Exercise-induced asthma demonstrable in young children

A test using a jumping castle has made it possible to demonstrate exercise-induced asthma in young children between 5 and 7 years old. In children, exercise-induced asthma often starts during exercise; it affects their ability to take part in sport and is a sign of poorly managed asthma. Exercise-induced asthma changes as the child grows older. These are the conclusions of PhD research carried out by trainee paediatrician Janneke van Leeuwen of the University Medical Center Groningen. She also concludes that when treating children who are also overweight, even the slightest weight loss improves exercise-induced asthma. She will be awarded a PhD by the University of Groningen on 18 February.

Exercise-induced asthma, a temporary constriction of the airways after exercise, is a common symptom of asthma in young children. It can start at 3 years of age. The characteristics of exercise-induced asthma change with age and are often missed by children, parents and even doctors. Conversely, an incorrect diagnosis of asthma can often be made. In her research, Janneke van Leeuwen focused on recognizing, monitoring and treating exercise-induced asthma in young children.

Exercise test

Very little is known about exercise-induced asthma in children younger than 8 years of age. For the purposes of her study, Van Leeuwen designed an exercise test to diagnose exercise-induced asthma in children aged between 5 and 7. The children were asked to jump on a jumping castle for 6 minutes, a test which they undertook with great enthusiasm (unlike many other tests). According to Van Leeuwen, this test is an appropriate, safe and effective way of diagnosing exercise-induced asthma in young children.

The results of the test show that exercise-induced asthma starts during exercise in many young children, rather than after exercise (breakthrough exercise-induced asthma). Their lung function dropped swiftly while they were exercising, sometimes after just two minutes. Children who experience shortness of breath during exercise may have exercise-induced asthma. Breakthrough exercise-induced asthma affects children’s ability to participate in sport and is seen as a sign of poorly managed asthma, as it coincides with a sharp drop in lung function. Van Leeuwen claims that exercise-induced asthma changes as children get older. The younger the child, the shorter the time taken to reach maximum airway constriction and the faster the child recovers from exercise-induced asthma.

Bronchiolitis

Van Leeuwen also noted that children who are admitted to hospital with bronchiolitis at an early age are more likely to develop exercise-induced asthma. Bronchiolitis is a viral bronchial infection that causes inflammation of the smallest airways in the lungs. Exercise-induced asthma was diagnosed in almost 40% of these children when they reached 5 to 7 years of age, four times as many as among their peers. This may help doctors to recognize exercise-induced asthma more quickly.

Obesity

There is a link between obesity and exercise-induced asthma. Overweight children have more serious exercise-induced asthma than children who are not overweight. Van Leeuwen examined the impact of losing weight on this group’s treatment. She discovered that even a slight drop in the BMI improved their exercise-induced asthma. Van Leeuwen thinks that this may be because losing weight enables them to take deeper breaths, or because losing weight reduces inflammation in the airways. She therefore stresses the importance of weight loss as part of the treatment for obese children with exercise-induced asthma.

Curriculum Vitae

J.C. van Leeuwen (Oude Pekela, 1984) studied Medicine at the University of Groningen. She conducted her PhD research in the Department of Paediatric Respiratory Diseases and the GUIDE Research Institute of the University Medical Center Groningen and the Medical Spectrum Twente (Enschede). Her thesis is entitled Exercise induced bronchoconstriction in childhood asthma. She is currently training to become a paediatrician.

Source: press release UMCG/RUG