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Liv-Jorunn Kolnes, Trine Stensrud
Otherwise healthy adolescent athletes presenting with respiratory symptoms consistent with exercise-induced laryngeal obstruction (EILO) are frequently encountered in clinical practice. The symptoms are often incorrectly considered to result from exercise-induced asthma, and may be wrongly treated as such. Given the potential implications for health and performance if EILO is left untreated, a more comprehensive understanding of contributory mechanisms is essential in order to create appropriate treatment procedures...
May 14, 2018: Physiotherapy Theory and Practice
Kiran Kafila Mirza, Emil Schwarz Walsted, Vibeke Backer
Background : Patients suffering from exercise-induced laryngeal obstruction (EILO) are subjected to several exhausting tests. We aimed to assess the feasibility of using a single test to obtain diagnostic measurements for maximum oxygen uptake (VO2 max) and exercise-induced laryngeal obstruction (EILO). Methods : Patients referred to the outpatient respiratory clinic at the University Hospital of Bispebjerg, Copenhagen with exercise-induced dyspnoea were evaluated for inclusion over 13 months. Eligible patients were aged 18-43 years, had a known EILO diagnosis (moderate or severe) and were inactive (self-reported activity) with less than 3 hours activity per week...
2017: European Clinical Respiratory Journal
Emil S Walsted, Azmy Faisal, Caroline J Jolley, Laura L Swanton, Matthew J Pavitt, Yuan-Ming Luo, Vibeke Backer, Michael I Polkey, James H Hull
Exercise-induced laryngeal obstruction (EILO), a phenomenon in which the larynx closes inappropriately during physical activity, is a prevalent cause of exertional dyspnea in young individuals. The physiological ventilatory impact of EILO and its relationship to dyspnea are poorly understood. The objective of this study was to evaluate exercise-related changes in laryngeal aperture on ventilation, pulmonary mechanics, and respiratory neural drive. We prospectively evaluated 12 subjects (6 with EILO and 6 healthy age- and gender-matched controls)...
February 1, 2018: Journal of Applied Physiology
Kristina L Johnston, Hannah Bradford, Heather Hodges, Camille M Moore, Emily Nauman, J Tod Olin
INTRODUCTION: Exercise-induced laryngeal obstruction (EILO), the condition previously known as paradoxical vocal fold motion and vocal cord dysfunction, is characterized by inappropriate glottic or supraglottic obstruction during high-intensity exercise, causing exertional dyspnea, frequently with stridor. EILO is definitively diagnosed through upper-airway visualization during a characteristic episode. Although respiratory retraining is a primary therapy for EILO, many patients report symptom persistence despite adequate performance of traditional techniques...
October 11, 2017: Journal of Voice: Official Journal of the Voice Foundation
Sarah Graham, Emily Deardorff, Kristina Johnston, J Tod Olin
Exercise-induced laryngeal obstruction (EILO) is the term for the condition previously named vocal cord dysfunction and paradoxical vocal fold motion. It is defined by glottic or supraglottic obstruction during periods of intense exercise. Not all patients respond to conventional therapy with speech-language pathology, behavioral health interventions, and treatment of contributing conditions. In this edition of Journal of Voice, the authors describe a novel series of respiratory retraining techniques, now called Olin EILOBI (EILO biphasic inspiratory) breathing techniques, specifically designed for athletes with EILO...
October 11, 2017: Journal of Voice: Official Journal of the Voice Foundation
Emil Schwarz Walsted, James H Hull, Jeppe Hvedstrup, Robert Christiaan Maat, Vibeke Backer
The current gold-standard method for diagnosing exercise-induced laryngeal obstruction (EILO) is continuous laryngoscopy during exercise (CLE), with severity classified by a visual grade scoring system. We evaluated the precision of this approach, by evaluating test-retest reliability of CLE and both inter- and intra-rater variability. In this prospective case-control study, subjects completed four consecutive treadmill CLE tests under identical conditions. Laryngoscopic video recordings were anonymised and graded by three expert raters...
July 2017: ERJ Open Research
Emil S Walsted, Laura L Swanton, Ken van van Someren, Tessa E Morris, Matthew Furber, Vibeke Backer, James H Hull
Exercise-induced laryngeal obstruction (EILO) is a key differential diagnosis for respiratory symptoms in athletes and is particularly prevalent in aquatic athletes. A definitive diagnosis of EILO is dependent on laryngoscopy, performed continuously, while an athlete engages in the sport that precipitates their symptoms. This report provides the first description of the feasibility of performing continuous laryngoscopy during exercise in a swimming environment. The report describes the methodology and safety of the use of continuous laryngoscopy while swimming...
October 2017: Laryngoscope
Irena Hočevar-Boltežar, Uroš Krivec, Maja Šereg-Bahar
Exercise-inducible laryngeal obstruction (EILO) has been recognized as a not rare respiratory problem in youth practicing sports. The aim of the study was to test the mechanosensitivity of the larynx, and to identify the factors affecting it in a group of youth with proven EILO. Laryngeal sensory testing was performed in 54 adolescents and young adults with EILO. Laryngeal mucosal alterations were assessed according to the Reflux Finding Score (RFS). The data concerning diseases possibly affecting the upper airway, findings of previously performed flexible videolaryngoscopy during exercise, and RFS score were compared between the participants with laryngeal hyposensitivity and those with normal sensitivity...
June 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
J Tod Olin, Emily H Deardorff, Elizabeth M Fan, Kristina L Johnston, Valerie L Keever, Camille M Moore, Bruce G Bender
BACKGROUND: Exercise-induced laryngeal obstruction (EILO) may affect as many as 6% of the adolescent population, with some patients experiencing symptoms refractory to conservative interventions. OBJECTIVES: This report describes therapeutic laryngoscopy during exercise, a novel, non-surgical intervention that harnesses real-time laryngoscopy video as biofeedback to control laryngeal aperture during high-intensity exercise. Additionally, we quantitate patient-reported perceptions of procedure safety, tolerability, learning value, and effectiveness...
June 2017: Pediatric Pulmonology
Savinda Liyanagedera, Robert McLeod, Hassan A Elhassan
Exercise induced laryngeal obstruction (EILO) is a condition where inappropriate vocal cord or glottic closure occurs during exercise. This review of the literature provides an overview of the current understanding of the definition, epidemiology, diagnosis and management of EILO. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines the Cochrane, Embase, Ovid MEDLINE and PubMed databases were searched. Four search domains "exercise", "induced", "laryngeal" and "obstruction" were used...
April 2017: European Archives of Oto-rhino-laryngology
Frederik Buchvald, Lue Drasbaek Phillipsen, Thomas Hjuler, Kim G Nielsen
BACKGROUND AND AIMS: Exercise-induced inspiratory symptoms (EIIS) have multiple causes, one of which is exercise-induced laryngeal obstruction (EILO). There is limited knowledge regarding EIIS in children, both in primary care practices and in pediatric asthma clinics. The aim of this study was to describe the feasibility of a diagnostic methodology and its results in a cohort of children with EIIS referred to our tertiary pediatric pulmonary center. METHODS: This study analyzed consecutively collected data in children from East Denmark and Greater Copenhagen referred during a 3½ years period...
November 2016: Pediatric Pulmonology
Emil Schwarz Walsted, James H Hull, Asger Sverrild, Celeste Porsbjerg, Vibeke Backer
INTRODUCTION: Exercise-induced laryngeal obstruction (EILO) is a key differential diagnosis for asthma in the presence of exertional respiratory symptoms. Continuous laryngoscopy during exercise (CLE), the current gold standard diagnostic test for EILO, has practical limitations. We aimed to establish if inspiratory flow data obtained during standard bronchoprovocation testing, to establish the presence of extra-thoracic hyper-responsiveness, may prove diagnostic for EILO and thus preclude requirement for CLE testing...
January 2, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Enrico Heffler, Matteo Bonini, Luisa Brussino, Paolo Solidoro, Giuseppe Guida, Monica Boita, Giuliana Nicolosi, Caterina Bucca
Exercise-induced dyspnea is common among adolescents and young adults and often originates from exercise-induced bronchoconstriction (EIB). Sometimes, dyspnea corresponds to exercise-induced laryngospasm (EILO), which is a paradoxical decrease in supraglottic/glottic area. Vitamin D deficiency, which occurs frequently at northern latitudes, might favor laryngospasm by impairing calcium transport and slowing striate muscle relaxation. The aim of this study was to evaluate whether vitamin D status has an influence on bronchial and laryngeal responses to exercise in young, healthy athletes...
July 2016: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
Camilla Slot Mehlum, Emil Schwarz Walsted, Christian Godballe, Vibeke Backer
Breathing difficulties during exertion may be caused by exercise-induced laryngeal obstruction (EILO). The diagnosis depends on visualization of the larynx during exercise, i.e. by continuous laryngoscopic exercise (CLE) test. In case of severe supraglottic collapse and pronounced symptoms during strenuous exertion, surgical treatment (supraglottoplasty) has been suggested. The aims of this study were to evaluate outcome and patient satisfaction after supraglottoplasty for EILO and to compare our results with previously reported data...
April 2016: European Archives of Oto-rhino-laryngology
Henrik Johansson, Katarina Norlander, Lars Berglund, Christer Janson, Andrei Malinovschi, Lennart Nordvall, Leif Nordang, Margareta Emtner
BACKGROUND: Exercise-induced respiratory symptoms are common among adolescents. Exercise is a known stimulus for transient narrowing of the airways, such as exercise-induced bronchoconstriction (EIB) and exercise-induced laryngeal obstruction (EILO). Our aim was to investigate the prevalence of EIB and EILO in a general population of adolescents. METHODS: In this cross-sectional study, a questionnaire on exercise-induced dyspnoea was sent to all adolescents born in 1997 and 1998 in Uppsala, Sweden (n=3838)...
January 2015: Thorax
B Panchasara, C Nelson, R Niven, S Ward, J H Hull
Exercise-induced laryngeal obstruction (EILO) is a key differential diagnosis for unexplained dyspnoea in athletes. The gold standard means for diagnosis of EILO is direct laryngoscopy, performed continuously, while an athlete undertakes the specific sport that precipitates their symptoms. This report provides the first descriptions of rowing-associated EILO in two competitive rowers presenting with unexplained dyspnoea and cough. The report describes the methodology and safety of the use of continuous laryngoscopy in the context of maximal rowing ergometry and the use of this technique as a therapeutic tool to provide biofeedback...
January 2015: Thorax
Ola Drange Røksund, John-Helge Heimdal, Jan Olofsson, Robert Christiaan Maat, Thomas Halvorsen
Exercise-induced shortness of breath is not uncommon in otherwise healthy young people. Based on the presenting symptoms alone, it is challenging to distinguish exercise-induced asthma (EIA) from exercise-induced obstruction of central airways, sometimes leading to diagnostic errors and inadequate treatment. Central airway obstruction usually presents with exercise-induced inspiratory symptoms (EIIS) during ongoing exercise. EIIS tends to peak towards the end of an exercise session or immediately after its completion, contradicting symptoms of EIA typically peaking 3-15 min after the exercise has stopped...
September 2015: European Archives of Oto-rhino-laryngology
S Miller, M Jungheim, C Schwemmle, S Schoof, M Ptok
UNLABELLED: Inducible Laryngeal Obstruction vs. Bronchial -Asthma Background: Inducible laryngeal obstructions (ILO) represent paroxysmal and sometimes severe dyspnea caused by different factors. Symptomatically ILO resembles bronchial asthma and is therefore often misdiagnosed. In the following 3 cases regarding a special type of ILO, the exercise induced laryngeal obstruction (EILO) will be presented. It will also be demonstrated, how EILO can be diagnosed and differentiated from bronchial asthma...
October 2014: Laryngo- Rhino- Otologie
Cecilie Kyrø, Anja Olsen, Rikard Landberg, Guri Skeie, Steffen Loft, Per Åman, Max Leenders, Vincent K Dik, Peter D Siersema, Tobias Pischon, Jane Christensen, Kim Overvad, Marie-Christine Boutron-Ruault, Guy Fagherazzi, Vanessa Cottet, Tilman Kühn, Jenny Chang-Claude, Heiner Boeing, Antonia Trichopoulou, Christina Bamia, Dimitrios Trichopoulos, Domenico Palli, Vittorio Krogh, Rosario Tumino, Paolo Vineis, Salvatore Panico, Petra H Peeters, Elisabete Weiderpass, Toril Bakken, Lene Angell Åsli, Marcial Argüelles, Paula Jakszyn, María-José Sánchez, Pilar Amiano, José María Huerta, Aurelio Barricarte, Ingrid Ljuslinder, Richard Palmqvist, Kay-Tee Khaw, Nick Wareham, Timothy J Key, Ruth C Travis, Pietro Ferrari, Heinz Freisling, Mazda Jenab, Marc J Gunter, Neil Murphy, Eilo Riboli, Anne Tjønneland, H B as Bueno-de-Mesquita
BACKGROUND: Few studies have investigated the association between whole-grain intake and colorectal cancer. Because whole-grain intake estimation might be prone to measurement errors, more objective measures (eg, biomarkers) could assist in investigating such associations. METHODS: The association between alkylresorcinols, biomarkers of whole-grain rye and wheat intake, and colorectal cancer incidence were investigated using prediagnostic plasma samples from colorectal cancer case patients and matched control subjects nested within the European Prospective Investigation into Cancer and Nutrition...
January 2014: Journal of the National Cancer Institute
Pernille M Christensen, Niels Rasmussen
Exercise-induced laryngeal obstructions (EILOs) cause exercise-related respiratory symptoms (ERRS) and are important differential diagnoses to exercise-induced asthma. The diagnostic method for EILOs includes provocation to induce the obstruction followed by a verification of the obstruction and the degree thereof. The objective of the present study was to examine if a eucapnic voluntary hyperventilation (EVH) test could induce laryngeal obstructions laryngoscopically identical in subtypes and development as seen during an exercise test...
November 2013: European Archives of Oto-rhino-laryngology
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