The usability of app-based spirometry tests for detection of exercise-induced bronchoconstriction in athletes

Abstract

<b>Background:</b> Exercise-induced bronchoconstriction (EIB) is triggered by strenuous physical activity. Diagnostic tests performed in a laboratory environment have limitations in terms of the ability to simulate the athlete9s natural training environment. An app-based health care system called AsthmaTuner may facilitate evaluation of EIB, but evidence on the usability lacks. <b>Objectives:</b> The primary aim was to evaluate the usability of app-based unstandardised and standardised field exercise challenge tests (ECT). The second aim was to assess variability in lung function during ECTs. <b>Methods:</b> This study included 60 athletes (15-28 years of age) with self-reported symptoms of EIB. The participants were equipped with AsthmaTuner and instructed to perform; 1) unstandardised field ECT measured by spirometry of forced expiratory volume in 1 s (FEV₁) during exercise, and 2) a standardised 8 minutes at &gt;85% of maximal heart rate field ECT, where FEV₁ was measured pre and repeatedly up to 30-minutes post ECT. The usability was evaluated by questionnaires and by number of completed ECTs. A fall of ≥10% in FEV₁ defined a positive unstandardised ECT, and two consecutive fall of ≥10% in FEV₁ the standardised ECT. <b>Results:</b> Fifty-five of 60 (92%) participants completed an unstandardised ECT, while all participants performed a standardised ECT. No adverse events were reported. 57/60 (95%) reported the app was easy to use. Unstandardised ECT was positive in 36%, while standardised ECT in 35%. <b>Conclusion:</b> This study implies that app-based field ECTs is a feasible and simple method for detecting EIB in athletes with respiratory symptoms.