Figures
- FIGURE 1
a) Continuous laryngoscopy exercise testing setup: the test subject exercises on a stationary ergometer bicycle with a laryngoscope in situ, fastened to specialist headgear. The subject performs an incremental-load exercise test to volitional maximum, while laryngoscopic recordings are saved for subsequent review. Note the laryngoscopic image on-screen showing a healthy larynx anatomy during inspiration. b) Laryngoscopic image (anonymised), taken during inspiration of an individual with supraglottic exercise-induced laryngeal obstruction (EILO), i.e. medial collapse of the arytenoid and aryepiglottic mucosa. The vocal folds are not affected. c) Laryngoscopic image, taken during inspiration of an individual with glottic EILO, i.e. a medial movement of the vocal folds.
- FIGURE 2
Age distribution in individuals with exercise-induced laryngeal obstruction, overall and by centre. Top row: overall; middle row: adult/mixed respiratory centres; bottom row: paediatric respiratory centres. DK: Denmark.
- FIGURE 3
Overall sex distribution by age for individuals with confirmed exercise-induced laryngeal obstruction.
- FIGURE 4
a) Exercise-induced laryngeal obstruction (EILO) subtype overall and by centre. b) EILO subtypes by age, overall. DK: Denmark.
- FIGURE 5
Kernel density estimation plots depicting the distribution of age and symptom duration in individuals with exercise-induced laryngeal obstruction (EILO) by centre. Symptom duration data from Rigshospitalet, Denmark (DK) were not available.
- FIGURE 6
Treatment approaches utilised for exercise-induced laryngeal obstruction. Exercise: physical exercise to improve fitness encouraged/prescribed.
Tables
- TABLE 1
Demographics of individuals with continuous laryngoscopy during exercise
General/adult respiratory services Paediatric respiratory services Bispebjerg Hospital (DK) Royal Brompton Hospital (UK) Cayuga Medical Center (USA) Aarhus University Hospital Skejby (DK) Rigshospitalet (DK) Total Subjects n 446 240 93 139 89 1007 Age years 24 (9–72) 32 (12–76) 17 (9–70) 13 (8–24) 14 (8–17) 24 (8–76) Female/male n (% female) 304/142 (68) 172/68 (71) 70/23 (75) 110/29 (79) 57/32 (64) 713/294 (71) Body mass index kg·m−2 23.2±3.7 24.8±5.0 22.5±3.8 19.8±3.1 20.1±2.6 22.8±15.1 EILO 218 (49) 156 (65) 60 (65) 111 (80) 41 (46) 586 (58) Asthma 233 (52) 82 (34) 13 (14) 46 (33) 23 (26) 397 (39) EILO and asthma 111 (25) 54 (22) 9 (10) 34 (24) 5 (6) 213 (21) Athlete status Non-competitive 238 (53) 32 (13) 15 (16) 102 (73) 64 (72) 451 (45) Competitive 75 (17) 80 (33) 69 (74) 28 (20) 15 (17) 267 (26) National/international level 111 (25) 21 (9) 7 (8) 9 (6) 10 (11) 158 (16) Unclassifiable 22 (5) 107 (45) 2 (2) 0 (0) 0 (0) 133 (13) Data are presented as median (range), mean±sd or n (%), unless otherwise stated. DK: Denmark: EILO: exercise-induced laryngeal obstruction.
- TABLE 2
Characteristics of individuals with and without exercise-induced laryngeal obstruction (EILO)
Total EILO No EILO p-value Subjects n 1007 586 421 Age years 24 (8–76) 21 (8–76) 27.5 (8–75) <0.001 Female/male n (% female) 713/295 (71) 444/142 (76) 269/152 (64) <0.001 Body mass index kg·m−2 22.8±15.1 22.2±14.9 23.9±15.7 0.08 Asthma 398 (39) 213 (36) 185 (44) 0.02 Athlete status Non-competitive 451 (45) 239 (41) 212 (50) <0.001 Competitive 267 (26) 192 (33) 75 (18) National/international level 158 (16) 91 (16) 67 (16) Unclassifiable 133 (13) 64 (11) 67 (16) Data are presented as median (range), mean±sd or n (%), unless otherwise stated.
- TABLE 3
Demographics of individuals with exercise-induced laryngeal obstruction (EILO)
General/adult respiratory services Paediatric respiratory services Total Bispebjerg Hospital (DK) Royal Brompton Hospital (UK) Cayuga Medical Center (USA) Aarhus University Hospital Skejby (DK) Rigshospitalet (DK) Subjects n 218 156 60 111 41 586 Age median years (range) 21 (9–59) 28 (12–76) 16 (9–50) 13 (8–24) 13 (8–17) 21 (8–76) Female/male n (% female) 160/58 (73) 122/34 (78) 50/10 (83) 89/22 (80) 23/18 (56) 444/142 (76) Body mass index kg·m−2 22.9±4.0 23.7±4.3 21.9±3.3 19.5±2.9 19.6±2.4 22.2±14.9 Asthma 111 (51) 54 (35) 9 (15) 34 (31) 5 (12) 213 (36) EILO Supraglottic predominant 110 (50) 119 (76) 14 (23) 92 (83) 19 (46) 354 (60) Glottic predominant 67 (31) 14 (9) 7 (12) 4 (4) 7 (17) 99 (18) Glottic and supraglottic 41 (19) 11 (7) 39 (65) 15 (14) 8 (20) 114 (19) Other 0 (0) 12 (8) 0 (0) 0 (0) 7 (17) 19 (3) Duration of EILO symptoms 24 (1–216) 24 (0–420) 22 (1–120) 24 (1–84) # 24 (0–420) Asthma Discontinued asthma medication 30 (14) 15 (9) 8 (13) 30 (27) 36 (88) 119 (20) Former or current asthma medication 51 (23) 16 (10) 20 (33) 41 (37) 36 (88) 164 (28) Sports Top five sports % EILO positive Running (19)
Swimming (13)
Cycling (11)
Soccer (6)
Fitness (5)Running (17)
Cycling (9)
Swimming (6)
Rowing (6)
Triathlon (3)Running (32)
Basketball (20)
Swimming (15)
Soccer (15)
Lacrosse (12)Handball (27)
Soccer (18)
Swimming (10)
Gymnastics (5)
Badminton (5)Soccer (15)
Handball (10)
Swimming (7)
Running (5)
Basketball (5)Running (15) Swimming (10)
Soccer (8)
Cycling (6)
Handball (6)Data are presented as median (range), mean±sd or n (%), unless otherwise stated. DK: Denmark; #: no data were available on symptom duration.
