Exercise challenge test on a cycle ergometer: preparation and procedure.

What the test shows.

The exercise challenge test is a standardised test of whether hard exercise makes your airways narrow. It reproduces your own trigger.

How to prepare.

• Important information about your medication: only pause if the clinic has asked you to. If the clinic has given you instructions, follow them, and call if you are in doubt.
• Medication pause (the clinic's standard): short-acting reliever (e.g. salbutamol): 8 hours · long-acting beta2 agonist (e.g. formoterol, salmeterol): 36–48 hours · ultra-long-acting beta2 agonist (e.g. vilanterol, indacaterol): 48 hours · ipratropium (e.g. Atrovent): 12 hours · long-acting anticholinergic (e.g. tiotropium): 7 days · antihistamine (allergy medication): 3 days · inhaled corticosteroid and montelukast: as agreed with the clinic.
• Avoid strenuous exercise in the last 4 hours and caffeine (coffee, tea, cola, energy drinks) on the day of the test, smoking/nicotine in the last hour and a large meal in the last 2 hours.
• An airway infection within the last 2–4 weeks: please call and move the appointment.
• Come in sports clothes and shoes you can cycle in.

Duration

The test itself takes about 45 minutes. Expect up to two hours at the clinic in total.

How it is done.

First, spirometry. You then cycle for about 8 minutes on the cycle ergometer, where the load is increased quickly, so you work very hard for the last 6 minutes, and you breathe dry air through a mouthpiece. Your pulse is measured during the test. Afterwards your lung function is measured repeatedly for up to 30 minutes.

After the test

If the test is positive, if your lung function has not recovered by the last measurement, or if you have symptoms, you are given airway-opening medication and measured again after 10 minutes.

Side effects

You become out of breath and tired, as after hard training. Coughing and chest tightness can occur.

When the test cannot be done.

The test cannot be done during pregnancy or with severely reduced lung function, a heart attack or stroke within the last 3 months, uncontrolled high blood pressure or a known aneurysm (a bulge on an artery). Tell us if you have heart problems or chest pain on exertion.

Your result

The result is available straight after the test and is reviewed with you before you leave.

What to bring

• Bring ID, for example your health insurance card or driving licence (app versions also count) or your passport. Your CPR number alone is no longer enough.
• Bring an up-to-date medication list and any earlier lung function measurements.
• Always bring your reliever inhaler.
• Arrive in good time, so you are not out of breath when we start.

Background and sources

• The clinic's own source for medication pauses and preparation (version 20-10-2026).
• Hallstrand TS et al. ERS technical standard on bronchial challenge testing: pathophysiology and methodology of indirect airway challenge testing. Eur Respir J 2018;52:1801033.

Asthma testing