Chest
Volume 128, Issue 4, October 2005, Pages 2412-2419
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Clinical Investigations PULMONARY FUNCTION TESTING
Airway Narrowing Measured by Spirometry and Impulse Oscillometry Following Room Temperature and Cold Temperature Exercise

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Study objective

The efficacy of using impulse oscillometry (IOS) as an indirect measure of airflow obstruction compared to spirometry after exercise challenges in the evaluation of exercise-induced bronchoconstriction (EIB) has not been fully appreciated. The objective was to compare airway responses following room temperature and cold temperature exercise challenges, and to compare whether IOS variables relate to spirometry variables.

Design

Spirometry and IOS were performed at baseline and for 20 min after challenge at 5-min intervals.

Setting

Two 6-min exercise challenges, inhaling either room temperature (22.0°C) or cold temperature (− 1°C) dry medical-grade bottled air. At least 48 h was observed between these randomly assigned challenges.

Participants

Twenty-two physically active individuals (12 women and 10 men) with probable EIB.

Interventions

Subjects performed 6 min of stationary cycle ergometry while breathing either cold or room temperature medical-grade dry bottled air. Subjects were instructed to exercise at the highest intensity sustainable for the duration of the challenge. Heart rate and kilojoules of work performed were documented to verify exercise intensity.

Measurements and results

Strong correlations were observed within testing modalities for post-room temperature and post-cold temperature exercise spirometry and IOS values. Spirometry revealed no differences in postexercise peak falls in lung function between conditions; however, IOS identified significant differences in respiratory resistance (p < 0.05), with room temperature-inspired air being more potent than cold temperature-inspired air.

Conclusions

Correlations were found between spirometric and IOS measures of change in airway function for both exercise challenges, indicating close equivalency of the methods. The challenges appeared to elicit the EIB response by a similar mechanism of water loss, and cold temperature did not have an additive effect. IOS detected a difference in degree of response between the temperatures, whereas spirometry indicated no difference, suggesting that IOS is a more sensitive measure of change in airway function.

Section snippets

Subjects

Twenty-two physically active individuals with probable EIB were recruited to participate in this study (mean age ± SD, 25.2 ± 8.4 years; height, 1.71 ± 0.08 m; weight, 74.7 ± 15 kg; 10 men and 12 women). The Institutional Review Board of Marywood University approved the study protocol, and subjects provided written informed consent for participation. Eight subjects reported using an inhaled β2-agonist prior to exercise, one subject was receiving salmeterol, one subject was receiving fluticasone

Baseline Lung Function

Individual and mean resting lung function values from IOS and spirometry are presented in Table 1. Resting FVC values were normal, ranging from 81.67 to 135.59% of predicted values. One subject demonstrated below-normal resting FEV1 (78.6% of predicted value). Five of 22 subjects (22.7%) demonstrated < 70% of predicted FEF50, suggestive of mild airflow limitation and small-airway involvement. Significant correlations were identified between resting spirometry and IOS values (p < 0.05): FVC and

Discussion

In this study, we compared airway responses following randomly assigned RTEX and CTEX challenges and examined whether resting and postchallenge spirometry variables correlated with resting and postchallenge IOS variables. Six minutes of exercise while breathing dry medical-grade bottled air was a suitable challenge for inducing the EIB response.25 Heart rate during exercise and the amount of work performed indicated that the challenges were at an intensity sufficient to provoke EIB,26 and

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  • Cited by (0)

    This study was supported by the American College of Sports Medicine Foundation, and performed at the Marywood University Human Performance Laboratory.

    The views, opinions, and findings contained in this report are those of the authors and should not be construed as an official Marywood University position.

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

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