Het beschermende effect van een enkele gangbare dosis inhalatiesteroid op inspanningsastma uitgevoerd met verschillende lichaamshoudingen tijdens inhalatie.

Exercise induced bronchoconstriction (EIB) is a highly specific and frequent symptom of asthma and also the most bothersome as reported by asthmatic children. Exercise challenge tests (ECT) can identify EIB and are therefore frequently used to diagnose asthma and evaluate asthma treatment. EIB can be treated with inhaled medication; inhaled corticosteroids (ICS) offer long term and pre-exercise bronchodilators short term protection. However, a single high dose ICS has been observed to offer protection against EIB on a short term base as well. It is well known that the vast majority of inhaled particles do not reach their target, ie the small airways, but impact in the upper airway. Main objective of this study is to investigate if body posture and head position can influence clinical effects of inhaled medication.

Inhalation of a single regular dose steroid (200ugr Qvar autohaler) with a stretched upper airway (achieved by leaning forward and flexing the head backwards) will protect more against exercise induced asthma compared to inhalation of a single regular dose steroid with the standard inhalation technique.

1. Patients inclusion: September - December 2013;

2. ECT's: October - January 2014.

1. Interview with investigator about history, complaints and medication use;

2. Anthropometric measurements (height, weight);

3. Physical examination (pulmonary auscultation);

4. Two ECT’s, which consists of either running on a treadmill for the older children or jumping on a jumping castle for the younger children for at least 4 minutes (maximum 6 minutes);

5. Four hours prior to each ECT children will inhale a single regular dose of 200 µgr BDP; one time with the standard body posture and head position and one time with the alternative forward leaning body posture with the head flexed backwards. Before inhalation they will perform baseline lungfunction measurements;

6. Pulmonary function measurements (flow volume curve) before (duplicated), during (twice) and after exercise at t= 1,2,3,5,7,10 and 15 minutes;

7. Parents or child will answer a short questionnaire regarding to the body posture during inhalation of their child.