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. 1996 Feb;74(2):108–114. doi: 10.1136/adc.74.2.108

Longitudinal study of free running exercise challenge: reproducibility.

C V Powell 1, R D White 1, R A Primhak 1
PMCID: PMC1511521  PMID: 8660071

Abstract

The reproducibility of free running exercise challenge has been examined in an unselected population of 8-10 year olds. Using a standardised protocol, monthly exercise tests were performed on 143 children over one year. A positive test was defined using both a 15% and 20% fall in peak expiratory flow after exercise. The mean (95% confidence interval, CI) population frequency for a positive test at 15% fall was 14.9% (6.5 to 23.3) and coefficient of variation 24.6%. For a 20% fall, the mean (95% CI) population frequency was 7.9% (2.9 to 12.9) and coefficient of variation 27.8%. Seventy two (50.3%) of the children gave at least one positive response at 15% fall. Exercise testing is not reproducible in the community setting and should not be used as a screening test. Exercise data from epidemiological studies of asthma should be interpreted with caution.

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Selected References

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

  1. Asher M. I., Keil U., Anderson H. R., Beasley R., Crane J., Martinez F., Mitchell E. A., Pearce N., Sibbald B., Stewart A. W. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J. 1995 Mar;8(3):483–491. doi: 10.1183/09031936.95.08030483. [DOI] [PubMed] [Google Scholar]
  2. Austin J. B., Russell G., Adam M. G., Mackintosh D., Kelsey S., Peck D. F. Prevalence of asthma and wheeze in the Highlands of Scotland. Arch Dis Child. 1994 Sep;71(3):211–216. doi: 10.1136/adc.71.3.211. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Barry D. M., Burr M. L., Limb E. S. Prevalence of asthma among 12 year old children in New Zealand and South Wales: a comparative survey. Thorax. 1991 Jun;46(6):405–409. doi: 10.1136/thx.46.6.405. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. 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]
  5. Burr M. L., Eldridge B. A., Borysiewicz L. K. Peak expiratory flow rates before and after exercise in schoolchildren. Arch Dis Child. 1974 Dec;49(12):923–926. doi: 10.1136/adc.49.12.923. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Chan N., Silverman M. Repeatability of ventilatory function measurements in a population survey of seven year old children. Thorax. 1989 Dec;44(12):1059–1059. doi: 10.1136/thx.44.12.1059. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Clifford R. D., Radford M., Howell J. B., Holgate S. T. Prevalence of respiratory symptoms among 7 and 11 year old schoolchildren and association with asthma. Arch Dis Child. 1989 Aug;64(8):1118–1125. doi: 10.1136/adc.64.8.1118. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Clough J. B., Williams J. D., Holgate S. T. Profile of bronchial responsiveness in children with respiratory symptoms. Arch Dis Child. 1992 May;67(5):574–579. doi: 10.1136/adc.67.5.574. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Cochrane A. L., Holland W. W. Validation of screening procedures. Br Med Bull. 1971 Jan;27(1):3–8. doi: 10.1093/oxfordjournals.bmb.a070810. [DOI] [PubMed] [Google Scholar]
  10. Cogswell J. J., Hull D., Milner A. D., Norman A. P., Taylor B. Lung function in childhood. I. The forced expiratory volumes in healthy children using a spirometer and reverse plethysmograph. Br J Dis Chest. 1975 Jan;69(1):40–50. doi: 10.1016/0007-0971(75)90054-6. [DOI] [PubMed] [Google Scholar]
  11. Cotes J. E., Dabbs J. M., Hall A. M., Heywood C., Laurence K. M. Sitting height, fat-free mass and body fat as reference variables for lung function in healthy British children: comparison with stature. Ann Hum Biol. 1979 Jul-Aug;6(4):307–314. doi: 10.1080/03014467900003691. [DOI] [PubMed] [Google Scholar]
  12. Cropp G. J. Relative sensitivity of different pulmonary function tests in the evaluation of exercise-induced asthma. Pediatrics. 1975 Nov;56(5 PT-2):860–867. [PubMed] [Google Scholar]
  13. Dahlqvist M., Eisen E. A., Wegman D. H., Kriebel D. Reproducibility of peak expiratory flow measurements. Occup Med. 1993 Apr-Jun;8(2):295–302. [PubMed] [Google Scholar]
  14. Foresi A., Mattoli S., Corbo G. M., Polidori G., Ciappi G. Comparison of bronchial responses to ultrasonically nebulized distilled water, exercise, and methacholine in asthma. Chest. 1986 Dec;90(6):822–826. doi: 10.1378/chest.90.6.822. [DOI] [PubMed] [Google Scholar]
  15. Frischer T., Meinert R., Urbanek R., Kuehr J. Variability of peak expiratory flow rate in children: short and long term reproducibility. Thorax. 1995 Jan;50(1):35–39. doi: 10.1136/thx.50.1.35. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Godfrey S. Exercise-induced asthma--clinical, physiological, and therapeutic implications. J Allergy Clin Immunol. 1975 Jul;56(1):1–17. doi: 10.1016/0091-6749(75)90029-9. [DOI] [PubMed] [Google Scholar]
  17. Godfrey S., Silverman M., Anderson S. D. Problems of interpreting exercise-induced asthma. J Allergy Clin Immunol. 1973 Oct;52(4):199–209. doi: 10.1016/0091-6749(73)90058-4. [DOI] [PubMed] [Google Scholar]
  18. Godfrey S., Springer C., Noviski N., Maayan C., Avital A. Exercise but not methacholine differentiates asthma from chronic lung disease in children. Thorax. 1991 Jul;46(7):488–492. doi: 10.1136/thx.46.7.488. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Green C. P., Price J. F. Prevention of exercise induced asthma by inhaled salmeterol xinafoate. Arch Dis Child. 1992 Aug;67(8):1014–1017. doi: 10.1136/adc.67.8.1014. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Haby M. M., Anderson S. D., Peat J. K., Mellis C. M., Toelle B. G., Woolcock A. J. An exercise challenge protocol for epidemiological studies of asthma in children: comparison with histamine challenge. Eur Respir J. 1994 Jan;7(1):43–49. doi: 10.1183/09031936.94.07010043. [DOI] [PubMed] [Google Scholar]
  21. Hill R., Williams J., Britton J., Tattersfield A. Can morbidity associated with untreated asthma in primary school children be reduced?: a controlled intervention study. BMJ. 1991 Nov 9;303(6811):1169–1174. doi: 10.1136/bmj.303.6811.1169. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Hsu K. H., Jenkins D. E., Hsi B. P., Bourhofer E., Thompson V., Hsu F. C., Jacob S. C. Ventilatory functions of normal children and young adults--Mexican-American, white, and black. II. Wright peak flowmeter. J Pediatr. 1979 Aug;95(2):192–196. doi: 10.1016/s0022-3476(79)80649-6. [DOI] [PubMed] [Google Scholar]
  23. Jenkins C. R., Breslin A. B. Upper respiratory tract infections and airway reactivity in normal and asthmatic subjects. Am Rev Respir Dis. 1984 Nov;130(5):879–883. doi: 10.1164/arrd.1984.130.5.879. [DOI] [PubMed] [Google Scholar]
  24. Josephs L. K., Gregg I., Mullee M. A., Holgate S. T. Nonspecific bronchial reactivity and its relationship to the clinical expression of asthma. A longitudinal study. Am Rev Respir Dis. 1989 Aug;140(2):350–357. doi: 10.1164/ajrccm/140.2.350. [DOI] [PubMed] [Google Scholar]
  25. Kattan M., Keens T. G., Mellis C. M., Levison H. The response to exercise in normal and asthmatic children. J Pediatr. 1978 May;92(5):718–721. doi: 10.1016/s0022-3476(78)80135-8. [DOI] [PubMed] [Google Scholar]
  26. Ninan T. K., Russell G. Is exercise testing useful in a community based asthma survey? Thorax. 1993 Dec;48(12):1218–1221. doi: 10.1136/thx.48.12.1218. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Ninan T. K., Russell G. Respiratory symptoms and atopy in Aberdeen schoolchildren: evidence from two surveys 25 years apart. BMJ. 1992 Apr 4;304(6831):873–875. doi: 10.1136/bmj.304.6831.873. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Peat J. K., Salome C. M., Toelle B. G., Bauman A., Woolcock A. J. Reliability of a respiratory history questionnaire and effect of mode of administration on classification of asthma in children. Chest. 1992 Jul;102(1):153–157. doi: 10.1378/chest.102.1.153. [DOI] [PubMed] [Google Scholar]
  29. Peat J. K., Salome C. M., Toelle B. G., Bauman A., Woolcock A. J. Reliability of a respiratory history questionnaire and effect of mode of administration on classification of asthma in children. Chest. 1992 Jul;102(1):153–157. doi: 10.1378/chest.102.1.153. [DOI] [PubMed] [Google Scholar]
  30. Powell C. V., Primhak R. A. Asthma treatment, perceived respiratory disability, and morbidity. Arch Dis Child. 1995 Mar;72(3):209–213. doi: 10.1136/adc.72.3.209. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Schnall R. P., Landau L. I. Protective effects of repeated short sprints in exercise-induced asthma. Thorax. 1980 Nov;35(11):828–832. doi: 10.1136/thx.35.11.828. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Silverman M., Anderson S. D. Metabolic cost of treadmill exercise in children. J Appl Physiol. 1972 Nov;33(5):696–698. doi: 10.1152/jappl.1972.33.5.696. [DOI] [PubMed] [Google Scholar]
  33. 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]
  34. Sterk P. J., Fabbri L. M., Quanjer P. H., Cockcroft D. W., O'Byrne P. M., Anderson S. D., Juniper E. F., Malo J. L. Airway responsiveness. Standardized challenge testing with pharmacological, physical and sensitizing stimuli in adults. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993 Mar;16:53–83. [PubMed] [Google Scholar]
  35. Strachan D. P. Repeatability of ventilatory function measurements in a population survey of 7 year old children. Thorax. 1989 Jun;44(6):474–479. doi: 10.1136/thx.44.6.474. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Terblanche E., Stewart R. I. The prevalence of exercise-induced bronchoconstriction in Cape Town schoolchildren. S Afr Med J. 1990 Dec 15;78(12):744–747. [PubMed] [Google Scholar]
  37. Tsanakas J. N., Bannister O. M., Boon A. W., Milner R. D. The 'Sport-tester': a device for monitoring the free running test. Arch Dis Child. 1986 Sep;61(9):912–914. doi: 10.1136/adc.61.9.912. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. 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]
  39. Williams D., Bruton J., Wilson I. Screening a state middle school for asthma using the free running asthma screening test. Arch Dis Child. 1993 Dec;69(6):667–669. doi: 10.1136/adc.69.6.667. [DOI] [PMC free article] [PubMed] [Google Scholar]

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