The free running asthma test: A useful tool in pediatric asthma assessment?

Pulmonary function tests are difficult to perform in primary care settings. Physicians have peak flow debimeter but not a spirometer and many of them are not trained. Free running asthma test (FRAT) is a helpful simple tool in screening asthma in children. We aimed to evaluate its usefulness in the assessment of pediatric asthma control. We conducted a prospective study that included asthmatic children(< 12 years old) between March 2023 and December 2023. All children underwent a Child-Asthma Control test questionnaire (C-ACT), spirometry and a 6-minute free-running asthma test. The FRAT measured peak expiratory flow rate (PEFR) before and at 1, 5, and 10 minutes after maximum voluntary running for at least 6 minutes. A fall in PEFR of greater than 15% in at least two post-exercise readings defined a positive test. Seventy-two children were included, among them, 38 were boys (52,8%). The mean age was 8.1±2.4years [4-12]. Asthma was allergic in 69% of cases. The FRAT was positive in 33.3% of patients. Fifteen were admitted for asthma exacerbation(20.8%). A fall in PEEFR in FRAT was more seen in children with uncontrolled asthma according to the C-ACT score (p<0.001). A history of acute severe asthma was more frequent in children with a positive FRAT (p=0.007). Children who practise sports were more likely to have a negative FRAT (p=0.013). An increase of FEV1 >12% after bronchodilatation test was associated with a positive FRAT (p=0.006). A simple free-running asthma test could help clinicians in primary care identify children with a risk of bad outcomes.