EXERCISE-INDUCED ASTHMA - DIAGNOSIS, PROPHYLAXIS AND TREATMENT

Sport can improve the quality of life of asthmatic children, However, athletic activity and even games are frequently disturbed by dyspnoeic events called exercise-induced asthma (EIA), The intensity and the ty pe of the exercise that provokes EIA vary from one patient to another. The maximal intensity of these attacks occurs between 5 and 15 minute s after the end of the exercise. In some asthmatic children, there see ms to be a late phase response. In 40 to 50% of asthmatics, EIA is fol lowed by a refractory period that lasts 2 to 4 hours. EIA is detected by exercise challenge testing. There are several types of tests involv ing different equipment: free running, treadmill or cycle ergometer. T he conditions under which these tests are performed must be rigorously controlled. Prevention of EIA must be adapted to the intensity and th e frequency of EIA. Prevention may be nonpharmacological, pharmacologi cal or both. Cromones and beta(2)-agonists are the drugs of choice in the prevention of EIA. Sport training in specialised centres is someti mes necessary, especially for patients with severe asthma. The purpose of this training is to decrease exercise-induced hyperventilation for a given level of work. The resulting improved tolerance to effort wil l increase the threshold of appearance of EIA. The choice of sport for an asthmatic child depends upon local possibilities, the child's tast es, the intensity of his/her EIA and the potential of the sport to ind uce asthma. Thus, asthmatic children and adolescents can and should pr actice sports.