"Monitoring inhalation technique"

The fall in FEV1 during an ECT, on a trampoline (6-12 year) or a treadmill (12-18 year), will be measured . The endpoint is the fall in FEV1at the ECT . The ECT performed on a treadmill is according to ATS/ERS recommendations. The ECT’s will be performed at the paediatric department. Children will run, nose clipped, on a treadmill with a 10% to 19, 5% slope, for 3 min period (7 times) with a heart rate at 80% of predicted maximum (210-age). The children less than 12 years perform the ECT on a trampoline. Children will be asked to jump 3 times 2 minutes on a trampoline with a heart rate at 80% of the predicted maximum (210-age).

• The use of Salbutamol in both groups, the children receive during visit 1 a Salbutamol inhaler for symptoms of breathlessness during the 4 weeks. This inhaler contains a counter that counts how many times the inhaler is used.

• The scores in critical errors of inhalation technique after 4 weeks treatment. Inhalation technique will be scored according to standardized inhalation protocols designed by the Lung Alliance Netherlands (LAN) for every inhalation device (see appendix).

• The symptom score endpoint will be the measured by the ACT; this is a questionnaire that is answered by caregivers(s) and the child. The first 4 questions must be answered by the child, the last three by the caregiver(s). Score below 20 points; the asthma is not likely to have been under control for the past 4 weeks. 20 points or more; the asthma was probably well under control over the last 4 weeks.