• You help the local football youth team to set out an appropriate exercise training program in preparation for the season.
• Jelle (9yrs) arrived late for the training. He gets dressed and joins the team that is completing an interval training. After the training you notice that Jelle is coughing. Upon inspection you notice visible contractions of his accessory respiratory muscles with inspiration.

Which potential diagnosis do you think of ?
What do you do ?
Prevention ?

Exercise Induced Asthma

• 9% of children/adults
• 15% of children/adult athletes

Typical Symptoms

• shortness of breath
• wheezing
• cough

Provoking factors

• exercise
• cold dry air
• air pollutants
• respiratory infection/common cold
  
• Example of FEV1 after an exercise challenge
  
• flow/volume asthma attack
  
• Exercise induced bronchoconstriction
  

Reversibility

Treatment

• Medication:
  • underlying Asthma
  • Depending on Asthma control
    • reliever and/or controller medication
  • Specific for EIB
• Preventive
  • Avoid contact with allergens/stimuli
  • Medication (SABA and if not sufficient add-on)
  • Ensure good physical condition
  • Avoid obesity

Asthma Control: PEF

Diagnosis

• Self-reported symptoms
  • wheezing, chest tightness, dyspnoea, excess sputum
• spirometry and exercise challenge
• peak flow/spirometry measurements