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Cao C, Wang Y, Peng L, Wu W, Yang H, Li Z. Asthma and Other Respiratory Diseases of Children in Relation to Personal Behavior, Household, Parental and Environmental Factors in West China. TOXICS 2023; 11:964. [PMID: 38133365 PMCID: PMC10747494 DOI: 10.3390/toxics11120964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/23/2023] [Accepted: 11/24/2023] [Indexed: 12/23/2023]
Abstract
Asthma and other respiratory diseases, which are of great concern in public health, are paid less attention in areas that are less economically developed. This research aimed to study the prevalence of critical respiratory diseases of children living in West China and figure out the potential influencing factors. A total of 575 children under the age of 14 were recruited from Xinjiang, China, to participate in the study in 2022. Information on activity patterns, socioeconomic and parental factors, and household and surrounding environment situations was obtained using a questionnaire survey. Logistic regression models were applied to estimate the odds ratios of respiratory disease prevalence in relation to behavior patterns, household, parental and environmental factors, respectively. The prevalence of ever doctor-diagnosed asthma, doctor-diagnosed bronchitis and current bronchitis were 4.7%, 19.0% and 14.4%, respectively. The prevalence of doctor-diagnosed pneumonia was 8.2%, which was two times higher in urban than rural areas. Longer annual heating duration was significantly associated with higher risks in children's asthma and bronchitis, with an odds ratio (OR) and 95% confidence interval (95% CI) of 3.363 (95% CI: 1.215-9.298) and 1.267 (95% CI: 1.002-1.601), respectively. Opening the window longer in autumn would lead to higher risks of bronchitis, with ORs of 1.165 and 1.133, respectively, for doctor-diagnosed bronchitis and current bronchitis. Residential air pollution and having a residence close to waste incineration plant or garbage station were, respectively, significantly associated with higher risks of doctor-diagnosed bronchitis and asthma. Parental disease history was associated with a higher prevalence of children's asthma and respiratory diseases, whereas breastfeeding and doing physical exercise were, respectively, significantly associated with a lower risk of asthma. A high prevalence of respiratory diseases in children in West China may be partly attributed to longer annual heating time, opening windows longer in autumn, surrounding environmental pollution, as well as parental disease history, whereas promoting physical activity and breastfeeding could be an effective measure to reduce the risk of childhood asthma in West China.
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Affiliation(s)
- Changan Cao
- School of Medicine, Xiamen University, Xiamen 361104, China;
| | - Yuna Wang
- School of Chemical and Environmental Sciences, YiLi Normal University, Yining 835000, China; (Y.W.)
| | - Li Peng
- School of Energy and Environmental Engineering, University of Science of Technology Beijing, Beijing 10083, China;
| | - Weiqi Wu
- Department of Geography, University College London, London WC1E 6BT, UK;
| | - Huimin Yang
- School of Chemical and Environmental Sciences, YiLi Normal University, Yining 835000, China; (Y.W.)
| | - Zhigang Li
- Chinese Research Academy of Environmental Sciences, Beijing 100012, China
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Han X, He X, Hao G, Cao L, Qi Y, Han K. The association of asthma duration with body mass index and Weight-Adjusted-Waist index in a nationwide study of the U.S. adults. Eur J Med Res 2023; 28:122. [PMID: 36918990 PMCID: PMC10012562 DOI: 10.1186/s40001-023-01089-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 03/05/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUNDS The association between obesity and asthma has been of interest, but whether the duration of asthma has an effect on obesity is still limitedly studied. AIM The purpose of this study was to investigate the association between asthma duration and obesity-related indexes, where obesity-related indexes include Body mass index (BMI) and Weight-adjusted-waist index (WWI). METHODS Data from National Health and Nutrition Examination Survey (NHANES) 2009-2018 were obtained to conduct this cross-sectional study. Duration of asthma was used as the independent variable and obesity-related indexes as the response variables. Multiple linear regression was used to assess the association between the independent variable and the response variables, and subsequently smoothed curve fitting and threshold effect analysis were performed to clarify whether there was a nonlinear correlation between the independent variable and the response variables. Finally, subgroup analysis was conducted to find sensitive populations. RESULTS A total of 9170 participants were included in the analysis. Asthma duration was statistically different between the two groups when all participants were grouped by median WWI (Q1 < 11.65, Q2 ≥ 11.65) (P < 0.001), but not by median BMI (Q1 < 31.8, Q2 ≥ 31.8) (P = 0.130). There was a positive association between asthma duration and WWI [β = 0.016, 95% CI (0.016, 0.017)], but a negative one with BMI [β = - 0.098, 95% CI (- 0.112, - 0.085)], and the correlations between the independent and response variables became more pronounced with increasing asthma duration (P for trend < 0.01). In addition, there were nonlinear relationships between asthma duration with BMI and WWI (log likelihood ratio < 0.001), with the best valid inflection points for asthma duration being 2 years (with WWI as the response variable) and 3 years (with BMI as the response variable), respectively. In the subgroup analysis, the positive association between asthma duration and WWI was more pronounced in the participants who were male, aged less than 40 years, and had asthma onset before 12 years of age. In contrast, when BMI was used as the response variable, the negative association between it and asthma duration was more pronounced among participants of female, aged 60 years or older, and with asthma onset less than 12 years of age. CONCLUSIONS In US adults, asthma duration might cause changes in obesity-related indexes. Longer asthma duration might cause weight loss, but might increase the risk of abdominal obesity.
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Affiliation(s)
- Xiaoxiao Han
- Department of Hyperbaric Oxygen, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Xiaofang He
- Department of Hyperbaric Oxygen, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Gui Hao
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Suzhou University, Suzhou, Jiangsu, China
| | - Lifang Cao
- Bozhou People's Hospital Affiliated with Anhui Medical University, Hefei, Anhui, China
| | - Yinliang Qi
- Department of Hyperbaric Oxygen, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China.
| | - Kexing Han
- Bozhou People's Hospital Affiliated with Anhui Medical University, Hefei, Anhui, China. .,The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, Anhui Province, People's Republic of China.
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Ding X, Whelan ME, Clifton DA, Zhu T. Physical activity and asthma symptom control in children during COVID-19 lockdown: A feasibility study. Digit Health 2023; 9:20552076231152165. [PMID: 36845081 PMCID: PMC9944184 DOI: 10.1177/20552076231152165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 01/03/2023] [Indexed: 02/23/2023] Open
Abstract
Objective The aim was to evaluate the impact of the COVID-19 lockdown on physical activity (PA) and asthma symptom control in children. Methods We conducted a single-cohort observational study on 22 children with a median age of 9 (8-11) years with a diagnosis of asthma being included in the study. Participants were asked to wear a PA tracker for 3 months; during the same 3-month period, the Paediatric Asthma Diary (PAD) was administered daily and the Asthma Control (AC) Questionnaire together with the mini-Paediatric Asthma Quality of Life (AQoL) Questionnaire administered at weekly intervals. Results Compared with the pre-lockdown period, there was a significant reduction in PA levels after the lockdown began. Daily total steps reduced by about 3000 steps (p < 0.001), very active minutes by 9 min (p < 0.001) and fairly active minutes almost halved (p < 0.001); while asthma symptom control marginally improved, with the AC and AQoL score improving by 0.56 (p < 0.005) and 0.47 (p < 0.05), respectively. Further, for those with AC score higher than 1, PA was positively associated with asthma control both before and after the lockdown. Conclusions This feasibility study suggests that PA engagement of children with asthma is negatively affected during the pandemic, but the beneficial effect of PA on asthma symptom control potentially sustains even during a lockdown period. These findings emphasize the importance of wearable device to monitor longitudinal PA and thus better management of PA for achieving the best outcome of asthma symptom control.
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Affiliation(s)
- Xiaorong Ding
- School of Life Science and Technology,
University of
Electronic Science and Technology of China,
Chengdu, China,Institute of Biomedical Engineering,
University of
Oxford, Oxford, UK,Xiaorong Ding, School of Life Science and
Technology, University of Electronic Science and Technology of China, Qingshuihe
Campus, No.2006, Xiyuan Ave, West Hi-Tech Zone, 611731, Chengdu, Sichuan, China.
| | - Maxine E Whelan
- Centre for Intelligent Healthcare, Coventry
University, Coventry, UK
| | - David A Clifton
- Institute of Biomedical Engineering,
University of
Oxford, Oxford, UK,Oxford Suzhou Centre for Advanced Research, Jiangsu, China
| | - Tingting Zhu
- Institute of Biomedical Engineering,
University of
Oxford, Oxford, UK
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Yourell J, Koskela-Staples N, Doty J, Fedele DA. Risk and Protective Factors for Physical Activity Engagement Among Adolescents With Comorbid Asthma and Obesity. J Pediatr Psychol 2022; 48:39-50. [PMID: 35849004 PMCID: PMC9836345 DOI: 10.1093/jpepsy/jsac061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE The current study identifies levels of physical activity (PA) engagement among adolescents with neither asthma nor overweight/obesity (OW/OB), one, or both conditions. Risk and protective factors are examined across groups. METHODS Data from 8th, 9th, and 11th graders were obtained from the 2019 Minnesota Student Survey (N = 125,164). One-way analysis of variance was used to assess PA levels across risk groups. Linear regressions were used to examine patterns of risk and protective factors for adolescent PA engagement across four groups (neither asthma nor OW/OB, asthma only, OW/OB only, and comorbid asthma + OW/OB). Results were stratified by race/ethnicity. RESULTS Adolescents with OW/OB only or asthma + OW/OB had significantly lower PA levels than youth with asthma only or neither condition (M = 3.65-3.67 days/week, SD = 2.20 vs M = 4.15-4.19 days/week, SD = 2.16-2.17, p < .001). The following variables were associated with adolescent PA (p < .001): Adult community care across all risk groups (β ranges = .13-.16), depressive symptoms among those with neither and both asthma + OW/OB (β's = -.10), and extracurriculars among those with asthma + OW/OB (β = .10). Extracurriculars and parent connectedness were protective for Hispanic adolescents. CONCLUSIONS Adolescents with OW/OB had significantly lower levels of PA compared to those without, regardless of asthma status. Individual and relational factors influenced adolescent PA. Future research investigating factors influencing adolescent PA should consider depressive symptoms, connectedness to adults in the community, non-sport-related extracurricular activity involvement, and address disparities among minoritized youth.
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Affiliation(s)
- Jacqlyn Yourell
- All correspondence concerning this article should be addressed to Jacqlyn Yourell, MS, Department of Family, Youth and Community Sciences, University of Florida, 3001 McCarty Hall D, PO Box 110310, Gainesville, FL 32611-0310, USA. E-mail:
| | | | - Jennifer Doty
- Department of Family, Youth and Community Sciences, University of Florida, Gainesville, FL, USA
| | - David A Fedele
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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The modifiable biopsychosocial drivers of psychological distress for adolescents with asthma: Implications for Clinical Care. Paediatr Respir Rev 2022; 41:68-72. [PMID: 34531130 DOI: 10.1016/j.prrv.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 07/16/2021] [Accepted: 07/28/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE Overwhelming distress exceeds the capacity of healthy coping strategies to feel better using healthy coping strategies alone, resulting in the use of unhealthy coping strategies. Unhealthy coping strategies may exacerbate asthma symptoms and asthma can contribute to overwhelming distress. This study aimed to review the modifiable drivers of overwhelming distress in adolescents with asthma. METHODS The biopsychosocial drivers of psychological distress for adolescents with asthma were explored within the domains of the modifiable biopsychosocial model of health and wellbeing. RESULTS Asthma in adolescents is associated with problems in the domains of environment, developmental outcomes, sense of belonging, health behaviours, coping, and treatment of illness. CONCLUSIONS The relationship between asthma and psychological distress highlights the need for holistic treatment of asthma. Further research is needed to establish causation between variables and to investigate whether interventions that address either asthma symptoms or biopsychosocial drivers of distress can improve both factors.
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Lagiou O, Fouzas S, Lykouras D, Sinopidis X, Karatza A, Karkoulias K, Dimitriou G, Anthracopoulos MB. Exercise Limitation in Children and Adolescents with Mild-to-Moderate Asthma. J Asthma Allergy 2022; 15:89-98. [PMID: 35082501 PMCID: PMC8785132 DOI: 10.2147/jaa.s335357] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 11/06/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Children with uncontrolled asthma are less tolerant to exercise due to ventilatory limitation, exercise-induced bronchoconstriction (EIB), or physical deconditioning. The contribution of these factors in children with controlled mild-to-moderate asthma is unknown. OBJECTIVE To explore the underlying mechanisms of reduced exercise capacity in children with controlled mild-to-moderate asthma. METHODS This was a cross-sectional study of 45 children and adolescents (age 8-18 years) with controlled mild-to-moderate asthma (asthma control test score 21-25) and 61 age-matched healthy controls. All participants completed a physical activity questionnaire and performed spirometry and cardiopulmonary exercise testing (CPET; maximal incremental protocol). Spirometric indices and CPET parameters were compared between the two groups. The effect of EIB (FEV1 decrease >10% post CPET), ventilatory limitation and physical deconditioning on maximum oxygen uptake (O2peak), was assessed by multivariable linear regression. RESULTS 62.2% of children with asthma and 29.5% of controls (P = 0.002) were categorized as inactive. Reduced exercise capacity (O2peak <80%) was noted in 53.3% of asthmatics and 16.4% of controls (P < 0.001). EIB was documented in 11.1% of participants with asthma. Physical deconditioning was noted in 37.8% of children with asthma and in 14.8% of controls (P = 0.013). Physical deconditioning emerged as the only significant determinant of O2peak, irrespective of asthma diagnosis, body mass index, ventilatory limitation and EIB. CONCLUSION Children with controlled mild-to-moderate asthma are less tolerant to strenuous exercise than their healthy peers. The decreased exercise capacity in this population should mainly be attributed to physical deconditioning, while the contribution of ventilatory limitation and EIB is rather small.
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Affiliation(s)
- Olga Lagiou
- Pediatric Respiratory Unit, University of Patras Medical School, Patras, Greece
- Department of Pediatrics, University of Patras Medical School, Patras, Greece
| | - Sotirios Fouzas
- Pediatric Respiratory Unit, University of Patras Medical School, Patras, Greece
- Department of Pediatrics, University of Patras Medical School, Patras, Greece
| | - Dimosthenis Lykouras
- Department of Respiratory Medicine, University Hospital of Patras, Patras, Greece
| | - Xenophon Sinopidis
- Department of Pediatrics, University of Patras Medical School, Patras, Greece
| | - Ageliki Karatza
- Department of Pediatrics, University of Patras Medical School, Patras, Greece
| | - Kiriakos Karkoulias
- Department of Respiratory Medicine, University Hospital of Patras, Patras, Greece
| | - Gabriel Dimitriou
- Department of Pediatrics, University of Patras Medical School, Patras, Greece
| | - Michael B Anthracopoulos
- Pediatric Respiratory Unit, University of Patras Medical School, Patras, Greece
- Department of Pediatrics, University of Patras Medical School, Patras, Greece
- Correspondence: Michael B Anthracopoulos Pediatric Respiratory Unit, University of Patras Medical School, Patras, 26504, GreeceTel +30 2610999716 Email
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Kamps AWA, Clevering AF, Nieuwdorp BW, de Weger WW, van Lente L. Asthma control is not associated with physical activity level in children with asthma during regular follow-up. J Asthma 2021; 59:1933-1939. [PMID: 34644214 DOI: 10.1080/02770903.2021.1993248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Engagement in physical activity (PA) is one of the important aims of long-term asthma treatment. The objective of this study is to evaluate whether improvement of asthma control is associated with enhanced PA during regular follow-up in children with asthma. METHODS Children, 6-18 years, with asthma were eligible for inclusion when their asthma was uncontrolled at a regular follow-up visit. Participants completed a seven-day recall questionnaire to assess engagement in different physical activities (Physical Activity Questionnaires for Children) at baseline and at the time asthma control was achieved according to predefined criteria. They were also instructed to wear an accelerometer (ActigraphTM GT1M) for seven consecutive days at these timepoints. RESULTS Thirty children (21 boys), aged 10.5 (2.9) years, with uncontrolled asthma were included. After a median (IQR) follow up time of 163 (94-253) days PA was assessed again. Accelerometer obtained moderate vigorous PA (median (IQR) 56 (43-66) versus 53 (35-63) minutes) as well as self-reported PA (median (IQR) PAQ score 7.4 (5.9-10.1) versus 7.2 (6.5-11.0)) were not significantly different at the time of uncontrolled and controlled asthma. Moderate vigorous PA increased in 46.2%, was comparable in 23.1%, and decreased in 30.7% of patients, respectively. Self-reported PA increased in 19.0%, was comparable in 52.4%, and decreased in 28.6% of patients, respectively. CONCLUSIONS Based on the results of this study we conclude that asthma control is not associated with self-reported and accelerometer obtained level of physical activity during regular follow-up in children with asthma.
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Affiliation(s)
- A W A Kamps
- Department of Pediatrics, Martini Hospital, Groningen, The Netherlands
| | - A F Clevering
- Department of Pediatrics, Martini Hospital, Groningen, The Netherlands
| | - B W Nieuwdorp
- Department of Pediatrics, Martini Hospital, Groningen, The Netherlands
| | - W W de Weger
- Department of Pediatrics, Martini Hospital, Groningen, The Netherlands
| | - L van Lente
- Department of Clinical Epidemiology, Martini Academy, Martini Hospital, Groningen, The Netherlands
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van der Kamp MR, Nieuwdorp BW, Thio BJ, Tabak M, Kamps AWA, Hermens HJ, Driessen JMM. Can the Childhood Physical Activity Questionnaire Be Used to Identify Physical Activity Levels in Children With Asthma? Front Pediatr 2021; 9:726695. [PMID: 34692606 PMCID: PMC8528107 DOI: 10.3389/fped.2021.726695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/01/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Children with asthma who are physically active have a better quality of life, emphasizing the importance of activity monitoring and promotion in daily life. The validity of self-reported activity measurements has been questioned in pediatric populations. In this study, we aim to compare the Physical Activity Questionnaire for Children (PAQ-C) with objectively measured PA using accelerometry. Design: In this comparison study, the pooled dataset of two cross-sectional studies was used, which prospectively home-monitored PA using the alternative self-report PAQ-C questionnaire as well as with the criterion standard accelerometry (Actigraph wGT3X-BT and GT1M). Participants:Ninety children with pediatrician-diagnosed asthma participated in the study. Main Outcome Measures:Correlation coefficients were calculated to determine the relation between the PAQ-C and accelerometer data. The predictive value of the PAQ-C in differentiating between achieving and failing the recommended daily level of moderate-to-vigorous activity (MVPA) was evaluated with receiver operator characteristic (ROC) analysis. Results: The results showed weak to moderate correlations of the PAQ-C with the accelerometer data (r = 0.29-0.47). A PAQ-C cutoff of 3.09 showed the best performance on predicting whether the recommended level of MVPA was achieved. With this cutoff, 21 of the 39 children that did achieve their daily MVPA level (53.8% sensitivity) and 33 of the 46 children that did fail their daily MVPA level (71.7% specificity) were correctly classified. A PAQ-C score of 3.5 revealed a negative predictive value of 100% for assessing physical inactivity. Conclusion: This study revealed a weak relation between the PAQ-C and PA assessed with accelerometry. However, a PAQ-C score of 3.5 or higher might be used as a low-cost and easy-to-use PA screening tool for ruling out physical inactivity in a portion of the pediatric asthma population. Clinical Trial Registration: Netherlands Trial Register: Trial NL6087.
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Affiliation(s)
- Mattienne R. van der Kamp
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
- Department of Pediatrics, Medisch Spectrum Twente, Enschede, Netherlands
- Roessingh Research and Development, Enschede, Netherlands
| | - Bram W. Nieuwdorp
- Department of Pediatrics, Martini Ziekenhuis, Groningen, Netherlands
| | - Boony J. Thio
- Department of Pediatrics, Medisch Spectrum Twente, Enschede, Netherlands
| | - Monique Tabak
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
- Roessingh Research and Development, Enschede, Netherlands
| | - Arvid W. A. Kamps
- Department of Pediatrics, Martini Ziekenhuis, Groningen, Netherlands
| | - Hermie J. Hermens
- Department of Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
- Roessingh Research and Development, Enschede, Netherlands
| | - Jean M. M. Driessen
- Independent Researcher, Groningen, Netherlands
- Department of Sports Medicine, Ziekenhuis Tjongerschans, Heerenveen, Netherlands
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Sanz-Santiago V, Diez-Vega I, Donadio MVF, Schiwe D, Lopez-Nuevo C, Vendrusculo FM, Santana-Sosa E, Burgos S, Escribano-Ceruelo E, Villa-Asensi JR, Perez-Ruiz M. Comparison of physical fitness between healthy and mild-to-moderate asthmatic children with exercise symptoms: A cross-sectional study. Pediatr Pulmonol 2021; 56:2512-2521. [PMID: 34061472 DOI: 10.1002/ppul.25506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/15/2021] [Accepted: 05/17/2021] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Asthma is a chronic disease that may affect physical fitness, although its primary effects on exercise capacity, muscle strength, functionality and lifestyle, in children and adolescents, are still poorly understood. This study aimed to evaluate the differences in cardiorespiratory fitness, muscle strength, lifestyle, lung function, and functionality between asthmatics with exercise symptoms and healthy children. In addition, we have analyzed the association between clinical history and the presence of asthma. STUDY DESIGN Cross-sectional study including 71 patients with a diagnosis of asthma and 71 healthy children and adolescents (7-17 years of age). Anthropometric data, clinical history, disease control, lifestyle (KIDMED and physical activity questionnaires), lung function (spirometry), exercise-induced bronchoconstriction test, aerobic fitness (cardiopulmonary exercise test), muscle strength and functionality (timed up and go; timed up and down stairs) were evaluated. RESULTS Seventy-one patients with asthma (mean age 11.5 ± 2.7) and 71 healthy subjects (mean age 10.7 ± 2.5) were included. All asthmatic children had mild to moderate and stable asthma. EIB occurred in 56.3% of asthmatic children. Lung function was significantly (p < .05) lower in the asthmatic group when compared to healthy peers, as well as the cardiorespiratory fitness, muscle strength, lifestyle and functionality. Moreover, asthmatic children were more likely to have atopic dermatitis, allergic reactions, food allergies, and a family history of asthma when compared to healthy children. CONCLUSIONS Children with mild-to-moderate asthma presenting exercise symptoms show a reduction in cardiorespiratory fitness, muscle strength, lung function, functionality, and lifestyle when compared to healthy peers. The study provides data for pediatricians to support exercise practice aiming to improve prognosis and quality of life in asthmatic children.
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Affiliation(s)
| | - Ignacio Diez-Vega
- Department of Nursing and Physiotherapy, Faculty of Health Sciences, Universidad de León, Ponferrada, León, Spain
| | - Márcio Vinícius Fagundes Donadio
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Daniele Schiwe
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | | | - Fernanda M Vendrusculo
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | | | - Silvia Burgos
- Faculty of Sport Sciences, European University of Madrid, Madrid, Spain
| | | | - Jose R Villa-Asensi
- Section of Pulmonology, Niño Jesús Children's University Hospital, Madrid, Spain
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Jezioro JR, Gutman SA, Lovinsky-Desir S, Rauh V, Perera FP, Miller RL. A Comparison of Activity Participation between Children with and without Asthma. OPEN JOURNAL OF OCCUPATIONAL THERAPY 2021; 9. [PMID: 34316416 DOI: 10.15453/2168-6408.1813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Asthma affects approximately 6 million children in the United States and can greatly impact quality of life and occupational engagement. Although occupational therapists are well-equipped to address participation limitations, insufficient evidence exists to support the role of occupational therapists in asthma treatment. Method The purpose of this study was to further understand the occupational limitations experienced by children with asthma. We also explored a dual diagnosis of asthma and obesity. The participants included children with (n = 84) and without (n = 63) asthma living in New York City. The Child Behavior Checklist, Youth Self Report, Brief Respiratory Questionnaire, and accelerometer data were used to examine occupational participation. Results Although accelerometry data demonstrated that children with asthma were equally as active as their non-asthmatic peers, the participants with asthma perceived themselves as participating more in sedentary occupations and were less likely to be members of sports teams. They also had more missed school days and nights of troubled sleep. The children with both asthma and obesity reported the highest level of activity limitations. Conclusion This study illustrates specific limitations experienced by children with asthma and supports the need for occupational therapy intervention. Future studies are needed to design and assess interventions that will support the addition of occupational therapists to multidisciplinary asthma treatment teams.
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Vasconcello-Castillo L, Torres-Castro R, Sepúlveda-Cáceres N, Acosta-Dighero R, Miranda-Aguilera S, Puppo H, Rodríguez-Borges J, Vilaró J. Levels of physical activity in children and adolescents with asthma: A systematic review and meta-analysis. Pediatr Pulmonol 2021; 56:1307-1323. [PMID: 33559968 DOI: 10.1002/ppul.25293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/15/2020] [Accepted: 01/22/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND In children and adolescents with asthma, the disease may reduce the perceived capability to participate in physical activity (PA) contributing to an increase in the sedentary lifestyle. The literature is unclear as to whether children and adolescents with asthma differ their PA levels from their healthy peers. OBJECTIVE Our objective was to describe the different methods and instruments used to measure PA and to compare the PA levels of children and adolescents with asthma with those of their healthy peers. STUDY DESIGN We conducted a systematic review of five databases. We included studies that compared the PA measured by objective and subjective instruments in children and adolescents with asthma versus controls. Two independent reviewers analyzed the studies, extracted the data, and assessed the quality of evidence. RESULTS Of the 5966 reports returned by the initial search, 28 articles reporting on 3184 patients were included in the data synthesis. A forest plot showed that both groups had similar values of moderate to vigorous PA (MVPA; mean difference, -0.05 h/day; 95% confidence interval [CI], -0.11-0.01; p = .13), sedentary time (mean difference 0.00 h/day; 95% CI, -0.22-0.23 h/day; p = .99) and steps/day (mean difference 354 steps/day; 95% CI, -563-1270 steps/day; p = .45). CONCLUSION Children and adolescents with asthma have similar MVPA, steps/day, and sedentary time compared to the controls. The main instruments used were questionnaires and accelerometers.
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Affiliation(s)
- Luis Vasconcello-Castillo
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.,International Physiotherapy Research Network (PhysioEvidence)
| | - Rodrigo Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.,International Physiotherapy Research Network (PhysioEvidence)
| | | | - Roberto Acosta-Dighero
- Unidad de (Re)Habilitación con Atención Clínica Integral (URACI), Hospital de Niños Roberto del Río, Santiago, Chile
| | | | - Homero Puppo
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.,International Physiotherapy Research Network (PhysioEvidence)
| | - Jorge Rodríguez-Borges
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.,Unidad de (Re)Habilitación con Atención Clínica Integral (URACI), Hospital de Niños Roberto del Río, Santiago, Chile
| | - Jordi Vilaró
- International Physiotherapy Research Network (PhysioEvidence).,Blanquerna School of Health Sciences, Global Research on Wellbeing (GRoW), Universitat Ramon Llull, Barcelona, Spain
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12
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Gianfrancesco L, Malheiro APG, Matsunaga NY, Oliveira MS, Grotta MB, Morcillo AM, Ribeiro JD, Toro AADC. Are there differences in the physical activity level and functional capacity among children and adolescents with and without asthma? J Pediatr (Rio J) 2021; 97:295-301. [PMID: 32521233 PMCID: PMC9432013 DOI: 10.1016/j.jped.2020.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/12/2020] [Accepted: 04/13/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The aim of this study was to analyze the physical activity level, using two tools, and the functional capacity of children and adolescents with asthma and with different levels of disease control, and to compare them to those of individuals without asthma. METHODS Cross-sectional study with children and adolescents with (asthma group, AG) and without asthma (WAG), aged from 7 to 17 years. All participants performed the six-minute walk test (6MWT), the Glittre Activities of Daily Living test (Glittre-ADL), the International Physical Activity Questionnaire (IPAQ), and daily record of steps on a pedometer. RESULTS The study included 145 individuals with asthma and 173 individuals without asthma. The WAG walked a greater distance in the 6MWT and performed the Glittre-ADL in less time than the AG. Individuals with uncontrolled, partially controlled, and controlled asthma presented the same functional capacity. A difference was observed in the IPAQ classification, with 13.9% of participants from the WAG being sedentary, compared with 26.2% in the AG. The mean quantity of steps measured by the pedometer was higher in the WAG. CONCLUSION There was a difference in the performance of individuals with and without asthma in the physical activity and functional capacity tests. The AG presented worse performance in the physical activity tests and, regardless of the level of asthma control, presented worse functional capacity.
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Affiliation(s)
- Lívea Gianfrancesco
- Universidade Estadual de Campinas (Unicamp), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Campinas, SP, Brazil; Universidade Estadual de Campinas (Unicamp), Laboratório de Fisiologia Pulmonar, Campinas, SP, Brazil
| | - Ana Paula Gaban Malheiro
- Universidade Estadual de Campinas (Unicamp), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Campinas, SP, Brazil; Universidade Estadual de Campinas (Unicamp), Laboratório de Fisiologia Pulmonar, Campinas, SP, Brazil
| | - Natasha Yumi Matsunaga
- Universidade Estadual de Campinas (Unicamp), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Campinas, SP, Brazil; Universidade Estadual de Campinas (Unicamp), Laboratório de Fisiologia Pulmonar, Campinas, SP, Brazil
| | - Marina Simões Oliveira
- Universidade Estadual de Campinas (Unicamp), Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Campinas, SP, Brazil; Universidade Estadual de Campinas (Unicamp), Laboratório de Fisiologia Pulmonar, Campinas, SP, Brazil
| | - Milena Baptistella Grotta
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil
| | - André Moreno Morcillo
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil
| | - José Dirceu Ribeiro
- Universidade Estadual de Campinas (Unicamp), Laboratório de Fisiologia Pulmonar, Campinas, SP, Brazil; Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil
| | - Adyléia Aparecida Dalbo Contrera Toro
- Universidade Estadual de Campinas (Unicamp), Laboratório de Fisiologia Pulmonar, Campinas, SP, Brazil; Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil.
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13
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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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14
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Cassim R, Dharmage SC, Peters RL, Koplin JJ, Allen KJ, Tang MLK, Lowe AJ, Olds TS, Fraysse F, Milanzi E, Russell MA. Are young children with asthma more likely to be less physically active? Pediatr Allergy Immunol 2021; 32:288-294. [PMID: 32997845 DOI: 10.1111/pai.13383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous research suggests that children who experience asthma may be less physically active; however, results have been inconclusive. This study aimed to investigate whether the presence of asthma or wheeze is associated with lower physical activity levels in children, and whether sex, body mass index or earlier asthma or wheeze status modifies the association. METHODS This study was conducted in 391 HealthNuts participants in Melbourne, Australia. Asthma and wheeze data were collected via questionnaire at age 4 and 6, and physical activity was measured through accelerometry. Using adjusted linear regression models, the cross-sectional and longitudinal associations were investigated. RESULTS There was no evidence of a difference in time spent in moderate-to-vigorous physical activity (MVPA) at age 6 years between children with and without asthma at age 4; children with asthma spent 8.3 minutes more time physically active per day (95% CI: -5.6, 22.1, P = .24) than children without asthma. Similar results were seen for children with current wheeze (5.8 minutes per day more, 95% CI: -5.9, 17.5, P = .33) or ever wheeze or asthma (7.7 minutes per day more, 95% CI: -4.8, 20.2, P = .23) at age 4 years. Comparable null results were observed in the cross-sectional analyses. Interaction with BMI could not be assessed; however, previous asthma or wheeze status and sex were not found to modify these associations. CONCLUSION This analysis found no evidence of asthma hindering physical activity in these young children. These results are encouraging, as they indicate that the Australian asthma and physical activity public health campaigns are being effectively communicated and adopted by the public.
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Affiliation(s)
- Raisa Cassim
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Heath, University of Melbourne, Parkville, Vic, Australia.,Population Allergy Group, Murdoch Children's Research Institute, Parkville, Vic, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Heath, University of Melbourne, Parkville, Vic, Australia.,Population Allergy Group, Murdoch Children's Research Institute, Parkville, Vic, Australia
| | - Rachel L Peters
- Population Allergy Group, Murdoch Children's Research Institute, Parkville, Vic, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Vic, Australia
| | - Jennifer J Koplin
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Heath, University of Melbourne, Parkville, Vic, Australia.,Population Allergy Group, Murdoch Children's Research Institute, Parkville, Vic, Australia
| | - Katrina J Allen
- Population Allergy Group, Murdoch Children's Research Institute, Parkville, Vic, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Vic, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Vic, Australia
| | - Mimi L K Tang
- Population Allergy Group, Murdoch Children's Research Institute, Parkville, Vic, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Vic, Australia.,Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Vic, Australia
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Heath, University of Melbourne, Parkville, Vic, Australia.,Population Allergy Group, Murdoch Children's Research Institute, Parkville, Vic, Australia
| | - Timothy S Olds
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Francois Fraysse
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, SA, Australia
| | - Elasma Milanzi
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Heath, University of Melbourne, Parkville, Vic, Australia
| | - Melissa A Russell
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Heath, University of Melbourne, Parkville, Vic, Australia.,Population Allergy Group, Murdoch Children's Research Institute, Parkville, Vic, Australia
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15
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Faleiro RC, Mancuzo EV, Lanza FC, Queiroz MVNP, de Oliveira LFL, Ganem VO, Lasmar LB. Exercise Limitation in Children and Adolescents With Severe Refractory Asthma: A Lack of Asthma Control? Front Physiol 2021; 11:620736. [PMID: 33574767 PMCID: PMC7870485 DOI: 10.3389/fphys.2020.620736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 12/31/2020] [Indexed: 11/13/2022] Open
Abstract
Background Patients with severe refractory asthma (SRA), even when using high doses of multiple controller medications in a regular and appropriate way, can have persistent complaints of exercise limitation. Methods This was a cross-sectional study involving patients with SRA (treated with ≥ 800 μg of budesonide or equivalent, with ≥ 80% adherence, appropriate inhaler technique, and comorbidities treated), who presented no signs of a lack of asthma control other than exercise limitation. We also evaluated healthy controls, matched to the patients for sex, age, and body mass index. All participants underwent cardiopulmonary exercise testing (CPET) on a cycle ergometer, maximum exertion being defined as ≥ 85% of the predicted heart rate, with a respiratory exchange ratio ≥ 1.0 for children and ≥ 1.1 for adolescents. Physical deconditioning was defined as oxygen uptake (VO2) < 80% of predicted at peak exercise, without cardiac impairment or ventilatory limitation. Exercise-induced bronchoconstriction (EIB) was defined as a forced expiratory volume in one second ≥ 10% lower than the baseline value at 5, 10, 20, and 30 minutes after CPET. Results We evaluated 20 patients with SRA and 19 controls. In the sample as a whole, the mean age was 12.9 ± 0.4 years. The CPET was considered maximal in all participants. In terms of the peak VO2 (VO2 peak), there was no significant difference between the patients and controls, (P = 0.10). Among the patients, we observed isolated EIB in 30%, isolated physical deconditioning in 25%, physical deconditioning accompanied by EIB in 25%, and exercise-induced symptoms not supported by the CPET data in 15%. Conclusion and Clinical Relevance Physical deconditioning, alone or accompanied by EIB, was the determining factor in reducing exercise tolerance in patients with SRA and was not therefore found to be associated with a lack of asthma control.
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Affiliation(s)
- Rita C Faleiro
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Eliane V Mancuzo
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fernanda C Lanza
- School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Mônica V N P Queiroz
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luciano F L de Oliveira
- School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Vinicius O Ganem
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Laura B Lasmar
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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16
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Physical Activity in Children and Adolescents With Chronic Respiratory Diseases: A Systematic Review and Meta-Analysis. J Phys Act Health 2021; 18:219-229. [PMID: 33440346 DOI: 10.1123/jpah.2020-0641] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/31/2020] [Accepted: 11/07/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The literature is unclear as to whether children and adolescents with chronic respiratory diseases (CRDs) differ from their healthy peers in physical activity (PA). OBJECTIVE To determine the PA levels measured through accelerometers in children and adolescents with CRDs. METHODS The authors conducted a systematic review using five databases. The authors included studies that assessed the PA measured by accelerometers in children and adolescents with CRDs. Two independent reviewers analyzed the studies, extracted the data, and assessed the quality of evidence. RESULTS From 11,497 reports returned by the initial search, 29 articles reporting on 4381 patients were included. In the sensitivity analysis, the authors found that children and adolescents with CRDs had a moderate-to-vigorous PA (MVPA) of -0.08 hours per day (95% confidence interval [CI], -0.12 to -0.03 h/d; P = .001), which was lower than the healthy controls; the values for sedentary time (mean difference -0.47 h/d; 95% CI, -1.29 to 0.36 h/d; P = .27) and steps/d (mean difference 361 steps/d; 95% CI -385 to 1707 steps/d; P = .45) were similar for both. CONCLUSION Children and adolescents with CRDs have a slight reduction in MVPA in comparison with healthy controls, but sedentary time and steps/d were similar for both.
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17
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Sousa AW, Cabral ALB, Silva RA, Fonseca AJ, Grindler J, Martins MA, Carvalho CRF. Physical fitness and quality of life in adolescents with asthma and fixed airflow obstruction. Pediatr Pulmonol 2021; 56:65-73. [PMID: 33155764 DOI: 10.1002/ppul.25160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/15/2020] [Accepted: 10/30/2020] [Indexed: 01/21/2023]
Abstract
UNLABELLED Asthma is a disease characterized by reversible bronchoconstriction, but some subjects develop fixed airflow obstruction (FAO). Subjects with FAO present more asthma symptoms and may have increased sedentary behavior; however, the effect of FAO on aerobic fitness and physical activity levels (PAL) remains poorly understood. AIM To compare adolescents with asthma and FAO and adolescents with asthma without FAO in terms of aerobic fitness, PAL, muscle strength, and health-related quality of life (HRQoL). METHODS This cross-sectional study included adolescents with asthma, both sexes, and aged 12-18 years. They were divided into two groups: FAO and non-FAO groups. The adolescents were diagnosed with asthma according to the Global Initiative for Asthma guidelines and underwent optimal pharmacological treatment for at least 12 months. FAO was diagnosed when the forced expiratory volume in the first second/forced vital capacity ratio was below the lower limit of the normal range after optimal treatment. Aerobic fitness, PAL, peripheral and respiratory muscle strength, and HRQoL were evaluated. RESULTS No significant differences were observed between FAO and non-FAO groups regarding the peak oxygen uptake (34.6 ± 8.5 vs. 36.0 ± 8.4 mLO2 /min/kg), sedentary time (578 ± 126 vs. 563 ± 90 min/day), upper limb muscle strength (29.1 ± 5.9 vs. 28.1 ± 5.7 kilograms of force [kgf]), lower limb muscle strength (42.8 ± 8.6 vs. 47.6 ± 9.6 kgf), or HRQoL (5.1 ± 1.3 vs. 4.7 ± 1.4 score; p > .05). However, the FAO group exhibited a higher maximal expiratory pressure than the non-FAO group (111.5 ± 15.5 vs. 101.5 ± 15.0 cmH2 O, respectively). CONCLUSION Our results suggest that FAO does not impair aerobic fitness, PAL, peripheral muscle strength, or HRQoL in adolescents with asthma. Furthermore, adolescents with asthma were physically deconditioned.
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Affiliation(s)
- Andrey Wirgues Sousa
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Sao Paulo, Brazil
| | | | - Ronaldo Aparecido Silva
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Sao Paulo, Brazil
| | - Alfredo José Fonseca
- Department of Clinical Medicine, School of Medicine, University of São Paulo, São Paulo, Sao Paulo, Brazil
| | - José Grindler
- Department of Clinical Medicine, School of Medicine, University of São Paulo, São Paulo, Sao Paulo, Brazil
| | - Milton Arruda Martins
- Department of Clinical Medicine, School of Medicine, University of São Paulo, São Paulo, Sao Paulo, Brazil
| | - Celso R F Carvalho
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Sao Paulo, Brazil
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18
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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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19
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Namburar S, Checkley W, Flores-Flores O, Romero KM, Fraser KT, Hansel NN, Pollard SL. Risk Factors for Physical Inactivity Among Children With and Without Asthma Living in Peri-Urban Communities of Lima, Peru. J Phys Act Health 2020; 17:816-822. [PMID: 32663801 DOI: 10.1123/jpah.2019-0553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/30/2020] [Accepted: 05/15/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The authors sought to examine physical activity patterns among children with and without asthma in 2 peri-urban communities in Lima, Peru, to identify socioeconomic and demographic risk factors for physical inactivity and examine the relationship between asthma and physical activity. METHODS The authors measured mean steps per day in 114 children (49 with asthma and 65 without) using pedometers worn over a 1-week period. They also used the 3-day physical activity recall to determine the most common activities carried out by children. RESULTS The authors found that 84.2% of the children did not meet the daily international physical activity recommendations. Girls took significantly fewer mean steps per day as compared with boys (2258 fewer steps, 95% confidence interval, 1042-3474), but no other factors, including asthma status, showed significant differences in the mean daily steps. Mean daily steps were positively associated with higher socioeconomic status among girls, and current asthma had a larger inverse effect on daily steps in boys when compared with girls. CONCLUSION Physical activity levels were below recommended guidelines in all children. There is a need for policy and neighborhood-level interventions to address low physical activity levels among Peruvian youth. Special focus should be given to increasing the physical activity levels in girls.
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20
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Brynjulfsen T, Demmelmaier I, Berntsen S, Foyn TH, Andersen OK, Stang J, Sigdestad JB, Stensrud T, Tufte K, Nielsen A, Westergren T. Motivation for physical activity in adolescents with asthma. J Asthma 2020; 58:1247-1255. [PMID: 32493080 DOI: 10.1080/02770903.2020.1778025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE We explored motivation for physical activity (PA) and exercise in adolescents with asthma who entered and continued a 10-week play-based exercise intervention. METHODS Eighteen adolescents with asthma, aged 13-17 years, participated in a 10-week play- and interval-based indoor exercise intervention during winter and autumn months. Semi-structured focus group interviews were conducted in weeks 2 and 8, focusing on motivation for PA and exercise, as well as field observations of exercise sessions in weeks 2, 6, and 8. The first interview was analyzed separately from the second one and descriptive observational data were obtained using thematic analysis and self-determination theory as a framework. RESULTS In the first round of focus group interviews, participants (n = 18) described amotivation and motivation for PA within the following five themes: "teachers' lack of asthma knowledge", "embarrassment over asthma symptoms", "not being able to keep pace with peers", "seasonal challenges", and "mastering fun physical activities". Based on the second interview (n = 14) and descriptive observational data (n = 18), participants reported and revealed amotivation and motivation for PA within the following four themes: "understanding and relatedness", "social support", "competition", and "mastering fun activities". CONCLUSION We conclude that play-based exercises designed for groups of adolescents with asthma can support motivation for PA and exercise and reduce social and asthma-specific barriers.
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Affiliation(s)
- Trine Brynjulfsen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Ingrid Demmelmaier
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Sveinung Berntsen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Tonje Hellum Foyn
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | | | - Julie Stang
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Trine Stensrud
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Kristine Tufte
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Thomas Westergren
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Eijkemans M, Mommers M, Remmers T, Draaisma JMT, Prins MH, Thijs C. Physical activity and asthma development in childhood: Prospective birth cohort study. Pediatr Pulmonol 2020; 55:76-82. [PMID: 31571422 PMCID: PMC6973260 DOI: 10.1002/ppul.24531] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 09/16/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Sedentary behavior and decreased physical activity are possible risk factors for developing asthma. This longitudinal study investigates the association between physical activity and subsequent asthma. We hypothesize that children with decreased physical activity at early school age, have higher risk of developing asthma. METHODS One thousand eight hundred thirty-eight children from the KOALA Birth Cohort Study were analyzed. Children who were born prematurely or with congenital defects/diseases with possible influence on either physical activity or respiratory symptoms were excluded. Physical activity, sedentary behavior, and screen time were measured at age 4 to 5 years by questionnaire and accelerometry in a subgroup (n = 301). Primary outcome was asthma, assessed by repeated ISAAC questionnaires between age 6 and 10. Secondary outcome was lung function measured by spirometry in a subgroup (n = 485, accelerometry subgroup n = 62) (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC] and FEV1/FVC ratio) at age 6 to 7 years. RESULTS Reported physical activity was not associated with reported asthma nor lung function. Accelerometry data showed that daily being 1 hour less physically active was associated with a lower FEV1/FVC (z score β, -0.65; 95% confidence interval, -1.06 to -0.24). CONCLUSIONS Physical activity at early school age was not associated with reported asthma development later in life. However, lung function results showed that sedentary activity time was associated with lower FEV1/FVC later in childhood. As this is the first longitudinal study with objectively measured physical activity and lung function, and because the subgroup sample size was small, this result needs replication.
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Affiliation(s)
- Marianne Eijkemans
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Department of Pediatrics, Catharina Hospital, Eindhoven, The Netherlands
| | - Monique Mommers
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Teun Remmers
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,School of Sport Studies, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Jos M Th Draaisma
- Department of Pediatrics, Radboudumc Amalia Children's Hospital, Nijmegen, The Netherlands.,Department of Pediatrics, Viecuri Medical Centre, Venlo, The Netherlands
| | - Martin H Prins
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Carel Thijs
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Reimberg MM, Pachi JRS, Scalco RS, Serra AJ, Fernandes L, Politti F, Wandalsen GF, Solé D, Dal Corso S, Lanza FC. Patients with asthma have reduced functional capacity and sedentary behavior. J Pediatr (Rio J) 2020; 96:53-59. [PMID: 30240630 PMCID: PMC9432245 DOI: 10.1016/j.jped.2018.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/30/2018] [Accepted: 07/03/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The modified shuttle test is a field test that avoids the ceiling effect, and there are no reports of a multidimensional assessment concerning physical activity in asthmatic patients. Thus, the aim was to evaluate functional capacity by MST, additionally to perform a multidimensional assessment as physical activity in daily life, muscle strength, and cytokine levels in children and adolescents with asthma, and to correlate these variables. METHOD This cross-sectional study included volunteers aged between 6 and 18 years who were divided into two groups: asthma group (n=43) that received regular treatment and control group (n=24). Functional capacity was evaluated by distance walked during the MST; physical activity in daily life was evaluated using an accelerometer by the number of steps. Quadriceps femoris strength was evaluated by load cell. RESULTS Distance walked was lower for the asthma group (790m [222m]) when compared with the control group (950m [240m]; p=0.007); however, the number of steps was similar between the two groups (asthma group: 7743 [3075]; control group: 7181 [3040]; p=0.41), and both groups were classified as sedentary behavior. There was no difference in muscle strength. Tumor necrosis factor-α differed, but interleukin levels were similar between groups. Quadriceps strength was correlated to distance walked (r=0.62; p<0.001) and tumor necrosis factor-α to the number of steps taken (r=-0.54, p=0.005). CONCLUSION Children and adolescents undergoing regular asthma treatment showed reduced functional capacity and sedentary behavior. The lower the quadriceps strength, the shorter the distance walked; the higher the tumor necrosis factor-α levels, the lower their daily physical activity levels.
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Affiliation(s)
- Mariana Mazzuca Reimberg
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | | | - Rebeca Souza Scalco
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Andrey Jorge Serra
- Universidade Federal de São Paulo (UNIFESP), Departamento de Cardiologia, São Paulo, SP, Brazil; Universidade Nove de Julho, Programa de Pós-Graduação em Biofotônica Aplicada à Ciência da Saúde, São Paulo, SP, Brazil
| | - Leandro Fernandes
- Universidade Federal de São Paulo (UNIFESP), Programa de Pós-Graduação em Psicobiologia, São Paulo, SP, Brazil
| | - Fabiano Politti
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Gustavo Falbo Wandalsen
- Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Alergia, Imunologia Clínica e Reumatologia, São Paulo, SP, Brazil
| | - Dirceu Solé
- Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Alergia, Imunologia Clínica e Reumatologia, São Paulo, SP, Brazil
| | - Simone Dal Corso
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Fernanda Cordoba Lanza
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil.
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Reimberg MM, Pachi JRS, Scalco RS, Serra AJ, Fernandes L, Politti F, Wandalsen GF, Solé D, Dal Corso S, Lanza FC. Patients with asthma have reduced functional capacity and sedentary behavior. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [DOI: 10.1016/j.jpedp.2018.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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24
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Spiegler J, Eves R, Mendonça M, Wolke D. Association of physical activity and cardiorespiratory function or BMI and body composition in preterm-born individuals: a systematic review. Acta Paediatr 2019; 108:1205-1214. [PMID: 30664798 DOI: 10.1111/apa.14726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 12/01/2022]
Abstract
AIM To evaluate the association of physical activity (PA) and forced expiratory volume in one second (FEV1), peak oxygen consumption (pVO2), body mass index (BMI) and body composition in preterm-born individuals. METHODS Cochrane Library, EMBASE, MEDLINE, AMED, ERIC, Web of Science and PsycInfo were searched with no restriction on language and date of publication from inception to January 2018. Data were extracted comparing preterm-born individuals with different frequencies of PA and the outcome of interest. RESULTS One randomized controlled, two longitudinal and thirteen cross-sectional studies comprising 1922 preterm-born individuals aged 5-25 were included. Assessment varied from a PA program to accelerometer data, interviews and self-report questionnaires. In preterm-born children, more PA was associated with better cardiorespiratory function in those groups with impaired lung function or with lower BMI in those groups with increased risk factors, but no association was found in unimpaired children. In preterm-born adults, more PA was associated with higher pVO2 and lower BMI. CONCLUSION Only tentative conclusions can be drawn, especially regarding differences of the association of PA between preterm- and term-born populations. Further studies are needed to analyse the association of PA in preterm-born individuals with reduced cardiorespiratory function.
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Affiliation(s)
- Juliane Spiegler
- Department of Psychology and Division of Mental Health & Wellbeing University of Warwick Coventry UK
- Department of Paediatrics University of Lübeck Lübeck Germany
| | - Robert Eves
- Department of Psychology and Division of Mental Health & Wellbeing University of Warwick Coventry UK
| | - Marina Mendonça
- Department of Psychology and Division of Mental Health & Wellbeing University of Warwick Coventry UK
| | - Dieter Wolke
- Department of Psychology and Division of Mental Health & Wellbeing University of Warwick Coventry UK
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25
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Sehgal S, Small B, Highland KB. Activity monitors in pulmonary disease. Respir Med 2019; 151:81-95. [PMID: 31047122 DOI: 10.1016/j.rmed.2019.03.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 03/25/2019] [Accepted: 03/27/2019] [Indexed: 12/20/2022]
Abstract
Physical activity is reduced in patients with chronic pulmonary diseases. Activity monitors can measure physical activity objectively and accurately over prolonged periods of time. Research grade and commercially available devices, using accelerometer technology, are being increasingly used in clinical studies. Physical activity levels have been found to have a moderate to strong correlation with important measures such as pulmonary function, exercise capacity, quality of life, and mortality and hospitalizations in patients with COPD, interstitial lung disease, pulmonary arterial hypertension and cystic fibrosis. Their use as a clinical trial end-point and as a tool to augment rehabilitation efforts has also been explored in patients with COPD with variable results. Due to the ease of use, economic viability, widespread availability and good patient compliance, their use in adult and pediatric medicine is expanding. This narrative review summarizes the current evidence of use of activity monitors in COPD, interstitial lung disease, asthma, pulmonary arterial hypertension, cystic fibrosis and lung transplant patients for the purposes of prognostication, monitoring, outcome measures and intervention.
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Affiliation(s)
- Sameep Sehgal
- Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
| | - Bronwyn Small
- Respiratory Institute, Cleveland Clinic, Cleveland, OH, USA
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26
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Jago R, Salway RE, Ness AR, Shield JPH, Ridd MJ, Henderson AJ. Associations between physical activity and asthma, eczema and obesity in children aged 12-16: an observational cohort study. BMJ Open 2019; 9:e024858. [PMID: 30662005 PMCID: PMC6340420 DOI: 10.1136/bmjopen-2018-024858] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/19/2018] [Accepted: 11/27/2018] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To compare the physical activity of adolescents with three common long-term conditions (asthma, eczema and obesity) with adolescents without these conditions. DESIGN Cross-sectional and longitudinal analyses of adolescents at ages 12, 14 and 16 in a large UK cohort study. SETTING The Avon Longitudinal Study of Parents and Children. PARTICIPANTS 6473 adolescents with complete accelerometer data at at least one time point. METHODS Mean minutes of moderate to vigorous intensity physical activity (MVPA) and sedentary time per day were derived from accelerometer-based measurements at ages 12, 14 and 16. Obesity was defined at each time point from height and weight measurements. Parents reported doctor-assessed asthma or eczema. Cross-sectional and longitudinal regression models examined any differences in MVPA or sedentary time for adolescents with asthma, eczema or obesity compared with those without. RESULTS In longitudinal models, boys engaged in an average of 69.7 (95% CI 67.6 to 71.7) min MVPA at age 12, declining by 3.1 (95% CI 2.6 to 3.6) min/year while girls' average MVPA was 47.5 (95% CI 46.1 to 48.9) min at age 12, declining by 1.8 (95% CI 1.5 to 2.1) min/year. There was no strong evidence of differences in physical activity patterns of those with and without asthma or eczema. Obese boys engaged in 11.1 (95% CI 8.7 to 13.6) fewer minutes of MVPA, and obese girls in 5.0 (95% CI 3.3 to 6.8) fewer minutes than their non-obese counterparts. Cross-sectional models showed comparable findings. CONCLUSIONS Mean minutes of MVPA per day did not differ between adolescents with asthma or eczema and those without, but obese adolescents engaged in fewer minutes of MVPA. Findings reinforce the need for strategies to help obese adolescents be more active but suggest no need to develop bespoke physical activity strategies for adolescents with mild asthma or eczema.
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Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West (CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Ruth E Salway
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Andy R Ness
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
- Bristol Dental School, University of Bristol, Bristol, UK
| | - Julian P Hamilton Shield
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Matthew J Ridd
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - A John Henderson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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27
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West SL, Banks L, Schneiderman JE, Caterini JE, Stephens S, White G, Dogra S, Wells GD. Physical activity for children with chronic disease; a narrative review and practical applications. BMC Pediatr 2019; 19:12. [PMID: 30621667 PMCID: PMC6325687 DOI: 10.1186/s12887-018-1377-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 12/18/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Physical activity (PA) is associated with a diverse range of health benefits. International guidelines suggest that children should be participating in a minimum of 60 min of moderate to vigorous intensity PA per day to achieve these benefits. However, current guidelines are intended for healthy children, and thus may not be applicable to children with a chronic disease. Specifically, the dose of PA and disease specific exercise considerations are not included in these guidelines, leaving such children with few, if any, evidence-based informed suggestions pertaining to PA. Thus, the purpose of this narrative review was to consider current literature in the area of exercise as medicine and provide practical applications for exercise in five prevalent pediatric chronic diseases: respiratory, congenital heart, metabolic, systemic inflammatory/autoimmune, and cancer. METHODS For each disease, we present the pathophysiology of exercise intolerance, summarize the pediatric exercise intervention research, and provide PA suggestions. RESULTS Overall, exercise intolerance is prevalent in pediatric chronic disease. PA is important and safe for most children with a chronic disease, however exercise prescription should involve the entire health care team to create an individualized program. CONCLUSIONS Future research, including a systematic review to create evidence-based guidelines, is needed to better understand the safety and efficacy of exercise among children with chronic disease.
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Affiliation(s)
- Sarah L. West
- Department of Biology, Trent/Fleming School of Nursing, Trent University, Toronto, Canada
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
| | | | - Jane E. Schneiderman
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
| | - Jessica E. Caterini
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
| | - Samantha Stephens
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
- Institute of Health Policy Management and Evaluation, The University of Toronto, Toronto, Canada
| | - Gillian White
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
| | - Shilpa Dogra
- Faculty of Health Sciences (Kinesiology), University of Ontario Institute of Technology, Oshawa, Canada
| | - Greg D. Wells
- Translational Medicine, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 10th floor, 686 Bay St., Toronto, ON M5G 0A4 Canada
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28
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Joschtel B, Gomersall SR, Tweedy S, Petsky H, Chang AB, Trost SG. Objectively measured physical activity and sedentary behaviour in children with bronchiectasis: a cross-sectional study. BMC Pulm Med 2019; 19:7. [PMID: 30621677 PMCID: PMC6323769 DOI: 10.1186/s12890-018-0772-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 12/20/2018] [Indexed: 11/10/2022] Open
Abstract
Background Bronchiectasis is a major contributor to respiratory morbidity and health care utilization in children and youth. Current treatment guidelines for bronchiectasis recommend participation in regular physical activity (PA) to improve aerobic fitness and quality of life (QoL). However, no previous study has assessed physical activity and sedentary behavior in this patient group, and the extent to which children with bronchiectasis meet guidelines for PA is unknown. In the absence of such data, we objectively measured the PA of children with bronchiectasis and compared them to current guidelines. Methods Forty-six children with bronchiectasis between 4 to 14 years (mean age 7.5 ± 2.6 years) were recruited from the Queensland Children’s Hospital, Brisbane. Daily time in sedentary, light, and moderate-to-vigorous PA (MVPA) was measured objectively over 7 days using the ActiGraph GT3X+ accelerometer and compared their values to current guidelines (minimum 60 min of MVPA daily). Compliance with the daily guideline and average daily steps counts were compared to normative data from two population–based health surveys of healthy children. Results We had complete measurements from 36 children. On average, they accumulated 48.6 min of MVPA daily and were sedentary for ~ 7 h/day. There was no statistical difference in these values between sexes or weekdays vs. weekends. Only 2 (5.6%) children met the 60-min daily MVPA recommendation compared to 42.1% of healthy children. Children with bronchiectasis accumulated 8229 steps/day (boys: 8422 ± SD 473, girls: 8037 ± 594), well below the recommended 12,000 steps/day. In comparison, daily step counts in healthy children ranged from 11,500–14,500 steps/day. Conclusion Children with bronchiectasis are insufficiently active for health benefit and would substantially benefit from programs to promote PA and reduce sedentary behavior.
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Affiliation(s)
- Barbara Joschtel
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Sjaan R Gomersall
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sean Tweedy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Helen Petsky
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia.,Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia.,Department of Respiratory Medicine, Queensland Children's Hospital, Children's Health Queensland, Brisbane, Australia
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia. .,QLD Centre for Children's Health Research (CCHR), Level 6, 62 Graham Street, South Brisbane, QLD, 4101, Australia.
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29
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Cassim R, Milanzi E, Koplin JJ, Dharmage SC, Russell MA. Physical activity and asthma: cause or consequence? A bidirectional longitudinal analysis. J Epidemiol Community Health 2018; 72:770-775. [PMID: 29730605 DOI: 10.1136/jech-2017-210287] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/26/2018] [Accepted: 04/24/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is increasing interest in the role physical activity (PA) can play in the development and management of asthma. Understanding whether PA can have a positive effect is hindered by the potential influence of asthma on PA and a lack of relevant longitudinal data, leading to a debate on the existence and direction of these links. The aim of this study was to explore whether having asthma results in lower PA levels, and/or whether lower PA levels lead to more asthma in children and adolescents. METHODS In a population-based study of 4983 children, data on asthma and PA were collected via questionnaires and time use diaries biennially, between the ages of 6 and 14. Current asthma was defined as use of asthma medications or wheeze in the past year, and incident asthma was defined as doctor's diagnosis since the previous wave. PA was time spent doing moderate-to-vigorous physical activities in a day. Bidirectionality of this relationship was investigated using cross-lagged structural equational models. RESULTS PA was not longitudinally associated with incident or current asthma. Similarly, there was no evidence that incident or current asthma predicted PA at any of the ages. CONCLUSIONS Using a novel strategy to investigate bidirectionality between PA and asthma, our results suggest that asthma and PA participation are not longitudinally associated in either direction. Our findings suggest that PA does not play an important role in the development or persistence of asthma.
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Affiliation(s)
- Raisa Cassim
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath, University of Melbourne, Melbourne, Victoria, Australia.,Gastro and Food Allergy Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Elasma Milanzi
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath, University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer J Koplin
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath, University of Melbourne, Melbourne, Victoria, Australia.,Gastro and Food Allergy Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath, University of Melbourne, Melbourne, Victoria, Australia.,Gastro and Food Allergy Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Melissa Anne Russell
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath, University of Melbourne, Melbourne, Victoria, Australia.,Gastro and Food Allergy Group, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
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30
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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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