The relationship between body mass index, aerobic performance and asthma in a pre-pubertal, population-level cohort

Effects of Physical Exercises on Pulmonary Rehabilitation, Exercise Capacity, and Quality of Life in Children with Asthma: A Meta-Analysis

OBJECTIVE

This study aimed to systematically evaluate the effect of exercise on pulmonary function, exercise capacity, and quality of life in children with bronchial asthma.

METHODS

A comprehensive search was performed using PubMed, Cochrane Library, Web of Science, EBSCO, CNKI, and Wanfang Data Knowledge Service platform to identify any relevant randomized controlled trials (RCTs) published from inception to April 2021. The Cochrane risk of the bias tool was utilized to evaluate the methodological quality of the included studies, and RevMan 5.3 was applied to perform data analyses.

RESULTS

A total of 22 RCTs involving 1346 patients were included. The results of the meta-analysis showed that exercise had significant advantages in improving lung function and exercising capacity and quality of life in children with asthma compared with conventional treatment, such as the forced vital capacity to predicted value ratio (SMD = 0.27; 95% CI: 0.13, 0.40, and P < 0.0001), the peak expiratory flow to predicted value ratio (MD = 4.53; 95% CI: 1.27, 7.80, and P=0.007), the 6-minute walk test (MD = 110.65; 95% CI: 31.95, 189.34, and P=0.006), rating of perceived effort (MD = -2.28; 95% CI: -3.21, -1.36, and P < 0.0001), and peak power (MD = 0.94; 95% CI: 0.37, 1.52, and P=0.001) on exercise capacity and pediatric asthma quality of life questionnaire (MD = 1.28; 95% CI: 0.60, 1.95, and P=0.0002) on quality of life. However, no significant difference was observed in the forced expiratory flow between 25% and 75% of vital capacity (P=0.25) and the forced expiratory volume at 1 second to predicted value ratio(P=0.07).

CONCLUSIONS

Current evidence shows that exercise has a certain effect on improving pulmonary function recovery, exercise capacity, and quality of life in children with bronchial asthma. Given the limitation of the number and quality of included studies, further research and verification are needed to guide clinical application.

The Effects of Climate Therapy on Cardiorespiratory Fitness and Exercise-Induced Bronchoconstriction in Children with Asthma

We investigated whether a 1-week stay in the mountains may have a positive impact on Exercise-Induced Bronchoconstriction (EIB) and cardiorespiratory endurance in asthmatic children from an urban area. Spirometry was performed before and 10 min after a 20 m shuttle run test (20mSRT) on the first and seventh day of a summer asthma camp in the Italian Alps at 900 m of altitude. Spirometry z-scores were derived from the Global Lung Initiative 2012 prediction equations, and percentiles of the 20mSRT performance were assigned according to De Miguel-Etayo’s and Tomkinson’s predictive equations. A FEV1 decrease ≥10% after the exercise was defined as EIB. Particulate matter pollution was monitored during the camp and in the urban area of provenience. Twenty-four subjects (age range 7–16 years) were included. Frequency of EIB decreased from 58% (14/24) at day-1 to 33% (8/24) at the end of the camp (p = 0.08). Most subjects with a 20mSRT in the lowest quartile at day 1 had EIB (9/11). The proportion of children with a 20mSRT <25° percentile decreased from 45% (11/24) at day-1 to 16% (4/24) at day-7 (p = 0.02). Conclusion: One-week climate therapy in the mountains improved both bronchial hyperreactivity and cardiorespiratory endurance in our cohort of asthmatic children.

Effect of exercise rehabilitation on exercise capacity and quality of life in children with bronchial asthma: a systematic review

OBJECTIVES

To systematically evaluate the effect of exercise rehabilitation on exercise capacity and quality of life in children with bronchial asthma.

METHODS

PubMed, Cochrane Library, Web of Science, EBSCO, China National Knowledge Infrastructure, Weipu Data, and Wanfang Data were searched for randomized controlled trials (RCTs) on the effect of exercise rehabilitation on children with bronchial asthma published up to February 2021. RevMan 5.3 was used to perform a Meta analysis.

RESULTS

A total of 14 studies were included, with 990 subjects in total. The Meta analysis showed that compared with the conventional treatment group, the exercise rehabilitation group had significantly better exercise capacity (distance covered in the 6-minute walk test: MD=108.13, P<0.01; rating of perceived effort: MD=-2.16, P<0.001; peak power: MD=0.94, P=0.001) and significantly higher total score of quality of life (SMD=1.28, P=0.0002), activity score (SMD=1.38, P=0.0002), symptom score (SMD=1.02, P<0.001), and emotional score (SMD=0.86, P<0.001) assessed by the Pediatric Asthma Quality of Life Questionnaire.

CONCLUSIONS

Current evidence shows that exercise rehabilitation has a positive effect in improving exercise capacity and quality of life in children with bronchial asthma. Due to limited number and quality of studies included in the analysis, further research is needed.

Association between Health-Related Physical Fitness and Respiratory Diseases in Adolescents: An Age- and Gender-Matched Study

The current study examined the differences in health-related physical fitness (HRPF), physical activity (PA), and sedentary behavior (SB) between adolescents with and without ongoing respiratory diseases (RD). This study's participants were from 12 to 15 years old (7th-10th grade) in South Korea. Adolescents with RD were selected through RD-related questions (i.e., asthma, rhinitis, sinusitis, and bronchitis) (n = 139); in contrast, adolescents without RD, randomly selected from the general group, responded to any health problem-related questions as "No" (n = 139). HRPF was measured based on the FITNESSGRAM and EURO FIT test batteries and the measurements of HRPF included cardiovascular endurance, muscular strength, muscular endurance, flexibility, and body composition. All statistical analyses were conducted by SPSS 25.0, and the independent t-test was used to compare the HRPF and PA between the two groups. Moreover, the measured HRPF was compared with a series of analyses of three-way ANOVAs (age × gender × group). Adolescents with RD had a positive association with less participation in PA (p < 0.05; RD: 3081.81 ± 4793.37; general: 2073.64 ± 3123.47) and with more time spent on SB (above 12 h per week: RD group (38.85%) and general group (33.09%)). Furthermore, adolescents in the RD group showed significant effects on all components of HRPF (p < 0.05). Our study confirmed that HRPF is an essential predictor of adolescents' health outcomes, especially for those with RD. We suggest that increased HRPF can be an effective treatment for respiratory diseases in adolescents, and health practitioners should pay more attention to helping adolescents with RD to gain or maintain high HRPF.

Low fitness and increased sedentary time are associated with worse asthma-The National Youth Fitness Survey

BACKGROUND

Asthma is the most common chronic illness in children and is independently impacted by obesity and by fitness. The National Youth Fitness Survey collected data on aerobic fitness, body composition, and health outcomes in children 6 to 11 years old. The goal of this study is to test hypotheses regarding relationships between asthma, aerobic fitness, and sedentary time in this uniquely studied cohort of young children.

METHODS

A total of 665 children (6-11 years old; 49% male) were included in analyses. We explored relationships between asthma outcomes and aerobic fitness (measured by endurance time), self-reported sedentary time, and body mass index categories. Fitness was categorized as unfit (lowest 25% of endurance times) or fit. Multivariate logistic regression models were created for asthma outcomes and adjusted for race, age, sex, poverty status, and overweight/obesity.

RESULTS

Among the participants, 17.9% had a previous history of asthma and 11.4% had current asthma. Additionally, 37.3% of participants were overweight or obese. Low fitness was significantly associated with increased odds of past asthma, current asthma, asthma attacks, wheeze with exercise, and wheeze with activity limitations in multivariate models. Increased sedentary time was significantly associated with increased odds of previous asthma, current asthma, asthma attacks, and wheeze with activity limitations.

CONCLUSION

Decreased aerobic fitness and increased sedentary time were associated with worse asthma outcomes in this group of children (6-11 years old). This data suggest that fitness and sedentary time, both modifiable factors, each have an independent effect on asthma and should be included in assessments and management of asthma health.

Asthma, body mass and aerobic fitness, the relationship in adolescents: The exercise for asthma with commando Joe's® (X4ACJ) trial

Although an association has been suggested between asthma, obesity, fitness and physical activity, the relationship between these parameters remains to be elucidated in adolescents. Six-hundred and sixteen adolescents were recruited (334 boys; 13.0 ± 1.1years; 1.57 ± 0.10m; 52.6 ± 12.9kg), of which 155 suffered from mild-to-moderate asthma (78 boys). Participants completed a 20-metre shuttle run test, lung function and 7-day objective physical activity measurements and completed asthma control and quality of life questionnaires. Furthermore, 69 adolescents (36 asthma; 21 boys) completed an incremental ramp cycle ergometer test. Although participants with asthma completed significantly fewer shuttle runs than their peers, peak V̇O₂ did not differ between the groups. However, adolescents with asthma engaged in less physical activity (53.9 ± 23.5 vs 60.5 ± 23.6minutes) and had higher BMI (22.2 ± 4.8 vs 20.4 ± 3.7kg·m-2), than their peers. Whilst a significant relationship was found between quality of life and cardiorespiratory fitness according to peak V̇O₂, only BMI was revealed as a significant predictor of asthma status. The current findings highlight the need to use accurate measures of cardiorespiratory fitness rather than indirect estimates to assess the influence of asthma during adolescence. Furthermore, the present study suggests that BMI and fitness may be key targets for future interventions seeking to improve asthma quality of life.