Perception of dyspnea during exercise-induced bronchoconstriction

Melani, Andrea S.; Ciarleglio, Giuseppina; Pirrelli, M; Sestini, Piersante

doi:10.1053/rmed.2003.1448

Cited by 15 publications

(10 citation statements)

References 25 publications

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“…This may be a relevant limitation of our study. The poor correlation between self-reported ERRS and the results of specific exercise tests has been shown previously and there is a rather high frequency of false positive and false negative results [8, 11-13, 29, 30]. In the study by Panditi et al, the severity of ERRS during the precedent week was not related to any of the parameters of the EIB test and the parent’s perception of ERRS in their children was very poorly related to the symptom perception by the children [12].…”

Section: Discussionmentioning

confidence: 93%

“…The available data on the relationship between reported exercise-related respiratory symptoms (ERRS) such as breathlessness or dyspnea and the magnitude of bronchoconstriction after an exercise test in the laboratory are very controversial. Some authors have shown that ERRS are predictive for exercise-induced bronchoconstriction (EIB) [8, 9], whereas others found no or a poor relationship between the reported ERRS and the results of specific exercise testing [10-14]. Several recent studies have shown a poor predictive value for the asthma control test (ACT) or the asthma control questionnaire (ACQ) in predicting EIB in asthmatic children with a high percentage of children showing a positive EIB test despite reporting well-controlled asthma according to the ACT or ACQ [15-17].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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BackgroundUnlimited physical activity is one of the key issues of asthma control and management. We investigated how reliable reported exercise-related respiratory symptoms (ERRS) are in predicting exercise-induced bronchoconstriction (EIB) in asthmatic children.MethodsIn this prospective study, 179 asthmatic children aged 7 - 15 years were asked for specific questions on respiratory symptoms related to exercise and allocated into two groups according to whether they complained about symptoms. Group I (n = 134) consisted of children answering “yes” to one or more of the questions and group II (n = 45) consisted of children answering “no” to all of the questions.ResultsSixty-four of 179 children showed a positive exercise challenge test (ECT). There was no difference in the frequency of a positive test between children in group I (n = 48) and group II (n = 12) (P = 0.47). The sensitivity of a positive report for ERRS to predict a positive ECT was only 37%, with a specificity of 0.72.ConclusionAccording to current guidelines, the report or lack of ERRS has direct consequences on treatment decisions. However, the history of ERRS did not predict EIB and one-third of asthmatic children without complaints of ERRS developed EIB during the ECT. This raises the question of the need for objective measures of bronchial hyperresponsiveness (BHR) in pediatric asthma management.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

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

et al. 2017

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“…Depending on the DPI device, elderly patients and/or those with more severe COPD may be unable to achieve a suffi cient peak inspiratory fl ow rate for optimal drug delivery ( Figure 1B-C). 11,13,28,31,[44][45][46] Different DPI models operate dissimilarly from one another in loading and priming of the device. Therefore, DPI devices cannot be interchanged with the assumption that they will work in the same way, and deliver an equivalent dose to the patient's lungs.…”

Section: Dry Powder Inhalersmentioning

confidence: 99%

Customizing Inhaled Therapy to Meet the Needs of COPD Patients

Fromer

Goodwin

Walsh

2010

Postgraduate Medicine

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Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by airflow limitation resulting from emphysema and chronic bronchitis. Inhaled therapy is the major therapeutic approach for treating COPD. Multiple inhaler medications are available in the United States and are delivered by a variety of different devices: metered-dose inhalers, dry powdered inhalers, and nebulizers. Each inhaler device has unique requirements for use that must be correctly performed by the patient for successful drug delivery. Patients with COPD represent a medically diverse population, with each patient having distinct characteristics, such as lung function, comorbidities, cognitive functions, hand strength, and lifestyle. These characteristics impact the patient's ability to properly use specific inhaler devices and therefore affect adherence to therapy, therapeutic outcomes, and quality of life. It is estimated that between 28% to 68% of patients do not use metered-dose inhalers or dry powder inhalers correctly. Worsening symptoms or increased frequency of exacerbations may not always indicate disease progression but may indicate a patient's inability to use their inhaler device properly. This review discusses the patient- and device-specific factors to be considered when choosing an inhaled therapy, which will be concordant with the patient's medical needs, preferences, and lifestyle. The review also considers how the ideas underlying the patient-centered medical home model can be incorporated into the choice and use of inhaler device for a given patient with COPD to improve treatment outcomes.

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“…EIB may be associated with cough, wheeze, chest pain or tightness, dyspnoea or excessive mucus production 6. However, the amount of bronchoconstriction does not always correlate well with the baseline level of lung function or presence or severity of symptoms 7 8. Nevertheless, these symptoms or the effect of bronchoconstriction on ventilation could limit athletic performance.…”

Section: Introductionmentioning

confidence: 99%