Perceptual Clinical Features in Exercise-Induced Laryngeal Obstruction (EILO): Toward Improved Diagnostic Approaches.
Adrianna C Shembel, Christopher J Hartnick, Glenn Bunting and 4 others
PMID 30195411WHAT IT FOUND
In adolescents with exercise-induced laryngeal obstruction, dyspnea ratings during exercise were significantly higher than in healthy athletes, but stridor and throat tightness were not.
All athletes get breathless with exertion, so breathlessness alone is not diagnostic.
Key findings
01Participants with confirmed EILO reported significantly greater inspiratory and expiratory dyspnea severity during exercise compared to controls, though they also had higher ratings at rest for expiratory dyspnea.
02Self-reported stridor and throat tightness increased with exercise in both groups, but there were no significant differences between the EILO and control groups at baseline or during exercise.
03Stress reactivity scores, measured by the EATQ-R Fear subscale, showed no significant difference between athletes with EILO and competitive athletes without the condition.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was very small (12 participants with confirmed EILO), limiting the generalizability of the findings. The study used a circular diagnostic approach where participants were recruited based on suspected EILO and then confirmed via the same symptom-reporting mechanism used in the analysis. The comparison was only against healthy competitive athletes, not against other conditions that mimic EILO such as asthma or muscle tension dysphonia. Symptom severity benchmarks (e.g., >30/100 for inspiratory dyspnea) are preliminary and require validation in larger cohorts.
Declared interests
The authors declare no conflicts of interest. The study was conducted at the Massachusetts Eye and Ear Voice and Speech Laboratory.
The easy way to misread this
Do not assume that the presence of stridor or throat tightness during exercise confirms EILO. These symptoms were common in healthy athletes as well and did not statistically distinguish the two groups.