Exercise-Induced Asthma Test

The exercise-induced asthma test (synonyms: EIA test, exercise-induced asthma test) is a variety of diagnostic procedures used to detect and evaluate exercise-induced bronchial asthma. Typically, cold air and exercise serve as triggers for the symptoms of exercise-induced asthma. Exercise-induced asthma itself is a common internal disease in sports, which is characterized by a high prevalence (disease frequency) of up to 35%, especially in winter athletes. Of decisive importance for the development of exercise-induced asthma is a deprivation of fluid and heat in the lining of the respiratory tract during exercise-induced increased breathing. The hyperventilation present (unphysiologically deepened and/or accelerated breathing) leads to a clinical picture of cough without sputum, dyspnea (shortness of breath), and possibly chest tightness. Usually, symptoms do not appear immediately on exertion but with a delay of up to 30 minutes.

Indications (areas of application)

  • Exercise-induced asthma – When exercise-induced bronchoconstriction (narrowing of the airway) is suspected, there is an indication to perform the Exercise-induced Asthma Test. “Exercise-induced bronchoconstriction” is defined as airway narrowing characterized by reversibility. By definition, exercise-induced bronchoconstriction in the presence of bronchial asthma is referred to as “exercise-induced asthma.” If the asthma criteria are not met, the clinical presentation is termed “exercise-induced bronchoconstriction.” Symptoms of exercise-induced asthma include dyspnea (shortness of breath), wheezing, whistling, and coughing after exertion.

Contraindications

In particular, existing concomitant diseases such as cardiovascular processes (cardiovascular diseases) are a contraindication depending on the severity. Asthma attacks occurring shortly before testing alter the test result and thus prevent the procedure from being performed.

Before the examination

  • Eating Behavior – A meal should be consumed before the Exercise-induced Asthma test, but it should not be eaten in the last two hours before testing. Furthermore, caffeine should be avoided before the test.
  • Medication intake – When performing the Exercise-induced Asthma test, medication must be abstained from for 24 hours prior to the procedure in order not to falsify the test results. Example substances that should not be used include short-acting beta-sympathomimetics (used to improve airway widening, among other things) such as salbutamol and fenoterol, and anticholinergic substances such as ipratroprium bromide and tiotropium bromide.

The procedure

The use of pharmacological agents to induce (bring about) provocation of the bronchial system is less reliable than “physiological provocations” such as a load itself or cold breathing air. However, standardization is much more difficult to achieve with targeted exercise. Standard diagnostics are available for the diagnosis of exercise-induced asthma:

  • Exercise test-A submaximal (below maximal) exercise is performed over ten minutes. To improve the validity of the procedure, the load used for testing should be a sport-specific load. As a submaximal load, a provocation is performed at 85% of the maximum heart rate.
  • Pulmonary function/spirometry – In order to use pulmonary function for assessment, it must be performed before exercise and afterwards for 3, 5 and 15 minutes. The critical value in this case is the “forced one-second capacity (FEV1)” as a parameter of bronchoconstriction. A positive result is present if an exercise-induced airway constriction with a drop in FEV1 of 10-15% of the initial value and/or an increase in airway resistance (Raw) of more than 150% can be detected.
  • Bodyplethysmography (large lung function) – Unlike spirometry, bodyplethysmography is a method of measuring lung and respiratory parameters (respiratory physiologic variables such as airway resistance, residual volume, or total lung capacity). The patient sits in a chamber and the cooperation of the patient can influence the results to a lesser extent.

After the examination

After completion of the Exercise-induced Asthma test, there are no special measures to be taken.

Possible complications

Complications may occur as a result of exercise, but the likelihood is considered very low. However, asthma-related complications such as wheezing, breath sounds, and anxiety are not uncommon.