

Asthma control questionnaire (ACQ) [23]

In general, during the past week, how limited were you in your activities because of your asthma

Asthma control scoring system (ACSS) [24]

3 + 3 + 1

Limitation of physical activity: none, very few, few, moderate, severe

Asthma control test for children (C-ACT) [26]

4 + 3

How much of a problem is your asthma when you run, exercise or play sports?

Asthma therapy assessment questionnaire (ATAQ) [27]

In the past 4 weeks, did your child have wheezing or difficulty breathing when exercising?

GINA [20]

Limitations of activities: none, any