Endowed Chair: Exercise Respiratory Center (ExRC) led by John Robertson, M.D.
Cook Children's has awarded John Robertson, M.D., an Endowed Chair for pioneering the Exercise Respiratory Center that specializes in maximal exercise exertion with simultaneous airway, respiratory and cardiovascular evaluation. Approximately 15% of adolescents in the general population and 20% of adolescent athletes experience disproportionate breathlessness during exercise. Many of these patients suffer from asthma or exercise-induced bronchoconstriction. However, for those who do not, the path to an accurate diagnosis and successful treatment can be long and cumbersome. Many of them struggle to perform at their best in sports and drastically reduce physical activity. The Exercise Respiratory Center specializes in assessing, treating, and researching conditions such as exercised-induced laryngeal obstruction (EILO) and dysfunctional breathing (DB), that can often be missed by traditional evaluations. This comprehensive approach uncovers the root cause(s) of symptoms detectable only during exercise. Cook Children's Exercise Respiratory Center is one of only three pediatric centers nationwide with the ability to evaluate the upper and lower airway continuously during high-intensity exercise. Our research will help keep children and adolescents healthy, active and performing at their best.


Meet Dr. Robertson
Dr. Robertson is dedicated to helping young athletes with exercise-induced laryngeal obstruction (EILO) breathe easier, enabling their safe return to their beloved sports.
Continuous laryngoscopy during exercise (CLE) testing: One of only three pediatric centers nationwide offering this test. It’s the gold standard for diagnosing exercise-induced laryngeal obstruction (EILO)
- First pediatric CLE in Texas on February 8, 2022.
- First pediatric continuous laryngoscopy during provocation (CLP) in Texas
on May 29, 2024. - First pediatric continuous bronchoscopy during exercise (CBE) on August 14, 2024. Create and optimize a single exercise testing protocol for the diagnosis of EILO, Dysfunctional Breathing (DB) and Exercise-Induced Bronchoconstriction (EIB)
Innovation
- Develop and validate a wearable sensor array for the evaluation of breathing patterns during real-world exercise in the field.
- Investigate the effect of prior exercise on EILO, DB and perceived breathlessness during subsequent exercise.
- Study the effect of inhaled Ipratropium Bromide on perceived breathlessness and EILO
- Build a comprehensive integrated treatment program for EILO and DB with the use of speech therapy, physical therapy and medication.
- Collaborate internationally to develop AI and machine learning technology to improve the accuracy of diagnosis and response to treatment in EILO patients.
- Study the relationship between dysfunctional breathing and EILO using state of the art motion capture technology.
- Discover the relationship between EILO and comorbid conditions including hypersensitive larynx, dysautonomia, asthma and mental health conditions
Collaboration
- Design improvements for CLE headgear for future commercial application.
- Develop continuing education resources for pediatricians to increase recognition and understanding of exercise induced breathing symptoms.
- Collaborate internationally to advance the diagnosis and treatment of DB using optoelectronic plethysmography and biofeedback technology.
- Brovina R, Robertson JM, and Kreutzer A (2025). "Estimating Minute Ventilation and Inspiratory Flow to Trigger Exercise-Induced Laryngeal Obstruction (EILO) in Pediatric Patients," International Journal of Exercise Science: Conference Proceedings: Vol. 2: Iss. 17, Article 89. Available at: https://digitalcommons.wku.edu/ijesab/vol2/iss17/89
- Kreutzer A, Brovina R, and Robertson JM. Minimum Minute Ventilation to Trigger Exercise-Induced Laryngeal Obstruction (EILO). Cook Research Symposium 2025
- Kreutzer A, Brovina R, Lim D, and Robertson JM. Continuous Bronchoscopy during Exercise in a Pediatric Patient: A Case Report. American Physiology Summit 2025
- Brovina R, Kreutzer A, Lim D, and Robertson JM. Continuous Bronchoscopy during Exercise in a Pediatric Patient: A Case Report. Cook Research Symposium 2025
- Brovina R, Robertson JM, and Kreutzer A (2025). "Estimating Minute Ventilation and Inspiratory Flow to Trigger Exercise-Induced Laryngeal Obstruction (EILO) in Pediatric Patients," International Journal of Exercise Science: Conference Proceedings: Vol. 2: Iss. 17, Article 89. Available at: https://digitalcommons.wku.edu/ijesab/vol2/iss17/89
Meet our researchers

Rebecca Brovina
I was born and raised in North Texas receiving my Bachelor of Science in Nursing at Texas Woman's University in 2018. I worked as a bedside nurse for six years in chronic care, acute care and critical care. I joined Cook Children's PICU as a charge nurse in 2022 with the opening of Cook Children's Medical Center - Prosper campus. In the Fall of 2023, I began my master's degree in health sciences at the University of Texas at Tyler. In May of 2024, I began my position as a research nurse coordinator with John Robertson, M.D., at the Exercise Respiratory Center in Prosper, Texas researching exercise induced laryngeal obstruction (EILO) and dysfunctional breathing. I also work with Lauren Akers, D.O.

Andy Kreutzer
I was born and raised in Germany. In 2009, I moved to Boise, ID, where I completed my undergrad degree at Boise State University and met my wife. We moved to Fort Worth, TX for grad school in 2012. I earned my master's degree and PhD in Exercise Physiology from Texas Christian University. Between the graduate degrees, I worked in the Pulmonary Physiology Lab at the Institute for Exercise and Environmental Medicine in Dallas, TX. During my PhD, I worked as a Laboratory Coordinator and Instructor for the Kinesiology Department at TCU, where I was involved in research projects ranging from sport and exercise performance to athlete and general population health. After a one-year appointment as a Visiting Assistant Professor at Texas Woman's University in Denton, TX, I joined Cook Children's as a Research Scientist in 2023. Here, I work with Dr. John Robertson at the Exercise Respiratory Center in Prosper, TX, where we research Exercise Induced Laryngeal Obstruction (EILO) and Dysfunctional Breathing. In my free time, I enjoy spending time with my wife and two daughters and our dog.
Related information
- Treating and Researching Exercise-Induced Laryngeal Obstruction | Cook Children's
- Exercise-Induced Laryngeal Obstruction (EILO) | Cook Children's
- Exercise Respiratory Center (ExRC) | Cook Children's
- Pulmonology | Cook Children's
- Investigator Initiated Research | Cook Children's
- Rehabilitation | Sports Physical Therapy | Cook Children's
- Rehabilitation | Speech Therapy | Cook Children's
- Health Professionals | Clinical Research | Cook Children's
- Health Professionals | Clinical Research | Endowed Chair | Cook Children's
- Health Professionals | Clinical Research | Active Research Projects | Cook Children's
- Health Professionals | Clinical Pathways | Cook Children's
- Treating and Researching Exercise-Induced Laryngeal Obstruction | Cook Children's
Support this research
Help kids get back to breathing easier. Support our research to find out what causes respiratory symptoms and be part of this innovative and life-changing work at Cook Children's. Donate to Cook Children's Endowed Chair today.