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3-Min step test and treadmill exercise for evaluating exercise-induced asthma

¹ Cystic Fibrosis Centre and ² Allergology and Immunology, ³ Paediatric Dept, University of Rome "La Sapienza", Rome, Italy

CORRESPONDENCE: G. Tancredi, Paediatric Department, Cystic Fibrosis Centre, University of Rome "La Sapienza", Viale Regina Elena, 324 – 00161 Rome, Italy. Fax: 39 686323436. E-mail: giancarlo.tancredi@uniroma1.it

Keywords: area above the curve_0–30min, exercise-induced asthma, 3-min step test, treadmill exercise test

Received: April 9, 2003
Accepted November 17, 2003

A simple exercise test would be useful for detecting exercise-induced asthma, a common problem in asthmatic children. The current study compared the 3-min step test with treadmill exercise for evaluating exercise-induced asthma in asthmatic children and assessed whether responses to both tests are influenced by baseline lung function and habitual physical activity.

A series of 154 asthmatic children (84 male children; mean age 12.9±0.9 yrs) underwent a 3-min step-test and treadmill testing on different days within a week at least 24 h apart. Before both tests each subject did spirometry to obtain the baseline forced expiratory volume in one second (FEV₁). After both exercise challenges all subjects did serial spirometry and the lowest FEV₁ recorded over time was used to calculate the fall in FEV₁ expressed as a percentage of the measured pre-exercise (baseline) value (% fall in FEV₁) and the area above the FEV₁ curve (AAC_0–30 min) expressed as a percentage of the pre-exercise value. Changes in both exercise variables were also analysed in percentile subgroups defined by questionnaire answers on habitual physical activity in hours.

The mean % fall in FEV₁ was significantly higher for treadmill exercise than for the step test (15.0±7.5 versus 11.7±5.9); and the AAC_0–30 min was larger for treadmill than for the step test (–261.6±139.9% versus –197.3±105.0% min). In all subgroups defined by habitual physical activity the mean % fall in FEV₁ decreased more after treadmill exercise than after the step test. After step test and treadmill exercise no significant correlation was found between % fall in FEV₁ and baseline lung function, or between % fall in FEV₁ among groups defined by habitual physical activity.

Although the 3-min step test yields a lower % fall in forced expiratory volume in one second (FEV₁) and a lower value of the area above the FEV₁ curve than treadmill testing, it is a quick, economical, reproducible and portable alternative procedure for identifying exercise-induced asthma in outpatients and epidemiological studies. Baseline lung function and habitual physical activity have no influence on the amount or duration of exercise-induced asthma.