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Burahmah E, Shanmugam S, Stansfield B. Full-Day Physical Activity and Sedentary Behaviour Levels of Typically Developing Children and Adolescents in the Middle East: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6940. [PMID: 37887678 PMCID: PMC10606092 DOI: 10.3390/ijerph20206940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/29/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
Physical activity (PA) and sedentary behaviour (SB) are important components of physical behaviour associated with long-term health outcomes. Environmental and cultural factors may influence physical behaviour. To explore full day PA and SB in children and adolescents (2-18 years old) in the Middle East, a systematic literature review was performed including 183 journal articles. A wide range of PA and SB outcomes were reported, in some cases making synthesis of results difficult. As a consequence, results were generally reported narratively (MVPA time, total PA, SB time). Meta-regression of daily step count revealed females took 4600 fewer steps than males, with 3000 fewer steps on weekdays than weekends, and overweight individuals taking 2800 fewer steps/day. Steps decreased with age. Meta-regression for TV viewing time demonstrated an increase by 0.04 h per year of age. Even though environmental and cultural conditions may be different, PA and SB of children and adolescents in the Middle East were largely comparable to those of Europeans and North Americans. The wide range of data collection instruments used (both self-report questionnaire and body-worn devices) and heterogeneity of data made synthesis of reported data across studies very difficult, suggesting a need for greater standardisation of data collection methods.
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Affiliation(s)
| | | | - Ben Stansfield
- School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK; (E.B.); (S.S.)
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2
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Brons A, Braam K, Broekema A, Timmerman A, Millenaar K, Engelbert R, Kröse B, Visser B. Translating Promoting Factors and Behavior Change Principles Into a Blended and Technology-Supported Intervention to Stimulate Physical Activity in Children With Asthma (Foxfit): Design Study. JMIR Form Res 2022; 6:e34121. [PMID: 35877162 PMCID: PMC9361148 DOI: 10.2196/34121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 11/28/2022] Open
Abstract
Background Children with asthma can decrease the impact of their disease by improving their physical activity (PA). However, health care providers lack interventions for children with asthma that effectively increase their PA levels and achieve behavior change. A technology-supported approach can positively influence PA and physical functioning in children. Objective The aims of this study were to develop a technology-supported intervention that facilitates health care providers in promoting PA for children (aged 8 to 12 years) with asthma and to systematically describe this developmental process. Methods Intervention mapping (IM) was applied to develop a blended and technology-supported intervention in cocreation with children with asthma, their parents, and health care providers. In accordance with the IM framework, the following steps were performed: conduct a needs assessment; define the intervention outcome, performance objectives, and change objectives; select theory-based intervention methods and strategies; create components of the intervention and conduct pilot tests; create an implementation plan; and create an evaluation plan. Results We developed the blended intervention Foxfit that consists of an app with a PA monitor for children (aged 8 to 12 years) with asthma and a web-based dashboard for their health care provider. The intervention focuses on PA in everyday life to improve social participation. Foxfit contains components based on behavior change principles and gamification, including goal setting, rewards, action planning, monitoring, shaping knowledge, a gamified story, personal coaching and feedback, and a tailored approach. An evaluation plan was created to assess the intervention’s usability and feasibility for both children and health care providers. Conclusions The IM framework was very useful for systematically developing a technology-supported intervention and for describing the translational process from scientific evidence, the needs and wishes of future users, and behavior change principles into this intervention. This has led to the technology-supported intervention Foxfit that facilitates health care providers in promoting PA in children with asthma. The structured description of the development process and functional components shows the way behavior change techniques are incorporated in the intervention. Trial Registration International Clinical Trial Registry Platform NTR6658; https://tinyurl.com/3rxejksf
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Affiliation(s)
- Annette Brons
- Digital Life Center, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
- Department of Information and Computing Sciences, Utrecht University, Utrecht, Netherlands
| | - Katja Braam
- Centre of Expertise Urban Vitality, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, Netherlands
| | - Aline Broekema
- Centre of Expertise Urban Vitality, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
| | | | - Karel Millenaar
- Play and Civid Media, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
| | - Raoul Engelbert
- Centre of Expertise Urban Vitality, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
- Department of Rehabilitation, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Ben Kröse
- Digital Life Center, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
- Department of Computer Science, University of Amsterdam, Amsterdam, Netherlands
| | - Bart Visser
- Centre of Expertise Urban Vitality, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
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3
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Kouis P, Michanikou A, Anagnostopoulou P, Galanakis E, Michaelidou E, Dimitriou H, Matthaiou AM, Kinni P, Achilleos S, Zacharatos H, Papatheodorou SI, Koutrakis P, Nikolopoulos GK, Yiallouros PK. Use of wearable sensors to assess compliance of asthmatic children in response to lockdown measures for the COVID-19 epidemic. Sci Rep 2021; 11:5895. [PMID: 33723342 PMCID: PMC7971022 DOI: 10.1038/s41598-021-85358-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 02/18/2021] [Indexed: 02/07/2023] Open
Abstract
Between March and April 2020, Cyprus and Greece health authorities enforced three escalated levels of public health interventions to control the COVID-19 pandemic. We quantified compliance of 108 asthmatic schoolchildren (53 from Cyprus, 55 from Greece, mean age 9.7 years) from both countries to intervention levels, using wearable sensors to continuously track personal location and physical activity. Changes in 'fraction time spent at home' and 'total steps/day' were assessed with a mixed-effects model adjusting for confounders. We observed significant mean increases in 'fraction time spent at home' in Cyprus and Greece, during each intervention level by 41.4% and 14.3% (level 1), 48.7% and 23.1% (level 2) and 45.2% and 32.0% (level 3), respectively. Physical activity in Cyprus and Greece demonstrated significant mean decreases by - 2,531 and - 1,191 (level 1), - 3,638 and - 2,337 (level 2) and - 3,644 and - 1,961 (level 3) total steps/day, respectively. Significant independent effects of weekends and age were found on 'fraction time spent at home'. Similarly, weekends, age, humidity and gender had an independent effect on physical activity. We suggest that wearable technology provides objective, continuous, real-time location and activity data making possible to inform in a timely manner public health officials on compliance to various tiers of public health interventions during a pandemic.
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Affiliation(s)
- Panayiotis Kouis
- Respiratory Physiology Laboratory, Medical School, Shacolas Educational Center of Clinical Medicine, University of Cyprus, Palaios Dromos Lefkosias-Lemesou 215/6, 2029, Aglantzia, Nicosia, Cyprus
| | - Antonis Michanikou
- Respiratory Physiology Laboratory, Medical School, Shacolas Educational Center of Clinical Medicine, University of Cyprus, Palaios Dromos Lefkosias-Lemesou 215/6, 2029, Aglantzia, Nicosia, Cyprus
| | - Pinelopi Anagnostopoulou
- Respiratory Physiology Laboratory, Medical School, Shacolas Educational Center of Clinical Medicine, University of Cyprus, Palaios Dromos Lefkosias-Lemesou 215/6, 2029, Aglantzia, Nicosia, Cyprus
- Institute of Anatomy, University of Bern, Bern, Switzerland
| | | | | | - Helen Dimitriou
- Medical School, University of Crete, Heraklion, Crete, Greece
| | - Andreas M Matthaiou
- Respiratory Physiology Laboratory, Medical School, Shacolas Educational Center of Clinical Medicine, University of Cyprus, Palaios Dromos Lefkosias-Lemesou 215/6, 2029, Aglantzia, Nicosia, Cyprus
| | - Paraskevi Kinni
- Respiratory Physiology Laboratory, Medical School, Shacolas Educational Center of Clinical Medicine, University of Cyprus, Palaios Dromos Lefkosias-Lemesou 215/6, 2029, Aglantzia, Nicosia, Cyprus
| | - Souzana Achilleos
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | | | - Stefania I Papatheodorou
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard TH Chan School of Public Health, Harvard University, Boston, USA
| | | | - Panayiotis K Yiallouros
- Respiratory Physiology Laboratory, Medical School, Shacolas Educational Center of Clinical Medicine, University of Cyprus, Palaios Dromos Lefkosias-Lemesou 215/6, 2029, Aglantzia, Nicosia, Cyprus.
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4
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Mackintosh KA, McNarry MA, Berntsen S, Steele J, Sejersted E, Westergren T. Physical activity and sedentary time in children and adolescents with asthma: A systematic review and meta-analysis. Scand J Med Sci Sports 2021; 31:1183-1195. [PMID: 33576534 DOI: 10.1111/sms.13937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/27/2021] [Accepted: 02/08/2021] [Indexed: 12/18/2022]
Abstract
The influence of asthma on physical activity (PA) in youth remains equivocal. This review synthesizes the evidence regarding the influence of asthma on PA and sedentary time and evaluates the role of key moderators for this relationship. In accordance with PRISMA guidelines, six electronic databases and gray literature were searched. Primary studies in English were included if they reported device-assessed PA in youth with and without asthma. Random effects meta-analyses examined the effect of asthma on PA and, separately, sedentary time. Mixed-effect meta-regression analyses were conducted using age and sex as moderators, with sub-group comparisons for study quality and asthma diagnosis criteria. Overall, of 3944 citations retrieved, 2850 were screened after the removal of supplication and 2743 citations excluded. Of the 107 full-text publications reviewed, 16 were included in data extraction and analysis, with 15 and five studies included in the PA and sedentary time meta-analyses, respectively. The robust effect size estimate for the influence of asthma on PA and sedentary time was -0.04 [95% CI = -0.11, 0.03] and -0.09 [95% CI = -0.12, -0.06], indicating a non-significant and significant trivial effect, respectively. The effect of asthma on PA levels or sedentary time was not associated with age or sex. Youth with controlled asthma are equally physically (in)active as their healthy peers, with asthma associated with less sedentary time. However, methodological limitations and a paucity of clear methodological reporting temper these conclusions. More rigorous device-based assessments, with a particular focus on sedentary time, and more robust diagnoses of asthma, especially with regard to severity, are needed.
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Affiliation(s)
| | | | - Sveinung Berntsen
- Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
| | - James Steele
- School of Sport, Health and Social Sciences, Solent University, Southampton, UK.,Ukactive Research Institute, London, UK
| | - Ellen Sejersted
- University Library, University of Agder, Kristiansand, Norway
| | - Thomas Westergren
- Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
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5
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van der Kamp MR, Thio BJ, Tabak M, Hermens HJ, Driessen J, van der Palen J. Does exercise-induced bronchoconstriction affect physical activity patterns in asthmatic children? J Child Health Care 2020; 24:577-588. [PMID: 31607144 DOI: 10.1177/1367493519881257] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Exercise-induced bronchoconstriction (EIB) is a sign of uncontrolled childhood asthma and classically occurs after exercise. Recent research shows that EIB frequently starts during exercise, called breakthrough-EIB (BT-EIB). It is unknown whether this more severe type of EIB forces children to adapt their physical activity (PA) pattern in daily life. Therefore, this pilot study aims to investigate daily life PA (amount, intensity, duration, and distribution) in children with BT-EIB, 'classic' EIB, and without EIB. A Fitbit Zip activity tracker was used for one week to objectively measure daily life PA at one-minute intervals. Thirty asthmatic children participated. Children with BT-EIB were less physically active compared to children without EIB (respectively 7994 and 11,444 steps/day, p = .02). Children with BT-EIB showed less moderate-to-vigorous PA compared to the children without (respectively 117 and 170 minutes/day, p = .02). Children with EIB (both BT and classic) had significant shorter bouts of activity and a less stretched distribution of bout lengths compared to the non-EIB group (all p < .05). These results emphasize a marked association between EIB severity and PA patterns in daily life, stressing the need for a thorough clinical evaluation of exercise-induced symptoms in childhood asthma.
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Affiliation(s)
- M R van der Kamp
- Department of Pediatrics, Medisch Spectrum Twente, Enschede, Netherlands.,Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - B J Thio
- Department of Pediatrics, Medisch Spectrum Twente, Enschede, Netherlands.,Medical School Twente, Medisch Spectrum Twente, Enschede, Netherlands
| | - M Tabak
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands.,Roessingh Research and Development, Enschede, Netherlands
| | - H J Hermens
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands.,Roessingh Research and Development, Enschede, Netherlands
| | - Jmm Driessen
- OCON Sport, Ziekenhuisgroep Twente, Hengelo, Netherlands.,Department of Sports Medicine, Ziekenhuis Tjongerschans, Heerenveen, Netherlands
| | - Jam van der Palen
- Medical School Twente, Medisch Spectrum Twente, Enschede, Netherlands.,Department of Research Methodology, Measurement and Data Analysis, University of Twente, Enschede, Netherlands
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6
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Promoting Factors for Physical Activity in Children with Asthma Explored through Concept Mapping. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224467. [PMID: 31766299 PMCID: PMC6888103 DOI: 10.3390/ijerph16224467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 01/07/2023]
Abstract
For children with asthma, physical activity (PA) can decrease the impact of their asthma. Thus far, effective PA promoting interventions for this group are lacking. To develop an intervention, the current study aimed to identify perspectives on physical activity of children with asthma, their parents, and healthcare providers. Children with asthma between 8 and 12 years old (n = 25), their parents (n = 17), and healthcare providers (n = 21) participated in a concept mapping study. Participants generated ideas that would help children with asthma to become more physically active. They sorted all ideas and rated their importance on influencing PA. Clusters were created with multidimensional scaling and cluster analysis. The researchers labelled the clusters as either environmental or personal factors using the Physical Activity for people with a Disability model. In total, 26 unique clusters were generated, of which 17 were labelled as environmental factors and 9 as personal factors. Important factors that promote physical activity in children with asthma according to all participating groups are asthma control, stimulating environments and relatives, and adapted facilities suiting the child’s needs. These factors, supported by the future users, enable developing an intervention that helps healthcare providers to promote PA in children with asthma.
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7
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Parikh K, Paul J, Fousheé N, Waters D, Teach SJ, Hinds PS. Barriers and Facilitators to Asthma Care After Hospitalization as Reported by Caregivers, Health Providers, and School Nurses. Hosp Pediatr 2018; 8:706-717. [PMID: 30287588 DOI: 10.1542/hpeds.2017-0182] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To develop a comprehensive understanding of the barriers and/or facilitators for asthma management for the health professionals and caregivers of children with >1 hospitalization. METHODS Individual interviews were conducted with family caregivers and health professionals. Focus groups were conducted with school nurses. The interview and focus group guide were used to probe for barriers and facilitators of asthma management. Interviews were recorded, transcribed, and coded by using qualitative software. Themes were identified by using content analysis in the interviews and descriptive qualitative analysis in the focus groups. RESULTS Caregivers (n = 10), asthma educators (n = 4), physicians (n = 4), and a payer (n = 1) were individually interviewed. School nurses were interviewed via a focus group (n = 10). Children had a median age of 7 years, mean length of stay of 1.9 days, and 56% had a previous hospitalization in the previous 12 months. The "gaps in asthma knowledge" theme (which includes an inadequate understanding of asthma chronicity, activity restrictions, and management with controller medications) emerged as a theme for both caregivers and health professionals but with different health beliefs. School nurses reinforced the difficulty they have in managing children who have asthma in schools, and they identified using the asthma action plan as a facilitator. CONCLUSIONS Caregivers and health professionals have different health beliefs about asthma knowledge, which raises challenges in the care of a child who has asthma. In addition, school nurses highlight specific barriers that are focused on medication use in schools. A comprehensive understanding of the barriers and facilitators of asthma management that families experience after hospital discharge is crucial to design better efforts to support families.
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Affiliation(s)
- Kavita Parikh
- Pediatric Hospitalist Division, .,George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | | | | | | | - Stephen J Teach
- Children's Research Institute, and.,George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Pamela S Hinds
- Department of Nursing Science, Professional Practice and Quality, Children's National Health System, Washington, District of Columbia; and.,George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
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8
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Hennegrave F, Le Rouzic O, Fry S, Behal H, Chenivesse C, Wallaert B. Factors associated with daily life physical activity in patients with asthma. Health Sci Rep 2018; 1:e84. [PMID: 30623040 PMCID: PMC6266451 DOI: 10.1002/hsr2.84] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/09/2018] [Accepted: 07/20/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Little is known about the consequences of asthma on daily life physical activity (DLPA). The aim of this study was to evaluate DLPA and determine its relationship to clinical and functional parameters in patients with asthma. METHODS This was a single-center prospective study of DLPA conducted between May 2015 and June 2016 in northern France. Fifty-one adult patients with asthma and 36 healthy control subjects were enrolled. Four DLPA parameters were assessed for 5 consecutive days with a physical activity monitor: number of steps walked per day (SPD), total energy expenditure (EE, in kcal/day), EE spent in physical activity requiring ≥3 metabolic equivalents (METs), and time (min) spent in activities requiring ≥3 METs. Clinical characteristics, pulmonary function tests, 6-minute walk test, and four questionnaires (modified Medical Research Council [mMRC] for dyspnea, asthma control test [ACT], quality of life [AQLQ], and hospital anxiety and depression scale [HADS]), were evaluated. Comparisons of DLPA parameters between the two groups were performed using an analysis of covariance adjusted for age, sex, and body mass index (BMI). Relationships between DLPA parameters and patient characteristics were assessed in multivariable linear regression models. RESULTS Compared with patients with mild/moderate asthma, those with severe asthma had lower mean (± standard deviation) forced expiratory volume in 1 s (FEV1) (66 ± 24 vs 94 ± 15% predicted, P < 0.001), ACT score (16.7 ± 4.5 vs 19.8 ± 4.2, P = 0.015), and AQLQ score (157 ± 40 vs 184 ± 33, P = 0.012). There were no significant differences between the two groups in SPD (6560 ± 3915 vs 8546 ± 3431; adjusted P = 0.95), EE in physical activity requiring ≥3 METs (620 ± 360 vs 660 ± 140 kcal/day; P = 0.86), time spent in activities requiring EE ≥3 (120 ± 54 vs 121 ± 32 min/day; P = 0.69), or total EE (2606 ± 570 vs 2666 ± 551 kcal/day; P = 0.80). These four DLPA measures showed strong inter-parameter correlations in patients with asthma (r = 0.37-0.95, all P < 0.01). All four parameters were lower in the patients with asthma group than in the control group: SPD, 7651 ± 3755 vs 11704 ± 4054 (adjusted P < 0.001); EE in activities requiring ≥3 METs, 642 ± 360 vs 852 ± 374 kcal/day (adjusted P = 0.041); time spent in activities requiring ≥3 EE, 120 ± 73 vs 189 ± 85 min (adjusted P = 0.005); and total EE, 2639 ± 555 vs 2746 ± 449 kcal/day (adjusted P = 0.007). In the patients with asthma group, the number of SPD correlated with age, FEV1, mMRC score, 6-minute walk test distance, and HADS scores, but not with BMI or ACT test score. Using multivariate analysis, the number of SPD was associated with only age, anxiety, and FEV1, whereas total EE was associated with mMRC score and BMI. CONCLUSION Age, anxiety, and FEV1 were significantly associated with the number of SPD in patients with asthma. Addressing anxiety should be further studied as way to attempt to increase physical activity in patients with asthma.
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Affiliation(s)
- Florence Hennegrave
- Service de Pneumologie et ImmunoAllergologie, Centre de Référence constitutif des Maladies Pulmonaires Rares, Univ. LilleCHU Lille, Hopital CalmetteLilleFrance
| | - Olivier Le Rouzic
- Service de Pneumologie et ImmunoAllergologie, Centre de Référence constitutif des Maladies Pulmonaires Rares, Univ. LilleCHU Lille, Hopital CalmetteLilleFrance
| | - Stéphanie Fry
- Service de Pneumologie et ImmunoAllergologie, Centre de Référence constitutif des Maladies Pulmonaires Rares, Univ. LilleCHU Lille, Hopital CalmetteLilleFrance
| | - Hélène Behal
- Department of Biostatistics, Univ. Lille, EA 2694‐Santé Publique: Epidémiologie et Qualité des SoinsCHU LilleLilleFrance
| | - Cécile Chenivesse
- Service de Pneumologie et ImmunoAllergologie, Centre de Référence constitutif des Maladies Pulmonaires Rares, Univ. LilleCHU Lille, Hopital CalmetteLilleFrance
| | - Benoit Wallaert
- Service de Pneumologie et ImmunoAllergologie, Centre de Référence constitutif des Maladies Pulmonaires Rares, Univ. LilleCHU Lille, Hopital CalmetteLilleFrance
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Silverberg JI, Kwa L, Kwa MC, Laumann AE, Ardalan K. Cardiovascular and cerebrovascular comorbidities of juvenile dermatomyositis in US children: an analysis of the National Inpatient Sample. Rheumatology (Oxford) 2018; 57:694-702. [PMID: 29373707 DOI: 10.1093/rheumatology/kex465] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Indexed: 01/16/2023] Open
Abstract
Objective JDM is associated with multiple potential risk factors for cardiovascular disease, including reduced heart rate variability, systolic/diastolic cardiac dysfunction, abnormal brachial artery reactivity and metabolic syndrome. However, little is known about cardiovascular risk in JDM. We sought to examine the association between JDM and cardiovascular risk factors and disease in US children. Methods Data from the 2002-12 National Inpatient Sample was analysed, including ∼20% of all US hospitalizations (n = 14 535 620 paediatric hospitalizations). Results JDM was significantly associated with 12 of 13 comorbidities, including hypertension [survey logistic regression; crude odds ratio (95% CI): 22.25 (15.51, 31.92)], obesity [5.87 (3.44, 10.02)], uncomplicated diabetes [7.95 (4.21, 15.00)], lipid abnormalities [5.84 (2.77, 12.31)], particularly lipodystrophy [151.08 (38.24, 596.86)], peripheral and visceral atherosclerosis [10.09 (3.70, 27.56)], late effects of cerebrovascular disease [15.49 (2.37, 101.43)], personal history of transient ischaemic attack and cerebral infarction [10.82 (2.46, 47.65)], pulmonary circulatory disorder [12.23 (2.59, 57.73)], arrhythmia [3.93 (2.80, 5.52)], bradycardia [4.22 (2.65, 6.74)] and hypotension [2.62 (1.27, 5.39)]. Conclusions There are significantly higher odds of cardiovascular and cerebrovascular comorbidities among inpatients with JDM, with adolescents, girls and racial/ethnic minorities being at highest risk.
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Affiliation(s)
- Jonathan I Silverberg
- Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lauren Kwa
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael C Kwa
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Anne E Laumann
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kaveh Ardalan
- Division of Rheumatology, Departments of Pediatrics and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Cordova-Rivera L, Gibson PG, Gardiner PA, McDonald VM. A Systematic Review of Associations of Physical Activity and Sedentary Time with Asthma Outcomes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1968-1981.e2. [PMID: 29510231 DOI: 10.1016/j.jaip.2018.02.027] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 02/05/2018] [Accepted: 02/22/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Physical inactivity and high sedentary time are associated with adverse health outcomes in several diseases. However, their impact in asthma is less clear. OBJECTIVE We aimed to synthesize the literature characterizing physical activity and sedentary time in adults with asthma, to estimate activity levels using meta-analysis, and to evaluate associations between physical activity and sedentary time and the clinical and physiological characteristics of asthma. METHODS Articles written in English and addressing the measurement of physical activity or sedentary time in adults ≥18 years old with asthma were identified using 4 electronic databases. Meta-analysis was used to estimate steps/day in applicable studies. RESULTS There were 42 studies that met the inclusion criteria. Physical activity in asthma was lower compared with controls. The pooled mean (95% confidence interval) steps/day for people with asthma was 8390 (7361, 9419). Physical activity tended to be lower in females compared with males, and in older people with asthma compared with their younger counterparts. Higher levels of physical activity were associated with better measures of lung function, disease control, health status, and health care use. Measures of sedentary time were scarce, and indicated a similar engagement in this behavior between participants with asthma and controls. High sedentary time was associated with higher health care use, and poorer lung function, asthma control, and exercise capacity. CONCLUSIONS People with asthma engage in lower levels of physical activity compared with controls. Higher levels of physical activity may positively impact on asthma clinical outcomes. Sedentary time should be more widely assessed.
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Affiliation(s)
- Laura Cordova-Rivera
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, New South Wales, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Peter G Gibson
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, New South Wales, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia
| | - Paul A Gardiner
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Woolloongabba, Queensland, Australia; Mater Research Institute, The University of Queensland, South Brisbane, Queensland, Australia
| | - Vanessa M McDonald
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, New South Wales, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, New South Wales, Australia; Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.
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11
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Elmesmari R, Reilly JJ, Martin A, Paton JY. Accelerometer measured levels of moderate-to-vigorous intensity physical activity and sedentary time in children and adolescents with chronic disease: A systematic review and meta-analysis. PLoS One 2017. [PMID: 28640907 PMCID: PMC5480890 DOI: 10.1371/journal.pone.0179429] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Context Moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) are important for child and adolescent health. Objective To examine habitual levels of accelerometer measured MVPA and ST in children and adolescents with chronic disease, and how these levels compare with healthy peers. Methods Data sources: An extensive search was carried out in Medline, Cochrane library, EMBASE, SPORTDiscus and CINAHL from 2000–2017. Study selection: Studies with accelerometer-measured MVPA and/or ST (at least 3 days and 6 hours/day to provide estimates of habitual levels) in children 0–19 years of age with chronic diseases but without co-morbidities that would present major impediments to physical activity. In all cases patients were studied while well and clinically stable. Results Out of 1592 records, 25 studies were eligible, in four chronic disease categories: cardiovascular disease (7 studies), respiratory disease (7 studies), diabetes (8 studies), and malignancy (3 studies). Patient MVPA was generally below the recommended 60 min/day and ST generally high regardless of the disease condition. Comparison with healthy controls suggested no marked differences in MVPA between controls and patients with cardiovascular disease (1 study, n = 42) and type 1 diabetes (5 studies, n = 400; SMD -0.70, 95% CI -1.89 to 0.48, p = 0.25). In patients with respiratory disease, MVPA was lower in patients than controls (4 studies, n = 470; SMD -0.39, 95% CI -0.80, 0.02, p = 0.06). Meta-analysis indicated significantly lower MVPA in patients with malignancies than in the controls (2 studies, n = 90; SMD -2.2, 95% CI -4.08 to -0.26, p = 0.03). Time spent sedentary was significantly higher in patients in 4/10 studies compared with healthy control groups, significantly lower in 1 study, while 5 studies showed no significant group difference. Conclusions MVPA in children/adolescents with chronic disease appear to be well below guideline recommendations, although comparable with activity levels of their healthy peers except for children with malignancies. Tailored and disease appropriate intervention strategies may be needed to increase MVPA and reduce ST in children and adolescents with chronic disease.
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Affiliation(s)
- Rabha Elmesmari
- School of Medicine, College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Scotland
- Al-Fatah Hospital, Medical School, Benghazi University, Benghazi, Libya
| | - John J. Reilly
- University of Strathclyde, Physical Activity for Health Group, Glasgow, Scotland
| | - Anne Martin
- Usher Institute for Population Health Sciences and Informatics, Edinburgh, Scotland
| | - James Y. Paton
- School of Medicine, College of Medical, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Scotland
- * E-mail:
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12
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Jago R, Searle A, Henderson AJ, Turner KM. Designing a physical activity intervention for children with asthma: a qualitative study of the views of healthcare professionals, parents and children with asthma. BMJ Open 2017; 7:e014020. [PMID: 28341689 PMCID: PMC5372067 DOI: 10.1136/bmjopen-2016-014020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES Qualitative methods were used to examine: (1) the attitudes of health professionals to promoting physical activity for children with asthma; (2) reasons why children with asthma are less active and (3) how a physical activity programme for children with asthma could be designed. DESIGN Semistructured interviews were conducted with health professionals, children with asthma and their parents between October 2015 and March 2016. Interviews were transcribed verbatim and thematically analysed. SETTING Primary and secondary care in Bristol (UK). PARTICIPANTS Interviews were held with 8 primary care practitioners (5 general practitioners, 2 nurse practitioners and 1 practice nurse), 9 parent-child dyads (2 fathers, 7 mothers, 6 sons, 3 daughters) of children aged 6-7 who had asthma and 4 secondary care professionals (2 respiratory consultants, 2 specialist nurses). RESULTS Health professionals reported that physical activity was beneficial for children with asthma and if managed appropriately, children with asthma could be as active as children without asthma. Current promotion of physical activity for children with asthma was limited and restricted by NHS staff time, access to inhalers at school and a lack of parental knowledge. Potentially important components of a new programme include parental education on the possibilities of activity for children with asthma and the difference between exercise-induced breathlessness and asthma symptoms. Other important elements include how to use inhalers as a preventive measure, coping with exacerbations and practical solutions (such as clearing sputum), managing transitions from warm to cold climates and general symptom control. CONCLUSIONS There is a need to build on current asthma programmes to increase the support for children with asthma to be physically active. Future programmes could consider working more closely with schools, increasing parental knowledge and providing children with practical support to help be physically active.
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Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Aidan Searle
- Biomedical Research Unit in Nutrition, National Institute for Health Research (NIHR), Diet and Lifestyle at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - A John Henderson
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Katrina M Turner
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK
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13
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Smith MP, Berdel D, Bauer CP, Koletzko S, Nowak D, Heinrich J, Schulz H. Asthma and Rhinitis Are Associated with Less Objectively-Measured Moderate and Vigorous Physical Activity, but Similar Sport Participation, in Adolescent German Boys: GINIplus and LISAplus Cohorts. PLoS One 2016; 11:e0161461. [PMID: 27560942 PMCID: PMC4999273 DOI: 10.1371/journal.pone.0161461] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/05/2016] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Physical activity (PA) protects against most noncommunicable diseases and has been associated with decreased risk of allergic phenotype, which is increasing worldwide. However, the association is not always present; furthermore it is not clear whether it is strongest for asthma, rhinitis, symptoms of these, or atopic sensitization; which sex is most affected; or whether it can be explained by either avoidance of sport or exacerbation of symptoms by exercise. Interventions are thus difficult to target. METHODS PA was measured by one-week accelerometry in 1137 Germans (mean age 15.6 years, 47% boys) from the GINIplus and LISAplus birth cohorts, and modeled as a correlate of allergic symptoms, sensitization, or reported doctor-diagnosed asthma or rhinitis. RESULTS 8.3% of children had asthma, of the remainder 7.9% had rhinitis, and of the remainder 32% were sensitized to aero-allergens (atopic). 52% were lung-healthy controls. Lung-healthy boys and girls averaged 46.4 min and 37.8 min moderate-to-vigorous PA per day, of which 14.6 and 11.4 min was vigorous. PA in allergic girls was not altered, but boys with asthma got 13% less moderate and 29% less vigorous PA, and those with rhinitis with 13% less moderate PA, than lung-healthy boys. Both sexes participated comparably in sport (70 to 84%). Adolescents with wheezing (up to 68%, in asthma) and/or nose/eye symptoms (up to 88%, in rhinitis) were no less active. CONCLUSIONS We found that asthma and rhinitis, but not atopy, were independently associated with low PA in boys, but not in girls. These results indicate that allergic boys remain a high-risk group for physical inactivity even if they participate comparably in sport. Research into the link between PA and allergy should consider population-specific and sex-specific effects, and clinicians, parents, and designers of PA interventions should specifically address PA in allergic boys to ensure full participation.
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Affiliation(s)
- Maia P. Smith
- Institute of Epidemiology I, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg/Munich, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Dietrich Berdel
- Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany
| | - Carl-Peter Bauer
- Department of Pediatrics, Technical University of Munich, Munich, Germany
| | - Sibylle Koletzko
- Dr. von Hauner Children’s Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Dennis Nowak
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg/Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
| | - Holger Schulz
- Institute of Epidemiology I, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg/Munich, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
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14
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Cassim R, Koplin JJ, Dharmage SC, Senaratna BCV, Lodge CJ, Lowe AJ, Russell MA. The difference in amount of physical activity performed by children with and without asthma: A systematic review and meta-analysis. J Asthma 2016; 53:882-92. [PMID: 27144654 DOI: 10.1080/02770903.2016.1175474] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Despite the benefits of a physically active lifestyle, some studies suggest fear of exacerbations by both children and their parents limit physical activity in children with asthma. We undertook a systematic review to quantify the difference in objectively measured physical activity levels of children and adolescents with and without asthma. DATA SOURCES MEDLINE, PubMed and EMBASE. STUDY SELECTION English language observational studies of children and adolescents to the age of 18 that compared objectively measured physical activity (accelerometer or pedometer devices) between those with asthma and without asthma. RESULTS Overall 22,285 articles were retrieved with 12 studies being included in the review: 1 cohort, 1 case-control and 10 cross-sectional. A meta-analysis of accelerometry data from the single cohort study and 8 cross-sectional studies produced an overall mean difference of 0.01 (95% CI: -0.09-0.11) activity counts per minute in children and adolescents without asthma compared to those with asthma. CONCLUSION We did not find any evidence that children and adolescents with and without asthma engaged in different amounts of physical activity when measured objectively by accelerometers. Children and adolescents with asthma may not require differentially targeted policies to encourage more physical activity, however further longitudinal studies are needed.
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Affiliation(s)
- Raisa Cassim
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,b Murdoch Childrens Research Institute , Parkville , Victoria , Australia
| | - Jennifer J Koplin
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,b Murdoch Childrens Research Institute , Parkville , Victoria , Australia
| | - Shyamali C Dharmage
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,b Murdoch Childrens Research Institute , Parkville , Victoria , Australia
| | - Baddewithana C V Senaratna
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,c Department of Community Medicine , University of Sri Jayewardenepura , Nugegoda , Sri Lanka
| | - Caroline J Lodge
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,b Murdoch Childrens Research Institute , Parkville , Victoria , Australia
| | - Adrian J Lowe
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,b Murdoch Childrens Research Institute , Parkville , Victoria , Australia
| | - Melissa A Russell
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,b Murdoch Childrens Research Institute , Parkville , Victoria , Australia
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15
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Heinzmann-Filho JP, Vendrusculo FM, Woszezenki CT, Piva TC, Santos AN, Barcellos AB, Vagliatti BB, Corrêa DG, Mattiello R, Donadio MVF. Inspiratory muscle function in asthmatic and healthy subjects: influence of age, nutrition and physical activity. J Asthma 2016; 53:893-9. [PMID: 27057823 DOI: 10.3109/02770903.2016.1165698] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To compare inspiratory muscle function (strength and endurance) between asthmatics and healthy controls, and the influence of age, nutritional status and physical activity on them. METHODS This is a cross-sectional study. Asthmatic and healthy subjects, aged 6 to 18 years old, recruited from two public schools in Southern Brazil were included in the study. Asthmatic subjects were selected using the criteria presented by the International Study on Asthma and Allergies in Children and control subjects based on the absence of respiratory symptoms. Anthropometric data was measured, body mass index calculated and subjects classified as normal weight, overweight or obese. Physical activity levels, maximum inspiratory pressure (MIP) and inspiratory muscle endurance (IME) were also evaluated. RESULTS A total of 314 participants were included, separated into control group (181) and asthmatics (133), with a total mean age of 11 years. When both groups were compared, there were no significant differences in both MIP and IME. However, when groups were analyzed subdivided in children and adolescents, IME was significantly reduced (p = 0.003) in asthmatic adolescents. Indeed, when groups were also stratified considering the nutritional status, IME showed a reduction in asthmatic adolescents with overweight (p = 0.042) and obesity (p = 0.041) when compared to healthy controls. No effects of physical activity levels between groups were found. CONCLUSIONS Results demonstrate a reduction in the IME in asthmatic adolescents with overweight and obesity, indicating an association between asthma, nutritional status and respiratory muscle function.
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Affiliation(s)
- João Paulo Heinzmann-Filho
- a Graduate Program in Pediatrics and Child Health , Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Fernanda Maria Vendrusculo
- a Graduate Program in Pediatrics and Child Health , Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Cristhiele Taís Woszezenki
- a Graduate Program in Pediatrics and Child Health , Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Taila Cristina Piva
- b School of Nursing , Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Andressa Nunes Santos
- b School of Nursing , Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Andressa Bombardi Barcellos
- b School of Nursing , Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Bruna Brufatto Vagliatti
- b School of Nursing , Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Débora Gonzales Corrêa
- b School of Nursing , Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Rita Mattiello
- a Graduate Program in Pediatrics and Child Health , Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil.,c Centro Infant , Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Márcio Vinícius Fagundes Donadio
- a Graduate Program in Pediatrics and Child Health , Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil.,b School of Nursing , Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil.,c Centro Infant , Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
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16
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Lövström L, Emtner M, Alving K, Nordvall L, Borres MP, Janson C, Malinovschi A. High levels of physical activity are associated with poorer asthma control in young females but not in males. Respirology 2015; 21:79-87. [PMID: 26581686 DOI: 10.1111/resp.12671] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Revised: 07/02/2015] [Accepted: 07/06/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND OBJECTIVE Earlier studies on the levels of physical activity in asthma patients compared with controls have yielded varying results. We have previously reported that high versus moderate levels of physical activity were associated with higher prevalence of wheezing, especially in females. Here we studied the levels of physical activity in young patients with asthma and healthy subjects and their effect on asthma control. METHODS Four hundred eight physician-diagnosed patients with asthma and 118 controls (10-34 years) answered questions concerning frequency and/or duration of physical activity and undertook the Asthma Control Test (ACT), spirometry, methacholine challenges and exhaled nitric oxide measurements. RESULTS Asthma patients were more frequently physically active (P = 0.01) and for longer durations (P = 0.002) than controls. Highly versus moderately physically active patients with asthma had a higher prevalence of not well-controlled asthma (ACT < 20) when physical activity was assessed by frequency (40.6% vs 24.1%, P = 0.001) or duration (39.0% vs 21.7%, P < 0.001). This was only seen in females who had reduced ACT items (P < 0.05). Frequently versus moderately active females had an odds ratio of 4.81 (2.43, 9.51) to have ACT < 20, while no such effect was found in males (OR 1.18 (0.61, 2.30)) and this interaction was statistically significantly associated with gender (P = 0.003). No differences in fraction of exhaled nitric oxide or methacholine reactivity were found between moderately and highly physically active females with asthma. CONCLUSION Young asthma patients were more active than controls. High levels of physical activity were associated with poor asthma control as judged by the ACT in females, but not in males, and this appears unrelated to airway inflammation or responsiveness.
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Affiliation(s)
- Ludvig Lövström
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Margareta Emtner
- Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden.,Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden
| | - Kjell Alving
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Lennart Nordvall
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Magnus P Borres
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Christer Janson
- Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden
| | - Andrei Malinovschi
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
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17
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Egan KB, Ettinger AS, DeWan AT, Holford TR, Holmen TL, Bracken MB. Longitudinal associations between asthma and general and abdominal weight status among Norwegian adolescents and young adults: the HUNT Study. Pediatr Obes 2015; 10:345-52. [PMID: 25405952 DOI: 10.1111/ijpo.271] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 09/07/2014] [Accepted: 10/02/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND In adolescents the temporal directionality to the asthma and adiposity association remains unclear. Asthma may be a consequence of obesity; however, asthma may increase adiposity. OBJECTIVES This study aimed to assess the associations between (i) baseline weight status and subsequent asthma and (ii) baseline asthma and subsequent weight status after 4 and 11 years of follow-up (N = 1543 and N = 1596, respectively) using data from three, sequentially enrolled population-based surveys of Norwegians aged 12-30 years from 1995 to 2008. METHODS Weight status was defined as general (body mass index) or abdominal (waist circumference) underweight, normal weight, overweight or obesity. Self-report physician-diagnosed asthma defined asthma status. RESULTS Over the longitudinal 11-year follow-up, baseline generally overweight or abdominally obese adolescents had increased risk of asthma. Likewise, baseline asthmatics had increased risk of general overweight or abdominal obesity. After sex stratification, these associations were stronger in males. Generally (odds ratio [OR] 1.90; 95% confidence interval [CI] 1.32, 2.73) or abdominally (OR 1.66; 95% CI 1.13, 2.44) overweight males were at increased risk of asthma. Baseline asthmatic males were also at increased risk of general (OR 2.14; 95% CI 1.54, 2.98) and abdominal (OR 1.77; 95% CI 1.27, 2.47) overweight. CONCLUSIONS Among Norwegian adolescents, a bidirectional association of asthma and adiposity was observed in males. Each baseline condition increased the risk of the other condition over time. No association was observed in females.
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Affiliation(s)
- K B Egan
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.,Center for Perinatal, Pediatric and Environmental Epidemiology, Yale University, New Haven, CT, USA.,Yale Graduate School of Arts and Sciences, New Haven, CT, USA
| | - A S Ettinger
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.,Center for Perinatal, Pediatric and Environmental Epidemiology, Yale University, New Haven, CT, USA.,Yale Graduate School of Arts and Sciences, New Haven, CT, USA
| | - A T DeWan
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.,Center for Perinatal, Pediatric and Environmental Epidemiology, Yale University, New Haven, CT, USA.,Yale Graduate School of Arts and Sciences, New Haven, CT, USA
| | - T R Holford
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.,Center for Perinatal, Pediatric and Environmental Epidemiology, Yale University, New Haven, CT, USA.,Yale Graduate School of Arts and Sciences, New Haven, CT, USA
| | - T L Holmen
- HUNT Research Centre, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Norway
| | - M B Bracken
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.,Center for Perinatal, Pediatric and Environmental Epidemiology, Yale University, New Haven, CT, USA.,Yale Graduate School of Arts and Sciences, New Haven, CT, USA.,Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
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