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Vigorous exercise can cause abnormal pulmonary function in healthy adolescents

  • Author(s): Abosaida, A
  • Chen, JJ
  • Nussbaum, E
  • Leu, SY
  • Chin, T
  • Schwindt, CD
  • et al.
Abstract

Copyright © 2015 by the American Thoracic Society. Rationale: Although exercise-induced bronchoconstriction is more common in adolescents with asthma, it also manifests in healthy individuals without asthma. The steady-state exercise protocol is widely used and recommended by the American Thoracic Society (ATS) as a method to diagnose exercise-induced bronchoconstriction. Airway narrowing in response to exercise is thought to be related to airway wall dehydration secondary to hyperventilation. More rigorous exercise protocols may have a role in detecting exercise-induced bronchoconstriction in those who otherwise have a normal response to steady-state exercise challenge. Objectives: The objective of this study was to determine the effect of two different exercise protocols-a constant work rate protocol and a progressive ramp protocol-on pulmonary function testing in healthy adolescents.We hypothesized that vigorous exercise protocols would lead to reductions in lung function in healthy adolescents. Methods: A total of 56 healthy adolescents (mean age, 15.2±3.3 [SD] years) were recruited to perform two exercise protocols: constant work rate exercise test to evaluate for exercise-induced bronchoconstriction (as defined by ATS) and standardized progressive ramp protocol. Pulmonary function abnormalities were defined as a decline from baseline in FEV1of greater than 10%. Measurements and Main Results: Ten participants (17.8%) had a significant drop in FEV1. Among those with abnormal lung function after exercise, three (30%) were after the ATS test only, five (50%) were after the ramp test only, and two (20%) were after both ATS and ramp tests. Conclusion: Healthy adolescents demonstrate subtle bronchoconstriction after exercise. This exercise-induced bronchoconstriction may be detected in healthy adolescents via constant work rate or the progressive ramp protocol. In a clinical setting, ramp testing warrants consideration in adolescents suspected of having exercise-induced bronchoconstriction and who have normal responses to steady-state exercise testing.

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