title: Activity limitation and exertional dyspnea in adult asthmatic patients: What do we know?
abstract: Limitation of activity is the most cited symptom described by uncontrolled asthma patients. Assessment of activity limitation can be undertaken through several ways, more or less complex, subjective or objective. Yet little is known about the link between patients sensations and objective measurements. The present review reports the current knowledge regarding activity limitation and symptom perception (i.e., exertional dyspnea) in adult patients with asthma. This work is based on references indexed by PubMed, irrespective of the year of publication. Overall, patients with stable asthma do not have a more sedentary lifestyle than healthy subjects. However, during a cycle ergometric test, the maximal load is reduced when FEV1, FVC and muscle strengths are decreased. Additionally, during the six-minute walking test, mild asthma patients walk less than healthy subjects even if the minimal clinically important difference is not reached. The major complaint of asthma patients when exercising is dyspnea that is mainly related to the inspiratory effort and also to dynamic hyperinflation in some circumstances. Finally, the administration of bronchodilator does not improve the ventilatory pattern and the exercise capacity of asthma patients and little is known on its effect on exertional dyspnea. The present review allows to conclude that until now there is no gold standard test allowing the objective assessment of "activity limitation and exertional dyspnea" in asthma patients.
authors: Chest Service, St Pierre University Hospital, Brussels, Belgium. Electronic address: vermeulenfr@yahoo.com.
authors: François
authors: F
authors: Vermeulen
authors: AP-HP, University Hospital Bicêtre, Pulmonary Function Laboratory, Reference Centre for Severe Pulmonary Hypertension, DHU TORINO "Thorax Innovation", Le Kremlin-Bicêtre, France; University Paris-South 11, Faculty of Medicine, Le Kremlin-Bicêtre, France; INSERM U999, LabEx LERMIT, Surgical Centre Marie Lannelongue, Le Plessis-Robinson, France.
authors: Gilles
authors: G
authors: Garcia
authors: Chest Service, St Pierre University Hospital, Brussels, Belgium; Université Libre de Bruxelles, Faculty of Medicine, Bruxelles, Belgium.
authors: Vincent
authors: V
authors: Ninane
authors: University Sorbonne, UPMC University Paris 06, INSERM, UMRS1158 Clinical and Experimental Respiratory Neurophysiology, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Unit of Respiration, Exercise and Dyspnea Assessment (Unit EFRED, Department "R3S", Pôle PRAGUES), Paris, France.
authors: Pierantonio
authors: P
authors: Laveneziana
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects; D001249:Asthma / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology; D001993:Bronchodilator Agents / Q000009:adverse effects; D004417:Dyspnea / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D004734:Energy Metabolism / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007320:Inspiratory Capacity / Q000502:physiology; D008297:Male; D053580:Muscle Strength / Q000187:drug effects / Q000502:physiology; D011788:Quality of Life; D012129:Respiratory Function Tests / Q000379:methods; D012132:Respiratory Muscles / Q000187:drug effects / Q000502:physiology; D016138:Walking / Q000502:physiology
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents
keywords: Asthma; Exercise physiology; Physical exertion; Review; Symptom assessment