Skip to main content
PMC home page
The British Journal of General Practice logoLink to The British Journal of General Practice
. 1994 Mar;44(380):127–131.

Screening for childhood asthma using an exercise test.

A Jones 1, M Bowen 1
PMCID: PMC1238815  PMID: 8204321

Abstract

BACKGROUND. Screening for asthma in children in the community could have advantages at a time when prevalence rates of the condition and associated hospital admission rates are rising. AIM. The aim of this study was to assess the usefulness of a standard exercise test as a marker of asthma or potential asthma in children, and to examine the relationship between asthma and other respiratory tract illnesses. METHOD. In 1985 a cross-sectional research study was undertaken in 10 primary schools in West Glamorgan; the children were followed up over six years until 1991. The exercise test involved measuring peak expiratory flow rate before and after the children ran as fast as they could for six minutes. A control group of children with a negative exercise test result were compared with those not known to have asthma who had a positive result (fall in peak expiratory flow rate of 15% or greater), using clinical data. Similar clinical comparisons were undertaken between the children known to have asthma and a control group. RESULTS. Of 864 children not known to have asthma, 60 had a positive exercise result. Of 92 children known to have asthma, 33 had a positive test result and seven were unable to finish the test because of bronchospasm, a sensitivity of 43% and a specificity of 93%. Follow up of 55 of the 60 children not known to have asthma but who had an abnormal response to the test showed that 32 had developed clinically recognizable asthma six years later. There was a significantly higher prevalence of atopic and respiratory illnesses (otitis media, hay fever and eczema) in the group of children with bronchial hyperreactivity demonstrated on exercise than in those without bronchial hyperreactivity. CONCLUSION. This research shows that bronchial hyperreactivity demonstrated by an exercise test can be a marker for childhood asthma. The study has also identified other respiratory tract illnesses which appear to belong to the same spectrum as asthma.

Full text

PDF
128

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson H. R., Bailey P. A., Cooper J. S., Palmer J. C., West S. Medical care of asthma and wheezing illness in children: a community survey. J Epidemiol Community Health. 1983 Sep;37(3):180–186. doi: 10.1136/jech.37.3.180. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Balfour-Lynn L., Tooley M., Godfrey S. Relationship of exercise-induced asthma to clinical asthma in childhood. Arch Dis Child. 1981 Jun;56(6):450–454. doi: 10.1136/adc.56.6.450. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Blackhall M. I. Ventilatory function in subjects with childhood asthma who have become symptom free. Arch Dis Child. 1970 Jun;45(241):363–366. doi: 10.1136/adc.45.241.363. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Burney P. G., Chinn S., Rona R. J. Has the prevalence of asthma increased in children? Evidence from the national study of health and growth 1973-86. BMJ. 1990 May 19;300(6735):1306–1310. doi: 10.1136/bmj.300.6735.1306. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Burr M. L., Butland B. K., King S., Vaughan-Williams E. Changes in asthma prevalence: two surveys 15 years apart. Arch Dis Child. 1989 Oct;64(10):1452–1456. doi: 10.1136/adc.64.10.1452. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Clifford R. D., Howell J. B., Radford M., Holgate S. T. Associations between respiratory symptoms, bronchial response to methacholine, and atopy in two age groups of schoolchildren. Arch Dis Child. 1989 Aug;64(8):1133–1139. doi: 10.1136/adc.64.8.1133. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Clough J. B., Holgate S. T. The natural history of bronchial hyperresponsiveness. Clin Rev Allergy. 1989 Fall;7(3):257–278. doi: 10.1007/BF02914478. [DOI] [PubMed] [Google Scholar]
  8. Cloutier M. M., Loughlin G. M. Chronic cough in children: a manifestation of airway hyperreactivity. Pediatrics. 1981 Jan;67(1):6–12. [PubMed] [Google Scholar]
  9. Colver A. F. Community campaign against asthma. Arch Dis Child. 1984 May;59(5):449–452. doi: 10.1136/adc.59.5.449. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Colver A. F. Underdiagnosis and undertreatment of asthma in childhood. Br Med J (Clin Res Ed) 1983 May 7;286(6376):1511–1512. doi: 10.1136/bmj.286.6376.1511-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Conway S. P., Littlewood J. M. Admission to hospital with asthma. Arch Dis Child. 1985 Jul;60(7):636–639. doi: 10.1136/adc.60.7.636. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Cookson W. O., Hopkin J. M. Dominant inheritance of atopic immunoglobulin-E responsiveness. Lancet. 1988 Jan 16;1(8577):86–88. doi: 10.1016/s0140-6736(88)90286-3. [DOI] [PubMed] [Google Scholar]
  13. Fleming D. M., Crombie D. L. Prevalence of asthma and hay fever in England and Wales. Br Med J (Clin Res Ed) 1987 Jan 31;294(6567):279–283. doi: 10.1136/bmj.294.6567.279. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Godfrey S., Kamburoff P. L., Nairn J. R. Spirometry, lung volumes and airway resistance in normal children aged 5 to 18 years. Br J Dis Chest. 1970 Jan;64(1):15–24. doi: 10.1016/s0007-0971(70)80045-6. [DOI] [PubMed] [Google Scholar]
  15. Gross N. J. What is this thing called love? --or, defining asthma. Am Rev Respir Dis. 1980 Feb;121(2):203–204. doi: 10.1164/arrd.1980.121.2.203. [DOI] [PubMed] [Google Scholar]
  16. JONES R. S., BUSTON M. H., WHARTON M. J. The effect of exercise on ventilatory function in the child with asthma. Br J Dis Chest. 1962 Apr;56:78–86. doi: 10.1016/s0007-0971(62)80005-9. [DOI] [PubMed] [Google Scholar]
  17. Jones A., Sykes A. The effect of symptom presentation on delay in asthma diagnosis in children in a general practice. Respir Med. 1990 Mar;84(2):139–142. doi: 10.1016/s0954-6111(08)80017-0. [DOI] [PubMed] [Google Scholar]
  18. Jones R. H., Jones R. S. Ventilatory capacity in young adults with a history of asthma in childhood. Br Med J. 1966 Oct 22;2(5520):976–978. doi: 10.1136/bmj.2.5520.976. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. König P., Godfrey S. Exercise-induced bronchial lability and atopic status of families of infants with wheezy bronchitis. Arch Dis Child. 1973 Dec;48(12):942–946. doi: 10.1136/adc.48.12.942. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Lee D. A., Winslow N. R., Speight A. N., Hey E. N. Prevalence and spectrum of asthma in childhood. Br Med J (Clin Res Ed) 1983 Apr 16;286(6373):1256–1258. doi: 10.1136/bmj.286.6373.1256. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. McFadden E. R., Jr Exertional dyspnea and cough as preludes to acute attacks of bronchial asthma. N Engl J Med. 1975 Mar 13;292(11):555–559. doi: 10.1056/NEJM197503132921103. [DOI] [PubMed] [Google Scholar]
  22. Pattemore P. K., Asher M. I., Harrison A. C., Mitchell E. A., Rea H. H., Stewart A. W. The interrelationship among bronchial hyperresponsiveness, the diagnosis of asthma, and asthma symptoms. Am Rev Respir Dis. 1990 Sep;142(3):549–554. doi: 10.1164/ajrccm/142.3.549. [DOI] [PubMed] [Google Scholar]
  23. Sibbald B., Collier J., D'Souza M. Questionnaire assessment of patients' attitudes and beliefs about asthma. Fam Pract. 1986 Mar;3(1):37–41. doi: 10.1093/fampra/3.1.37. [DOI] [PubMed] [Google Scholar]
  24. Silverman M., Anderson S. D. Standardization of exercise tests in asthmatic children. Arch Dis Child. 1972 Dec;47(256):882–889. doi: 10.1136/adc.47.256.882. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Speight A. N., Lee D. A., Hey E. N. Underdiagnosis and undertreatment of asthma in childhood. Br Med J (Clin Res Ed) 1983 Apr 16;286(6373):1253–1256. doi: 10.1136/bmj.286.6373.1253. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Spelman R. Chronic or recurrent cough in children--a presentation of asthma? J R Coll Gen Pract. 1984 Apr;34(261):221–222. [PMC free article] [PubMed] [Google Scholar]
  27. Strachan D. P. Wheezing presenting in general practice. Arch Dis Child. 1985 May;60(5):457–460. doi: 10.1136/adc.60.5.457. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Tsanakas J. N., Milner R. D., Bannister O. M., Boon A. W. Free running asthma screening test. Arch Dis Child. 1988 Mar;63(3):261–265. doi: 10.1136/adc.63.3.261. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Usherwood T. P. Factors affecting estimates of the prevalence of asthma and wheezing in childhood. Fam Pract. 1987 Dec;4(4):318–321. doi: 10.1093/fampra/4.4.318. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

RESOURCES