ArticleMedicine and science in sports and exercise2020
Pitfalls in Expiratory Flow Limitation Assessment at Peak Exercise in Children: Role of Thoracic Gas Compression.
Article in Medicine and science in sports and exercise, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 10 citations in OpenAlex.
- Respiratory symptoms and exercise responses among adult E-cigarette users with and without obesity.Physiological reports · 2026Article
- Effects of Obesity and Sex on Supine Functional Residual Capacity and Expiratory Flow Limitation in Children.Pediatric pulmonology · 2025Article
- Thoracic load carriage impairs the acute physiological response to hypoxia in healthy males.Physiological reports · 2025Article
- Body composition in early pubescent children with obesity: effects following 1 year of nonintervention.Journal of applied physiology (Bethesda, Md. : 1985) · 2024Article
- Mechanical effects of obesity on central and peripheral airway resistance in nonasthmatic early pubescent children.Pediatric pulmonology · 2022Article
- Sex differences in the ventilatory responses to exercise in mild to moderate obesity.Experimental physiology · 2022Article
- Sex, gender and the pulmonary physiology of exercise.European respiratory review : an official journal of the European Respiratory Society · 2022Review
- Inhaled albuterol increases estimated ventilatory capacity in nonasthmatic children without and with obesity.Respiratory physiology & neurobiology · 2021Article
- Effects of obesity on the oxygen cost of breathing in children.Respiratory physiology & neurobiology · 2021Article
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Authors and funding
4 authors at 4 institutions in 1 country.
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Abstract
purposeThoracic gas compression and exercise-induced bronchodilation can influence the assessment of expiratory flow limitation (EFL) during cardiopulmonary exercise tests. The purpose of this study was to examine the effect of thoracic gas compression and exercise-induced bronchodilation on the assessment of EFL in children with and without obesity.
methodsForty children (10.7 ± 1.0 yr; 27 obese; 15 with EFL) completed pulmonary function tests and incremental exercise tests. Inspiratory capacity maneuvers were performed during the incremental exercise test for the placement of tidal flow volume loops within the maximal expiratory flow volume (MEFV) loops, and EFL was calculated as the overlap between the tidal and the MEFV loops. MEFV loops were plotted with volume measured at the lung using plethysmography (MEFVp), with volume measured at the mouth using spirometry concurrent with measurements in the plethysmograph (MEFVm), and from spirometry before (MEFVpre) and after (MEFVpost) the incremental exercise test. Only the MEFVp loops were corrected for thoracic gas compression.
resultsNot correcting for thoracic gas compression resulted in incorrect diagnosis of EFL in 23% of children at peak exercise. EFL was 26% ± 15% VT higher for MEFVm compared with MEFVp (P < 0.001), with no differences between children with and without obesity (P = 0.833). The difference in EFL estimation using MEFVpre (37% ± 30% VT) and MEFVpost (31% ± 26% VT) did not reach statistical significance (P = 0.346).
conclusionsNot correcting the MEFV loops for thoracic gas compression leads to the overdiagnosis and overestimation of EFL. Because most commercially available metabolic measurement systems do not correct for thoracic gas compression during spirometry, there may be a significant overdiagnosis of EFL in cardiopulmonary exercise testing. Therefore, clinicians must exercise caution while interpreting EFL when the MEFV loop is derived through spirometry.
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