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To evaluate the exercise capacity of children and adolescents with severe therapy resistant asthma (STRA) aiming to identify its main determinants. Cross-sectional study including individuals aged 6–18 years with a diagnosis of STRA. Clinical (age and gender), anthropometric (weight, height and body mass index) and disease control data were collected. Lung function (spirometry), cardiopulmonary exercise testing (CPET) and exercise-induced bronchoconstriction (EIB) test were performed. Twenty-four patients aged 11.5 ± 2.6 years were included. The mean forced expiratory volume in one second (FEV 1 ) was 91.3 ± 9.2%. EIB occurred in 54.2% of patients. In CPET, the peak oxygen uptake ( V O 2peak ) was 34.1 ± 7.8 mL kg −1  min −1 . A significant correlation between ventilatory reserve and FEV 1  ( r  = 0.57;  p  = 0.003) was found. Similarly, there was a significant correlation between CPET and percent of FEV 1  fall in the EIB test for both  VE / V O 2  ( r  = 0.47;  p  = 0.02) and  VE / V CO 2  ( r  = 0.46;  p  = 0.02). Patients with FEV 1 &lt;80% had lower ventilatory reserve ( p  = 0.009). In addition, resting heart rate correlated with  V O 2peak  (r=-0.40;  p  = 0.04),  VE / V O 2  ( r  = 0.46;  p  = 0.02) and  VE / V CO 2  ( r  = 0.48;  p  = 0.01). Exercise capacity is impaired in approximately 30% of children and adolescents with STRA. The results indicate that different aspects of aerobic fitness are influenced by distinct determinants, including lung function and EIB.

Determinants of exercise capacity in children and adolescents with severe therapy-resistant asthma