1
|
Ma Q, Lu M, Yang Q, Gong F, Zhou L, Xu D. Effects of aerobic exercise-based pulmonary rehabilitation on quality of life in pediatric asthma: A systematic review and meta-analysis. Heart Lung 2024; 69:11-30. [PMID: 39276534 DOI: 10.1016/j.hrtlng.2024.09.005] [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: 05/21/2024] [Revised: 09/01/2024] [Accepted: 09/03/2024] [Indexed: 09/17/2024]
Abstract
BACKGROUND Pediatric asthma poses a significant global health burden, impacting the well-being and daily lives of affected children. Aerobic exercise-based pulmonary rehabilitation emerges as a promising intervention to address the multifaceted challenges faced by pediatric asthma patients. OBJECTIVES The purpose of this systematic review and meta-analysis was to comprehensively evaluate the effects of aerobic exercise-based pulmonary rehabilitation on pulmonary function and quality of life in pediatric asthma patients. METHODS Randomized controlled trials (RCTs) involving pediatric participants (5-18 years) were included. Aerobic exercise program-based pulmonary rehabilitation interventions were assessed for their impact on actual and percentage predicted values of lung volumes and flow rates such as forced vital capacity (FVC), maximum mid-expiratory flow (FEF25-75), peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), FEV1/FVC, and on quality of life (QoL) measures. A systematic search of databases, hand-searching, and consultation with experts identified relevant studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines guided study selection, data extraction, and quality assessment. RESULTS The systematic review included 20 studies with diverse exercise interventions and outcomes. The meta-analysis using fixed-effects model showed that there was a significant improvement in FVC (% predicted) [SMD= 0.30, 95 %CI: 0.13, 0.48] and FEF25-75 (% predicted) [SMD= 0.31, 95 %CI: 0.03, 0.58] in the experimental group compared with the control group. Furthermore, using a random-effects model involving 12 studies, significant increases in the QoL [SMD= 0.70, 95 %CI: 0.14, 1.26] were found in the exercise group. Due to inter-study heterogeneity, additional analyses were conducted. Publication bias analysis indicated robustness, with no significant asymmetry in funnel plots. CONCLUSION Aerobic exercise-based pulmonary rehabilitation significantly enhances pulmonary function and quality of life in pediatric asthma patients. The findings, supported by improvements in FVC and FEF25-75, demonstrate the efficacy of these interventions. Quality of life measures also showed notable improvements. Despite inter-study heterogeneity, the results are robust, suggesting that aerobic exercise should be considered a valuable non-pharmacological strategy in managing pediatric asthma.
Collapse
Affiliation(s)
- Qunying Ma
- Department of Pediatrics, Zi Gong First People's Hospital, Zigong, Sichuan, 643000, China
| | - Min Lu
- Department of Pediatrics, Suzhou Hospital, Affiliated Hospital of Medical School Nanjing University, Suzhou, Jiangsu, 215128, China
| | - Qiying Yang
- Military casualty management Department, General Hospital of Western Theater of Chinese People's Liberation Army, Chengdu, Sichuan, 610036, China
| | - Feng Gong
- Department of Pediatrics, Zi Gong First People's Hospital, Zigong, Sichuan, 643000, China
| | - Li Zhou
- Department of Pediatrics, Zi Gong First People's Hospital, Zigong, Sichuan, 643000, China
| | - Dandan Xu
- Department of Pediatrics, Heilongjiang Provincial Hospital, District, Harbin, Heilongjiang, 150036, China.
| |
Collapse
|
2
|
Kim DY, Mo YH, Kim KW, Hong SM, Park A, Jang BH, Lee SH, Lee JH, Yoon J, Yu J, Ko EJ. Feasibility of Home-Based Pulmonary Rehabilitation of Pediatric Patients with Chronic Respiratory Diseases. CHILDREN (BASEL, SWITZERLAND) 2024; 11:534. [PMID: 38790529 PMCID: PMC11119592 DOI: 10.3390/children11050534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND AND OBJECTIVE Chronic respiratory diseases in children deteriorate their daily life due to dyspnea and reduced lung function. We aimed to evaluate the feasibility of home-based pulmonary rehabilitation in pediatric chronic respiratory diseases. METHODS This prospective, single-arm, cohort study included children with chronic lung disease. They were instructed to perform home-based pulmonary rehabilitation 30 min/session, three sessions/week for three months. Pulmonary function test (PFT) using spirometry, respiratory muscle strength (RMT), cardiopulmonary exercise test (CPET), 6 min walk test (6MWT), dyspnea questionnaires, speech evaluation, and pediatric quality of life inventory (PedsQL) were assessed pre- and post-pulmonary rehabilitation. Compliance and satisfaction of the program were also evaluated. RESULTS Twenty children (mean age: 11.2 ± 3.1 years) with chronic respiratory diseases without cardiopulmonary instability participated. The overall compliance was 71.1% with no related adverse events. After pulmonary rehabilitation, forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), RMT, 6MWT, dyspnea questionnaire, speech rate, and PedsQL (child) significantly improved (p < 0.05), particularly better in the FEV1 < 60% group than in the FEV1 ≥ 60% group and in the high-compliance group (compliance ≥ 50%) than in the low-compliance group (compliance < 50%). CONCLUSIONS Home-based pulmonary rehabilitation for children with chronic lung disease was feasible with high compliance and effective in terms of objective functions, subjective dyspnea symptom, and quality of life.
Collapse
Affiliation(s)
- Da Yeong Kim
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (D.Y.K.); (B.H.J.); (S.H.L.); (J.H.L.)
| | - Young Hoon Mo
- Department of Rehabilitation Medicine, Asan Medical Center, Seoul 05505, Republic of Korea (K.W.K.); (S.M.H.)
| | - Kun Woo Kim
- Department of Rehabilitation Medicine, Asan Medical Center, Seoul 05505, Republic of Korea (K.W.K.); (S.M.H.)
| | - Sae Mi Hong
- Department of Rehabilitation Medicine, Asan Medical Center, Seoul 05505, Republic of Korea (K.W.K.); (S.M.H.)
| | - Arum Park
- Asan Institute for Life Sciences, Asan Medical Center, Seoul 05505, Republic of Korea;
| | - Baek Hee Jang
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (D.Y.K.); (B.H.J.); (S.H.L.); (J.H.L.)
| | - Seung Hak Lee
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (D.Y.K.); (B.H.J.); (S.H.L.); (J.H.L.)
| | - Joon Hee Lee
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (D.Y.K.); (B.H.J.); (S.H.L.); (J.H.L.)
| | - Jisun Yoon
- Department of Pediatrics, Chung-Ang University Gwangmyeong Hospital, College of Medicine, Chung-Ang University, Gwangmyeong 14353, Republic of Korea;
| | - Jinho Yu
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
| | - Eun Jae Ko
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (D.Y.K.); (B.H.J.); (S.H.L.); (J.H.L.)
| |
Collapse
|
3
|
Qian K, Xu H, Chen Z, Zheng Y. Advances in pulmonary rehabilitation for children with bronchial asthma. Zhejiang Da Xue Xue Bao Yi Xue Ban 2023; 52:518-525. [PMID: 37643985 PMCID: PMC10495252 DOI: 10.3724/zdxbyxb-2023-0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023]
Abstract
Bronchial asthma is a heterogeneous disease characterized by chronic airway inflammation and airway hyperresponsiveness. With the development of the whole-life-cycle health concept, the focus of treatment for bronchial asthma in children has gradually shifted from pharmacological control to an integrated management model of functional rehabilitation and pharmacological assistance. As a non-pharmacological integrated approach, pulmonary rehabilitation plays an equally important role in the management of childhood asthma as pharmacological treatments. Breathing techniques such as Buteyko breathing, pursed lip breathing, diaphragmatic breathing training, threshold-pressure inspiratory muscle training and yoga breathing can improve lung function indicators such as forced expiratory volume in first second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and maximal voluntary ventilation (MVV) in children. Comprehensive pre-exercise assessment, development of exercise prescriptions, and implementation and evaluation of exercise effects can improve physical fitness, neuromuscular coordination, and self-confidence of children with asthma. The comprehensive interventions of health education, psychological support and nutritional intervention can improve the compliance and effectiveness of rehabilitation training. This article reviews the research progress on respiratory training, physical exercise, and comprehensive interventions in the pulmonary rehabilitation of asthmatic children, to provide theoretical basis and practical guidance for the scientific and rational management of pulmonary rehabilitation of asthmatic children in clinical settings.
Collapse
Affiliation(s)
- Kongjia Qian
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
| | - Hongzhen Xu
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
| | - Zhimin Chen
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| | - Ying Zheng
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
| |
Collapse
|
4
|
Zhou L, Xu H. Feasibility of exercise therapy for children with asthma: a meta-analysis. Front Cell Dev Biol 2023; 11:1192929. [PMID: 37492220 PMCID: PMC10364120 DOI: 10.3389/fcell.2023.1192929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/24/2023] [Indexed: 07/27/2023] Open
Abstract
Background: Although numerous studies have demonstrated the clear benefits of exercise for people with asthma, controversy remains. This study evaluated the effects of sustained exercise types on lung function and quality of life in patients with asthma. Methods: We searched PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang database since January 2000 to August 2022 .included randomized controlled trials (RCTs) of asthmatic children intervened with exercise. The outcomes were lung function and asthma-related quality of life. Fixed-effects model (I2≤50%) or random-effects model (I2>50%) was applied to calculate the pooled effects. Funnel plots were quantified to present publication bias, and a P value <0.05 was statistically significant. Results: Eventually, 15 trials conformed to the selection criteria. The exercise group significantly improved lung function (FEV1 and FVC) in asthmatic children compared with the control group. Forced Expiratory Volume in 1 Second (MD = 2.12, 95%CI = 0.70, 3.53; p = 0.003; I2 = 15%); Forced Vital Capacity (MD = 2.78, 95%CI = 1.26, 4.31; p = 0.0004; I2 = 56%). The immune system markers IL-6 and TNF-α, were significantly reduced in the exercise group. Interleukin-6 (MD = -0.49, 95%CI = -0.81, -0.17; p = 0.003; I2=0%); tumor necrosis factor-α (MD = -0.54, 95%CI = -0.92, -0.15; p = 0.006; I2 = 0%). That quality of life (PAQLQ) was significantly improved in children with asthma in the exercise group. PAQLQ-Total score (MD = 1.06, 95%CI = 0.46, 1.66; p = 0.006; I2 = 94%); PAQLQ-Emotional (MD = 0.91, 95%CI = 0.76, 1.06; p<0.00001; I2 = 90%); PAQLQ-symptoms (MD = 0.87, 95%CI = 0.71, 1.02; p<0.00001; I2 = 95%); PAQLQ-activities (MD = 1.20, 95%CI = 0.58, 1.82; p = 0.00001; I2 = 93%). Meta-analysis showed significant improvements in body composition in the exercise group. BMI (MD = -2.42, 95%CI = -4.40, 0.44; p = 0.02; I2 = 85%). Conclusions: This meta-analysis demonstrated the effectiveness of exercise in improving pulmonary function index (FEV1, FVC), immune system (IL-6, TNF-α, Feno), exercise ability (6MWT), body composition (BMI), and quality of life (PAQLQ) in asthmatic children. Asthmatic children should regularly participate in physical exercise.
Collapse
|
5
|
Jiang J, Zhang D, Huang Y, Wu Z, Zhang W. Exercise rehabilitation in pediatric asthma: A systematic review and network meta-analysis. Pediatr Pulmonol 2022; 57:2915-2927. [PMID: 36103241 DOI: 10.1002/ppul.26134] [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: 06/10/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This systematic review delineates various exercise-based pulmonary rehabilitation (PR) designs and quantifies how they may be optimized in pediatric asthma treatment. DESIGN Comprehensive systematic review, network meta-analysis, and quality analyses using PubMed, Embase, Cochrane Library, Web of Science Core Collection, and Medline searches. INTERVENTIONS Discrete and combined endurance, respiratory, resistance, strength, and interval training. MAIN OUTCOME MEASURES Forced expiratory volume at 1 s to predicted value ratio (FEV1 % pred), forced vital capacity to predicted value ratio (FVC% pred), forced expiratory flow between 25% and 75% of vital capacity ratio (FEF25%-75%), the Pediatric Asthma Quality of Life Questionnaire (PAQLQ), and the 6-min walk test (6MWT). RESULTS Twenty-four randomized controlled trials (RCTs) involving a combined 1031 patients were included. Endurance training was the most common form of PR (58.3%), typically conducted through outpatient clinics (29.2%). Network meta-analysis showed that compared with other PR, interval training significantly improved PAQLQ total scores, and activity, symptom, and emotional domains. Interval training also had a significant effect on the 6MWT. No adverse events were reported. Exercise training did not have a significant effect on FEV1 % pred; however, combined endurance and respiratory training significantly improved both FVC% pred and FEF25%-75%. CONCLUSIONS Exercise-based PR is safe and effective in childhood asthma treatment. Interval training may be a core component for improving quality of life and exercise capacity in this patient population, while combined respiratory and endurance training may significantly affect lung function. The clinical efficacy of these results should be confirmed through high-quality RCTs.
Collapse
Affiliation(s)
- Jing Jiang
- School of pediatrics, Henan University of Chinese Medicine, Zhengzhou, Henan, China.,Department of Pediatric Respiratory Diseases, Nanyang Zhang Zhongjing Hospital, Nanyang, China
| | - Dong Zhang
- School of pediatrics, Henan University of Chinese Medicine, Zhengzhou, Henan, China.,Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Yapan Huang
- Department of Pediatric Respiratory Diseases, Nanyang Zhang Zhongjing Hospital, Nanyang, China
| | - Zhenguo Wu
- School of pediatrics, Henan University of Chinese Medicine, Zhengzhou, Henan, China.,Department of Pediatric Respiratory Diseases, Nanyang Zhang Zhongjing Hospital, Nanyang, China
| | - Wei Zhang
- Department of Pediatric Respiratory Diseases, Nanyang Zhang Zhongjing Hospital, Nanyang, China
| |
Collapse
|
6
|
Ogonowska-Slodownik A, Labecka MK, Kaczmarczyk K, McNamara RJ, Starczewski M, Gajewski J, Maciejewska-Skrendo A, Morgulec-Adamowicz N. Water-Based and Land-Based Exercise for Children with Post-COVID-19 Condition (postCOVIDkids)-Protocol for a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14476. [PMID: 36361362 PMCID: PMC9659109 DOI: 10.3390/ijerph192114476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
The most common symptoms of post-COVID-19 condition in children are fatigue, shortness of breath, exercise intolerance, and weakness. The post-COVID-19 condition in children can be very debilitating and lead to prolonged school absences, high morbidity, and limitations in daily functioning. The aim of this research project is to determine the effectiveness of land-based and water-based exercise interventions on exercise capacity, fatigue, health-related quality of life, and pulmonary function in children with post-COVID-19 condition. This study is a prospective randomized controlled study with pre- and post-intervention assessment. Participants will be recruited from Warsaw's primary schools and primary healthcare units according to the inclusion criteria: (i) symptoms of post-COVID-19 condition lasting more than one month following initial COVID-19 infection confirmed by the diagnosis by general practitioner (including obligatory fatigue and shortness of breath/respiratory problems); (ii) age 10-12 years old. Participants meeting the inclusion criteria will be randomized to one of three groups: water-based exercise, land-based exercise, or control (no exercise). We hope this study will provide guidance for long-COVID-19 rehabilitation in children.
Collapse
Affiliation(s)
- Anna Ogonowska-Slodownik
- Faculty of Rehabilitation, Jozef Pilsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland
| | - Marta Kinga Labecka
- Faculty of Rehabilitation, Jozef Pilsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland
| | - Katarzyna Kaczmarczyk
- Faculty of Rehabilitation, Jozef Pilsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland
| | - Renae J. McNamara
- Physiotherapy, Prince of Wales Hospital, Sydney, NSW 2031, Australia
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW 2006, Australia
- Woolcock Institute of Medical Research, Sydney, NSW 2037, Australia
| | - Michał Starczewski
- Faculty of Rehabilitation, Jozef Pilsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland
| | - Jan Gajewski
- Faculty of Rehabilitation, Jozef Pilsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland
| | - Agnieszka Maciejewska-Skrendo
- Faculty of Physical Culture, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland
- Institute of Physical Culture Sciences, University of Szczecin, 70-453 Szczecin, Poland
| | - Natalia Morgulec-Adamowicz
- Faculty of Rehabilitation, Jozef Pilsudski University of Physical Education in Warsaw, Marymoncka 34, 00-968 Warsaw, Poland
| |
Collapse
|
7
|
Zhu Q, Zhu J, Wang X, Xu Q. A Meta Analysis of Physical Exercise on Improving Lung Function and Quality of Life Among Asthma Patients. J Asthma Allergy 2022; 15:939-955. [PMID: 35859665 PMCID: PMC9289173 DOI: 10.2147/jaa.s369811] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/26/2022] [Indexed: 11/30/2022] Open
Abstract
Objective This paper aims to perform a systematic assessment of the influence of physical exercise on asthma patients and discuss the intervention effects of different exercises on the lung function FEV1 (%pred) and quality of life among asthma patients so as to lay a scientific foundation for improving asthma symptoms. Methods Both Chinese and English databases were retrieved, including PubMed, Web of Science, Embase, The Cochrane Library, CBM, CNKI, Wan Fang Data, and VIP, whose retrieval period started from the founding date of each database to 1st, November 2021. Randomized controlled trials (RCT) studying the symptom indicators of asthma patients were collected. Those collected papers were screened according to the Inclusion Criteria and Exclusion Criteria. Then, methodological quality assessments were conducted on the included papers, and combined effect sizes were analyzed by using software ReMan 5.3.5. Results The meta analysis showed that physical exercise could significantly improve lung function FEV1 (%pred) and quality of life score. Trails containing breathing exercise are the main source of heterogeneity, and the subgroup of breathing exercise may have better performance than the subgroup of aerobic exercise in improving FEV1 (%pred). Conclusion Physical exercise can significantly improve the symptoms and quality of life of asthma patients. Except the breathing exercise that showed heterogeneity, the subgroup of aerobic exercise could improve the capacity of FEV1 (%pred) more effectively, which led to a significant difference in the influence of quality of life. However, with regard to the gymnastic exercise including breathing exercise, there are limited same intervention methods and insufficient same outcome indicators. Therefore, more precise and high-quality researches are needed to make deeper verification in the future.
Collapse
Affiliation(s)
- Qiaoyu Zhu
- School of Physical Education, Shanghai University, Shanghai, 200444, People's Republic of China
| | - Jianming Zhu
- Sports Department, East China University of Political Science and Law, Shanghai, 200042, People's Republic of China
| | - Xing Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, People's Republic of China
| | - Qiong Xu
- School of Physical Health, Shanghai Business School, Shanghai, 201400, People's Republic of China
| |
Collapse
|
8
|
Effect of Routine Therapy Assisted by Physical Exercise on Pulmonary Function in Patients with Asthma in Stable Stage: A Systematic Review and Meta-analysis of Randomized Clinical Trials. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:2350297. [PMID: 35747133 PMCID: PMC9213151 DOI: 10.1155/2022/2350297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/21/2022]
Abstract
Objective This study is aimed at investigating the efficacy of physical exercise-assisted routine therapy on the pulmonary function of patients with stable asthma to provide clinical evidence and data support to guide disease management. Methods Randomized controlled clinical trials of drug therapy and/or physical exercise for patients with stable asthma were retrieved from the China National Knowledge Infrastructure (CNKI), Wanfang database, Embase, PubMed, and Web of Science database. The studies published between January 2000 and June 2021 that met the criteria were included, and corresponding data were extracted. The meta-analysis was performed using the statistical software Stata 16.0. Statistical pooled effect sizes and 95% confidence intervals were calculated using a random-effects or fixed-effects model, as funnel plots were made with Begg's rank correlation method to evaluate publication bias. Result This meta-analysis included 14 randomized controlled studies. Physical exercise-assisted treatment (experiment group) or routine therapy was associated with significantly elevated levels of forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) (P < 0.05). As for the peak expiratory flow (PEF) level (P < 0.05), its level was significantly increased with physical exercise-assisted therapy compared with the conventional approach (P > 0.05). Subgroup analysis indicated that the FVC level in the experimental group was higher than that in the control group (P < 0.05) regardless of the adoption of aerobic exercise/anaerobic exercise. In regard to the FEV1 and PEE levels, aerobic exercise was associated with elevated levels in the experimental group (P < 0.05), while no significant difference in anaerobic exercise between both groups was observed (P > 0.05). Further, FEV1, FVC, and PEF levels in the experimental group were higher than those receiving conventional treatment in the control group (P < 0.05). Conclusion Routine treatment combined with physical exercise could improve the levels of FEV1, FVC, and PEF in patients with bronchial asthma in the nonacute attack stage and enhance pulmonary functions. As a safe and efficient adjuvant therapy, physical exercise can contribute to an improved prognosis and quality of life for patients with asthma.
Collapse
|
9
|
Nyenhuis SM, Kahwash B, Cooke A, Gregory KL, Greiwe J, Nanda A. Recommendations for Physical Activity in Asthma: A Work Group Report of the AAAAI Sports, Exercise, and Fitness Committee. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:433-443. [PMID: 34844909 DOI: 10.1016/j.jaip.2021.10.056] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/27/2021] [Accepted: 10/15/2021] [Indexed: 10/19/2022]
Abstract
Regular physical activity not only improves general health but also can positively impact asthma outcomes, such as control and quality of life. Despite this, many asthma patients do not engage in regular physical activity because they mistakenly believe that they should restrict exercise participation. Health care providers have an opportunity to influence the physical activity levels of their patients during regular office visits. Nonetheless, health care providers often overlook physical activity counseling as an adjunct to pharmacological therapy in asthma patients, and in particular, overlook physical activity counseling. Some providers who acknowledge the benefits of physical activity report being unaware how to approach a conversation with patients about this topic. To address these issues, members of the Sports, Exercise, and Fitness Committee of the American Academy of Allergy, Asthma, and Immunology (AAAAI) performed a focused literature search to identify and evaluate the effects of physical activity in patients with asthma. The purpose of this report is to summarize the evidence for physical activity's impact on asthma patients' disease control, pulmonary function, and overall well-being. Several subpopulations of patients with asthma, including children, adolescents, and older adults, are considered individually. In addition, this report offers practical recommendations for clinicians, including how to identify and overcome barriers to counseling, and methods to incorporate physical activity counseling into asthma treatment practice.
Collapse
Affiliation(s)
- Sharmilee M Nyenhuis
- Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, Ill.
| | - Basil Kahwash
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn
| | - Andrew Cooke
- Lake Allergy, Asthma, and Immunology, Tavares, Fla
| | - Karen L Gregory
- Oklahoma Allergy and Asthma Clinic, Oklahoma City, Okla, and Georgetown University School of Nursing and Health Studies, Washington, DC
| | - Justin Greiwe
- Bernstein Allergy Group, Inc, Cincinnati, Ohio; Division of Immunology/Allergy Section, Department of Internal Medicine, The University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Anil Nanda
- Asthma and Allergy Center, Lewisville and Flower Mound, Texas; Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas, Texas
| |
Collapse
|
10
|
Beemer LR, Lewis TC, Ajibewa TA, Dopp R, B Eisman A, Hasson RE. Classroom-Based Strategies to Reduce Disparities in Physical Activity Among Children with Asthma. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:587-597. [PMID: 35080712 DOI: 10.1007/s11121-022-01347-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 10/19/2022]
Abstract
Children with asthma often experience physical activity (PA) induced symptoms 5-15 min following the start of exercise. Classroom PA breaks provide short intermittent bouts of PA and may represent a novel strategy to safely promote PA participation in this clinical population. The purpose of this study was to determine the feasibility of a classroom-based PA intervention, Interrupting Prolonged Sitting with Activity (InPACT), where teachers implement 5 × 4-min moderate-to-vigorous physical activity (MVPA) breaks throughout the school day. Nine classrooms at one elementary-middle school in Detroit, MI (student demographics: 79% Hispanic; 80% on free/reduced lunch; 31% prevalence of asthma and asthma-like symptoms) participated in this 20-week intervention. Asthma status was self-reported via the International Study of Asthma and Allergies in Childhood (ISAAC) Video Questionnaire in conjunction with nurse documentation. PA participation, exercise intensity, and asthmatic symptom occurrence were assessed via direct observation. Students accumulated approximately 17 min of activity per day during PA breaks. Compared to students without asthma, a higher percentage of students with asthma participated in MVPA (asthma: 52.9% ± 1.2%; non-asthma: 46.2% ± 0.8%; p = 0.01), a lower percentage participated in light PA (asthma: 25.9% ± 1.0%; non-asthma: 30.1% ± 0.7%; p = 0.01), and sedentary time during activity breaks (asthma: 21.2% ± 0.9%; non-asthma: 23.8% ± 0.7%; p = 0.02). Out of 294 observations, six instances of asthmatic symptoms (coughing) were observed in students with asthma 5-15 min following the PA break. Symptoms self-resolved within 15-min of the PA break and did not result in sustained exercise-induced bronchoconstriction. Classroom-based interventions that incorporate short intermittent bouts of PA represent safe exercises for children with asthma and may help to reduce PA disparities in this clinical population.
Collapse
Affiliation(s)
- Lexie R Beemer
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA.,Childhood Disparities Research Laboratory, University of Michigan, Ann Arbor, MI, USA
| | - Toby C Lewis
- School of Public Health, University of Michigan, Ann Arbor, MI, USA.,Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Tiwaloluwa A Ajibewa
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA.,Childhood Disparities Research Laboratory, University of Michigan, Ann Arbor, MI, USA
| | - Richard Dopp
- Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Andria B Eisman
- College of Education, Wayne State University, Detroit, MI, USA
| | - Rebecca E Hasson
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA. .,Childhood Disparities Research Laboratory, University of Michigan, Ann Arbor, MI, USA. .,School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| |
Collapse
|
11
|
Liu Y, Zhao Y, Liu F, Liu L. Effects of Physical Exercises on Pulmonary Rehabilitation, Exercise Capacity, and Quality of Life in Children with Asthma: A Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2021; 2021:5104102. [PMID: 34976094 PMCID: PMC8718301 DOI: 10.1155/2021/5104102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE This study aimed to systematically evaluate the effect of exercise on pulmonary function, exercise capacity, and quality of life in children with bronchial asthma. METHODS A comprehensive search was performed using PubMed, Cochrane Library, Web of Science, EBSCO, CNKI, and Wanfang Data Knowledge Service platform to identify any relevant randomized controlled trials (RCTs) published from inception to April 2021. The Cochrane risk of the bias tool was utilized to evaluate the methodological quality of the included studies, and RevMan 5.3 was applied to perform data analyses. RESULTS A total of 22 RCTs involving 1346 patients were included. The results of the meta-analysis showed that exercise had significant advantages in improving lung function and exercising capacity and quality of life in children with asthma compared with conventional treatment, such as the forced vital capacity to predicted value ratio (SMD = 0.27; 95% CI: 0.13, 0.40, and P < 0.0001), the peak expiratory flow to predicted value ratio (MD = 4.53; 95% CI: 1.27, 7.80, and P=0.007), the 6-minute walk test (MD = 110.65; 95% CI: 31.95, 189.34, and P=0.006), rating of perceived effort (MD = -2.28; 95% CI: -3.21, -1.36, and P < 0.0001), and peak power (MD = 0.94; 95% CI: 0.37, 1.52, and P=0.001) on exercise capacity and pediatric asthma quality of life questionnaire (MD = 1.28; 95% CI: 0.60, 1.95, and P=0.0002) on quality of life. However, no significant difference was observed in the forced expiratory flow between 25% and 75% of vital capacity (P=0.25) and the forced expiratory volume at 1 second to predicted value ratio(P=0.07). CONCLUSIONS Current evidence shows that exercise has a certain effect on improving pulmonary function recovery, exercise capacity, and quality of life in children with bronchial asthma. Given the limitation of the number and quality of included studies, further research and verification are needed to guide clinical application.
Collapse
Affiliation(s)
- YiRan Liu
- School of Sport and Health, Nanjing Sport Institute, Nanjing 210014, Jiangsu, China
| | - Yan Zhao
- School of Sport and Health, Nanjing Sport Institute, Nanjing 210014, Jiangsu, China
| | - Fang Liu
- Respiratory Medicine of Xuyi People's Hospital, Huaian 223001, Jiangsu, China
| | - Lin Liu
- School of Sport and Health, Nanjing Sport Institute, Nanjing 210014, Jiangsu, China
| |
Collapse
|
12
|
Fazel N, Kundi M, Jensen-Jarolim E, Pali-Schöll IM, Kazemzadeh A, Esmaily H, Abdizadeh MF, Akbarzadeh R, Ahmadi R, Jabbari H. Quality of life and asthma control in pregnant women with asthma. BMC Pulm Med 2021; 21:415. [PMID: 34920702 PMCID: PMC8680333 DOI: 10.1186/s12890-021-01797-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 12/15/2021] [Indexed: 12/02/2022] Open
Abstract
Background Asthma is the most commonly occurring respiratory illness during pregnancy. Associations with complications of pregnancy and adverse perinatal outcome have been established. However, little is known about quality of life (QoL) in pregnant women with asthma and how it relates to asthma control particularly for Iran. Objective To determine the relationship between asthma related QoL and asthma control and severity. Methods We conducted a prospective study in pregnant women with asthma. We used the Asthma Control Questionnaire and the Asthma Quality of Life Questionnaire (AQLQ) and the guidelines of the Global Initiative for Asthma for assessment of asthma severity. Results Among 1603 pregnant women, 34 were diagnosed with asthma. Of these 13 had intermittent, 10 mild, 8 moderate and 3 severe persistent asthma. There was a significant decrease of QoL with poorer asthma control (p = 0.014). This decline could be due to limitations of activity in those with poorer asthma control, which is underlined by the significant decline of QoL with increasing asthma severity (p = 0.024). Conclusion Although the majority of pregnant women with asthma had a favorable score in AQLQ, reduced QoL was related to increased asthma severity and poor asthma control. This underlines the importance of controlling asthma during pregnancy not only for the prevention of adverse pregnancy outcomes but also for the preservation of QoL.
Collapse
Affiliation(s)
- Nasrin Fazel
- Iranian Research Center On Healthy Aging, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran. .,Department of Environmental Health, Center for Public Health, Medical University Vienna, Vienna, Austria.
| | - Michael Kundi
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Vienna, Austria
| | - Erika Jensen-Jarolim
- Institute for Pathophysiology and Allergy Research, Medical University Vienna, Vienna, Austria.,Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University of Vienna, Vienna, Austria
| | - Isabella Maria Pali-Schöll
- Institute for Pathophysiology and Allergy Research, Medical University Vienna, Vienna, Austria.,Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University of Vienna, Vienna, Austria
| | - Asghar Kazemzadeh
- Iranian Research Center On Healthy Aging, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Habibollah Esmaily
- Department of Biostatistics and Epidemiology, Neonatal Research Center, Mashhad University of Medical Sciences, Mashad, Iran
| | - Mojtaba Fattahi Abdizadeh
- Iranian Research Center On Healthy Aging, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Roya Akbarzadeh
- Iranian Research Center On Healthy Aging, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran.,Department of Anesthesia and Operating Room, School of Paramedic, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Raheleh Ahmadi
- Iranian Research Center On Healthy Aging, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | |
Collapse
|
13
|
Liu F, Liu YR, Liu L. Effect of exercise rehabilitation on exercise capacity and quality of life in children with bronchial asthma: a systematic review. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:1050-1057. [PMID: 34719422 PMCID: PMC8549640 DOI: 10.7499/j.issn.1008-8830.2104124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/16/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To systematically evaluate the effect of exercise rehabilitation on exercise capacity and quality of life in children with bronchial asthma. METHODS PubMed, Cochrane Library, Web of Science, EBSCO, China National Knowledge Infrastructure, Weipu Data, and Wanfang Data were searched for randomized controlled trials (RCTs) on the effect of exercise rehabilitation on children with bronchial asthma published up to February 2021. RevMan 5.3 was used to perform a Meta analysis. RESULTS A total of 14 studies were included, with 990 subjects in total. The Meta analysis showed that compared with the conventional treatment group, the exercise rehabilitation group had significantly better exercise capacity (distance covered in the 6-minute walk test: MD=108.13, P<0.01; rating of perceived effort: MD=-2.16, P<0.001; peak power: MD=0.94, P=0.001) and significantly higher total score of quality of life (SMD=1.28, P=0.0002), activity score (SMD=1.38, P=0.0002), symptom score (SMD=1.02, P<0.001), and emotional score (SMD=0.86, P<0.001) assessed by the Pediatric Asthma Quality of Life Questionnaire. CONCLUSIONS Current evidence shows that exercise rehabilitation has a positive effect in improving exercise capacity and quality of life in children with bronchial asthma. Due to limited number and quality of studies included in the analysis, further research is needed.
Collapse
Affiliation(s)
- Fang Liu
- Department of Respiratory Medicine, Xuyi People's Hospital, Huai'an, Jiangsu 211700, China (Liu L, )
| | | | | |
Collapse
|
14
|
Winn CON, Mackintosh KA, Eddolls WTB, Stratton G, Wilson AM, McNarry MA, Davies GA. Effect of high-intensity interval training in adolescents with asthma: The eXercise for Asthma with Commando Joe's® (X4ACJ) trial. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:488-498. [PMID: 34304826 PMCID: PMC8343006 DOI: 10.1016/j.jshs.2019.05.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/15/2019] [Accepted: 03/15/2019] [Indexed: 05/07/2023]
Abstract
BACKGROUND Higher levels of cardiorespiratory fitness are associated with reduced asthma severity and increased quality of life in those with asthma. Therefore, the purpose of this study was to evaluate the effectiveness of a 6-month high-intensity interval training (HIIT) intervention in adolescents with and without asthma. METHODS A total of 616 adolescents (334 boys; 13.0 ± 1.1 years, 1.57 ± 0.10 m, 52.6 ± 12.9 kg, mean ± SD), including 155 with asthma (78 boys), were recruited as part of a randomized controlled trial from 5 schools (4 control and 1 intervention). The 221 intervention participants (116 boys; 47 asthma) completed 6 months of school-based HIIT (30 min, 3 times per week, 10-30 s bouts at >90% age-predicted maximum heart rate with equal rest). At baseline, mid-intervention, post-intervention, and 3-month follow-up, measurements for 20-m shuttle run, body mass index (BMI), lung function, Pediatric Quality of Life Inventory, Paediatric Asthma Quality of Life Questionnaire, and Asthma Control Questionnaire were collected. Additionally, 69 adolescents (39 boys (of the 36 with asthma there were 21 boys)) also completed an incremental ramp test. For analysis, each group's data (intervention and control) were divided into those with and without asthma. RESULTS Participants with asthma did not differ from their peers in any parameter of aerobic fitness, at any time-point, but were characterized by a greater BMI. The intervention elicited a significant improvement in maximal aerobic fitness but no change in sub-maximal parameters of aerobic fitness, lung function, or quality of life irrespective of asthma status. Those in the intervention group maintained their BMI, whereas BMI significantly increased in the control group throughout the 6-month period. CONCLUSION HIIT represents an effective tool for improving aerobic fitness and maintaining BMI in adolescents, irrespective of asthma status. HIIT was well-tolerated by those with asthma, who evidenced a similar aerobic fitness to their healthy peers and responded equally well to a HIIT program.
Collapse
Affiliation(s)
- Charles O N Winn
- Swansea University Medical School, Singleton Campus, Swansea University, Swansea SA2 8PP, UK; Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Bay Campus, Swansea University, Swansea SA1 8EN, UK
| | - Kelly A Mackintosh
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Bay Campus, Swansea University, Swansea SA1 8EN, UK
| | - William T B Eddolls
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Bay Campus, Swansea University, Swansea SA1 8EN, UK
| | - Gareth Stratton
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Bay Campus, Swansea University, Swansea SA1 8EN, UK
| | - Andrew M Wilson
- Norwich Medical School, University of East Anglia, Norwich, England NR4 7TJ, UK
| | - Melitta A McNarry
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Bay Campus, Swansea University, Swansea SA1 8EN, UK.
| | - Gwyneth A Davies
- Swansea University Medical School, Singleton Campus, Swansea University, Swansea SA2 8PP, UK.
| |
Collapse
|
15
|
Zhang W, Wang Q, Liu L, Yang W, Liu H. Effects of physical therapy on lung function in children with asthma: a systematic review and meta-analysis. Pediatr Res 2021; 89:1343-1351. [PMID: 32244247 DOI: 10.1038/s41390-020-0874-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/27/2020] [Accepted: 03/11/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Asthma is a common chronic respiratory disease in children. In addition to medications, physical therapy is considered as a treatment strategy for asthma. We conducted this study to investigate the effects of physical therapy on lung function in children with asthma. METHODS Three databases were searched. We conducted the meta-analysis for the forced expiratory volume in the first second in percent predicted values [FEV1(%pred)], the forced vital capacity in percent predicted values [FVC(%pred)], and the peak expiratory flow in percent predicted values [PEF(%pred)] by using a random effect model. RESULTS Of the 6474 identified studies, 18 studies (16 in physical training, 2 in breathing exercise or inspiratory muscle training) were included in the systematic review and 11 studies (all in physical training) were included in the meta-analysis. The meta-analysis showed a significantly improved FVC(%pred) in the experimental group. CONCLUSIONS Physical training improved FVC(%pred) significantly in children with asthma. Further study is needed, especially on the effects of breathing exercise and inspiratory muscle training in children with asthma. IMPACT Our study reviewed the physical therapies for children with asthma and clarified whether and how these therapies affect them. Our study found that physical training improved the forced vital capacity in percent predicted values [FVC(%pred)] significantly in asthmatic children. Our study provided evidence that physical training could improve lung function in children with asthma, which is not identical to the Global Initiative for Asthma (GINA) guidelines.
Collapse
Affiliation(s)
- Weijian Zhang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China
| | - Qiu Wang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China.,Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China
| | - Lilong Liu
- Department of Gastrointestinal Surgery, People's Hospital of Deyang City, 618000, Deyang, Sichuan, China
| | - Wenhao Yang
- Department of Pediatrics, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China
| | - Hanmin Liu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, 610041, Chengdu, Sichuan, China.
| |
Collapse
|
16
|
Effect of 8 Weeks of Incremental Aerobic Training on Inflammatory Mediators, Cardiorespiratory Indices, and Functional Capacity in Obese Children With Bronchial Asthma. Pediatr Exerc Sci 2021; 33:23-31. [PMID: 33761464 DOI: 10.1123/pes.2020-0076] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 10/15/2020] [Accepted: 10/21/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To appraise the effects of incremental aerobic training (IAT) on systemic inflammatory mediators, cardiorespiratory indices, and functional capacity in obese children with bronchial asthma. METHODS This study included 30 children with asthma (age = 8-16 y) allocated randomly into either the control group (n = 15; received the traditional pulmonary rehabilitation program) or IAT group (n = 15; engaged in 8 weeks of IAT in addition to the traditional pulmonary rehabilitation program). The systemic inflammatory mediators (high-sensitivity C-reactive protein and interleukin-6), cardiorespiratory indices (peak oxygen uptake, minute ventilation, maximum heart rate, heart rate recovery at 1 min after exercises, and oxygen pulse), and functional capacity (represented by 6-min walk test) were analyzed pretreatment and posttreatment. RESULTS A significant reduction in the level of high-sensitivity C-reactive protein and interleukin-6 and increase in peak oxygen uptake, minute ventilation, maximum heart rate, and heart rate recovery at 1 minute after exercises was observed among the IAT group as compared with the control group. In addition, the IAT group covered a longer distance in the 6-minute walk test than the control group, suggesting favorable functional capacity. CONCLUSION The study results imply that IAT has the potential to improve the inflammatory profile, cardiorespiratory fitness, and functional capacity of obese children with bronchial asthma.
Collapse
|
17
|
Jones JC, Sugimoto D, Kobelski GP, Rao P, Miller S, Koilor C, Corrado GD, Shipon DM. Parameters of cardiac symptoms in young athletes using the Heartbytes database. PHYSICIAN SPORTSMED 2021; 49:37-44. [PMID: 32281468 DOI: 10.1080/00913847.2020.1755908] [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] [Indexed: 10/24/2022]
Abstract
Introduction: To determine clinical parameters that are related to abnormal cardiac symptoms in physically active youth. Methods: We used Simon's Heart Heartbytes National Youth Cardiac Registry to collect data from adolescent athletes in southeastern Pennsylvania. We collected age, race/ethnicity, abnormal cardiac symptoms, medical history, medication use, caffeine intake, and family history. We obtained height, weight, blood pressure, cardiac murmur findings, and ECGs. Echocardiogram was obtained if necessary. Binary logistic regression analysis was performed to identify independent associations between abnormal cardiac symptoms and collected variables. The odds ratio (OR), 95% confidence interval (95% CI), and p-values were used as statistical values. Results: Of the 887 athletes (543 males and 344 females, age = 16.9 ± 2.1 years, height = 166.9 ± 11.4 cm, weight = 62.0 ± 16.0 kg), 186 (21%) had abnormal cardiac symptoms including chest pain, passing out, difficulty breathing, extreme fatigue, and heart race. There was an independent association between abnormal symptoms and a past medical history (OR: 4.77, 95%CI: 3.18, 7.17, p = 0.001) and medication use (OR: 1.74, 95%CI: 1.08, 2.79, p = 0.022). In medical history, young athletes with asthma showed a greater propensity of abnormal cardiac symptoms (48.9%) compared to young athletes without (14.0%, p = 0.001). Additionally, young athletes with anxiety or depression demonstrated a higher proportion of abnormal cardiac symptoms (48.9%) than those without (19.5%, p = 0.001). Although the association between the presence of abnormal symptoms and African-American race (OR: 2.04, 95%CI: 0.96, 4.35, p = 0.065) and average daily consumption of at least 2 caffeine drinks (OR: 2.08, 95%CI: 0.86, 5.02, p = 0.103) were not significant, there was a trend to reach the a priori significance level. Conclusions: This study identified several clinical parameters that are associated with symptoms suggestive of abnormal cardiac conditions. Larger studies need to be done to better sort out the clinical history that may contribute to false positives to further reduce false positives at heart screenings.
Collapse
Affiliation(s)
- Jacob C Jones
- The Micheli Center for Sports Injury Prevention , Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital , Waltham, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School , Boston, MA, USA
| | - Dai Sugimoto
- The Micheli Center for Sports Injury Prevention , Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital , Waltham, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School , Boston, MA, USA
| | - Greggory P Kobelski
- The Micheli Center for Sports Injury Prevention , Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital , Waltham, MA, USA
| | - Prashant Rao
- Division of Cardiovascular Medicine, Department of Medicine, Thomas Jefferson University Hospitals , Philadelphia, PA, USA
| | - Stanton Miller
- Department of Surgery, Sidney Kimmel Medical College at Thomas Jefferson University , Philadelphia, PA, USA
| | - Chris Koilor
- Division of Cardiovascular Medicine, Department of Medicine, Thomas Jefferson University Hospitals , Philadelphia, PA, USA
| | - Gianmichel D Corrado
- The Micheli Center for Sports Injury Prevention , Waltham, MA, USA.,Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital , Waltham, MA, USA.,Department of Orthopaedic Surgery, Harvard Medical School , Boston, MA, USA
| | - David M Shipon
- Division of Cardiovascular Medicine, Department of Medicine, Thomas Jefferson University Hospitals , Philadelphia, PA, USA
| |
Collapse
|
18
|
Wu X, Gao S, Lian Y. Effects of continuous aerobic exercise on lung function and quality of life with asthma: a systematic review and meta-analysis. J Thorac Dis 2020; 12:4781-4795. [PMID: 33145051 PMCID: PMC7578506 DOI: 10.21037/jtd-19-2813] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Despite the obvious benefits of aerobic exercise for asthmatic patients, controversies persist. The current study evaluated the effectiveness of continuous aerobic exercise on lung function and quality of life of asthmatic patients. Methods We searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials databases up to May 2019 and included randomized controlled trials (RCTs) of asthmatic patients intervened with whole body continuous aerobic exercise (moderate intensity, at least 20 minutes and two times a week, over a minimum period of four weeks), in which the endpoint measures were lung function and asthma-related quality of life. A fixed-effects model (I2≤50%) or random-effects model (I2>50%) was applied to calculate the pooled effects according to the I2-and Chi-squared (χ2) test, funnel plots were quantified to present publication bias, and a P value <0.05 was statistically significant. Results Eventually, 22 trials conformed to the selection criteria. In the aerobic exercise group, the forced expiratory volume improved in one second (FEV1) (I2=10.2%, WMD: 0.12, P=0.011), peak expiratory flow (PEF) (I2=87.3%, WMD: 0.66, P=0.002), forced vital capacity (FVC) (I2=0.0%, WMD: 0.18, P<0.001), FVC/predict (I2=3.9%, WMD: 4.3, P=0.014), forced expiratory flow between 25% and 75% of vital capacity (FEF25-75%) (I2=0.0%, WMD: 9.6, P=0.005), Asthma Quality of Life Questionnaire (AQLQ) (I2=0.0%, WMD: 0.20, P=0.002), and Pediatric Asthma Quality of life Questionnaire (PAQLQ) (I2=72.1%, WMD: 0.81, P<0.001), respectively, while no statistical significance existed in FEV1%predict (I2=36.0%, WMD: 0.68, P=0.312) and FEV1/FVC ratio (I2=0.0%, WMD: 0.27, P=0.443) compared with the control group. When the exercise mode was taken into account, we observed significant improvement in FEV1, PEF, and FVC in the swimming (P<0.05) or indoor treadmill (P<0.05) training group. Conclusions Our meta-analysis proved that regular continuous aerobic exercise benefits asthma patients on FEV1, PEF, FVC, FVC%pred, FEF25-75%, and quality of life, and was well tolerated, while there were no improvements in FEV1%pred and FEV1/FVC%. As such, swimming and treadmill training may be appropriate options.
Collapse
Affiliation(s)
- Xinggui Wu
- Department of Respiration Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Shiyuan Gao
- Department of Respiration Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yixin Lian
- Department of Respiration Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
19
|
Sanz-Santiago V, Diez-Vega I, Santana-Sosa E, Lopez Nuevo C, Iturriaga Ramirez T, Vendrusculo FM, Donadio MVF, Villa Asensi JR, Pérez-Ruiz M. Effect of a combined exercise program on physical fitness, lung function, and quality of life in patients with controlled asthma and exercise symptoms: A randomized controlled trial. Pediatr Pulmonol 2020; 55:1608-1616. [PMID: 32353218 DOI: 10.1002/ppul.24798] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Asthmatic patients may benefit from exercise training, although the effects of a combined aerobic and resistance training program are still poorly investigated in children and adolescents. OBJECTIVE To analyze the effects of a combined exercise training (resistance and aerobic) program on aerobic fitness, lung function, asthma control and quality of life in a group of mild-moderate asthmatic children with exercise symptoms. METHODS This was a 12-week randomized controlled trial including children and adolescents diagnosed with mild-moderate asthma and presenting exercise-induced symptoms. The intervention group (IG) performed the exercise training (resistance and aerobic) 3 days/week, for 60 minutes. The control group (CG) followed routine clinical orientations. The main outcomes were cardiorespiratory fitness, muscle strength, lung function, quality of life, asthma control, and functional tests after 3 months of the intervention. RESULTS Fifty-three patients (IG = 25 and CG = 28) with a mean age of 11.5 ± 2.6 years were included. No significant differences were found between groups regarding lung function, asthma control, quality of life, and functional tests. Ventilatory equivalent for oxygen consumption at ventilatory threshold (P = .025; ηp2 = 0.083), peak oxygen consumption (P = .008; ηp2 = 0.116) and test duration (P = .014; ηp2 = 0.1) presented greater improvements in the IG. In addition, improvements were observed in leg press (P < .001; ηp2 = 0.36), hamstring curl (P = .001; ηp2 = 0.217), high row (P = .003; ηp2 = .167), low row (P = .009; ηp2 = 0.128) and quadriceps leg extension (P = .015; ηp2 = 0.108) in the IG. CONCLUSION Combined exercise training (resistance and aerobic) improved cardiorespiratory fitness and muscle strength in children and adolescents with controlled asthma and exercise symptoms.
Collapse
Affiliation(s)
| | - Ignacio Diez-Vega
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Physical Fitness, Body Composition, and Adherence to the Mediterranean Diet in Young Football Players: Influence of the 20 mSRT Score and Maturational Stage. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093257. [PMID: 32392773 PMCID: PMC7246506 DOI: 10.3390/ijerph17093257] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/02/2020] [Accepted: 05/05/2020] [Indexed: 01/05/2023]
Abstract
This study aimed to analyze the differences in physical fitness variables, body composition, and adherence to the Mediterranean diet according to the cardiorespiratory fitness and the maturational stage in young football players. A total of 194 male football players (aged 8–16) from three football sport schools participated in this study. Data on cardiorespiratory fitness (the 20-m shuttle run test), anthropometric measurements, handgrip strength, respiratory capacity (forced spirometry), and adherence to the Mediterranean diet (KIDMED questionnaire) were collected. Players were divided into two groups depending on their maturational stage (prepubertal n = 127 and pubertal n = 67). The results show a direct relationship between low levels of cardiorespiratory fitness and body mass index, as well as body fat and leg fat. Similarly, players with lower cardiorespiratory fitness presented higher values of handgrip strength in the prepubertal state. On the other hand, improvements in respiratory values were observed in the pubertal state with the rest of the parameters when the cardiorespiratory fitness was increased. Therefore, the promotion of recreational football that encourage and develop cardiorespiratory fitness is a key factor and can be used as an effective sport activity to promote physical fitness and healthy habits in children and adolescents as well as within the population that is already physically active.
Collapse
|
21
|
Tai Chi Chuan Exercise Improves Lung Function and Asthma Control through Immune Regulation in Childhood Asthma. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:9146827. [PMID: 31772603 PMCID: PMC6854913 DOI: 10.1155/2019/9146827] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/22/2019] [Accepted: 09/20/2019] [Indexed: 11/17/2022]
Abstract
Background Tai Chi Chuan (TCC) is an exercise of low to moderate intensity with key features of mindfulness, structural alignment, and flexibility to relax the body and mind in adults. Our previous study showed that TCC could improve the quality of life (QoL), pulmonary function, and fractional exhaled nitric oxide in asthmatic children. We further investigated whether the benefits induced by TCC were associated with immune regulation. Method Six- to twelve-year-old children diagnosed with mild to severe persistent asthma for at least one year according to the Global Initiative for Asthma guidelines were enrolled from a tertiary pediatric allergy center in Taiwan. Asthmatic children were divided into two groups based on their choice: (1) the TCC group had a 60-minute TCC exercise session once weekly led by an instructor and (2) the control group kept their original activity levels. All other exercises were encouraged as usual. Pulmonary function tests, laboratory tests, standardized pediatric asthma QoL questionnaire (PAQLQ(S)), and childhood asthma control test (C-ACT) were performed before and after the TCC program (12 weeks). Data on medications and exacerbations were collected from medical records. Results There were no differences between the TCC (n = 25) and control (n = 15) groups at baseline, except that the C-ACT showed significantly lower results in the TCC group (p=0.045). After 12 weeks, the number of leukocytes (p=0.041) and eosinophils (p=0.022) decreased, while regulatory T cells increased significantly (p=0.008) only in the TCC group. Lung functions (FEV1 and PEFR) were significantly improved in both the TCC (p < 0.001) and control (p=0.045 and 0.019, respectively) groups, while the PAQLQ(S) and C-ACT (p < 0.001) showed improvement only in the TCC group. Moreover, compared to the control group, the exacerbations within 12 weeks after the study were significantly decreased in the TCC group (p=0.031). After multiple regression by a conditional forward method, the factors that were significantly associated with exacerbation within 12 weeks after study is the practice of TCC and exacerbation within 24 weeks before study (p=0.013 and 0.015, respectively) after adjusting for age, sex, asthma severity, PEF, FEV1, C-ACT, PAQLQ(S), and medication score at baseline. Conclusion TCC exercise may improve pulmonary functions, asthma control, and QoL and prevent exacerbations in asthmatic children through immune regulation. Further research on detailed mechanisms is mandated.
Collapse
|
22
|
Islamovic F, Silver EJ, Reznik M. Do Urban Minority Parents and Children Agree on Asthma Symptoms with Exercise, Worries, and Confidence in Disease Management? Acad Pediatr 2019; 19:624-630. [PMID: 31103884 PMCID: PMC6684356 DOI: 10.1016/j.acap.2019.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 05/06/2019] [Accepted: 05/11/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Providers commonly rely on parent reports of a child's asthma symptoms; however, children as young as 7 years can report on their own health. Our study compared parent and child reports of asthma symptoms with exercise, worries about developing an asthma attack, and confidence in disease management. METHODS We recruited children ages 7 to 10 years with asthma from 4 Bronx, NY, schools, as well as their parents. The parents and children completed interview surveys with parallel questions regarding perceived asthma symptoms, asthma-related worries, and confidence in disease management. We used McNemar tests for paired data to compare parent and child responses. RESULTS We analyzed data for 105 parent-child pairs. Mean child age was 8.5 years (standard deviation, 0.99); 53% were male, and 82% were Hispanic. Children were more likely than their parents to report ever having an exercise-induced asthma attack (85% vs 48%; P < .001) and that they "worry a lot" about developing an asthma attack during exercise (63% vs 45%; P = .01). Children felt more confident about using an inhaler correctly (76% of the children were "very sure" vs 60% of the parents; P = .009) and were more likely to report having an inhaler available in case of an attack (38% of the children were "very sure" vs 20% of the parents; P = .003). CONCLUSIONS In this school-based sample of urban children with asthma, we found disagreement between parent and child reports of symptoms with exercise, worry about developing an attack, and confidence in medication use. These findings suggest that including child reports during history taking could help providers identify children in need of enhanced asthma management.
Collapse
Affiliation(s)
- Florinda Islamovic
- Department of Pediatrics, Division of Academic General Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY; F Islamovic is now a medical student at St Georges University School of Medicine, Grenada, West Indies
| | - Ellen Johnson Silver
- Department of Pediatrics, Division of Academic General Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY; F Islamovic is now a medical student at St Georges University School of Medicine, Grenada, West Indies
| | - Marina Reznik
- Department of Pediatrics, Division of Academic General Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY; F Islamovic is now a medical student at St Georges University School of Medicine, Grenada, West Indies.
| |
Collapse
|
23
|
Bellocq A, Gaspard W, Couffignal C, Vigan M, Guerder A, Ambard J, Caruana S, Similowski T, Garcia G, Taillé C. Outpatient pulmonary rehabilitation for severe asthma with fixed airway obstruction: Comparison with COPD. J Asthma 2019; 56:1325-1333. [PMID: 30693816 DOI: 10.1080/02770903.2018.1541351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: The benefit of exercise has been demonstrated in asthma, but the role of pulmonary rehabilitation (PR) in people with severe asthma, especially with airway obstruction, has been less investigated. The activity limitation mechanisms differ in asthma and COPD, so the effect of a PR program not specific to asthma is unclear. Methods: We retrospectively compared the effect of an ambulatory PR program in nonsmoking patients with severe asthma and airway obstruction (FEV1/FVC ratio <70% and FEV1 < 80% measured twice, not under an exacerbation) and sex-, age-, FEV1-, and BMI-matched COPD controls. Results: We included 29 patients, each with asthma and COPD. Airway obstruction was moderate (median FEV1 57% [44-64]). VO2 at peak was higher for asthma than COPD patients (19.0 [15.7-22.2] vs 16.1 [15.3-19.6] ml.min-1.kg-1, p = 0.05). After PR, asthma and COPD groups showed a significant and similar increase in constant work cycling test of 378 [114-831] s and 377 [246-702] s. Changes in Hospital Anxiety and Depression Scale (HAD) total score were similar (-2.5 [-7.0 to 0.0] vs -2.0 [-5.0 to 2.0], p > 0.05). Quality of life on the St. George's Respiratory Questionnaire (SGRQ) was significantly improved in both groups (-14.0 [-17.7 to -2.0], p < 0.005 and -8.3 [-13.0 to -3.6], p < 0.0001). Conclusion: Outpatient PR is feasible and well tolerated in patients with severe asthma with fixed airway obstruction. A nondedicated program strongly improves HAD and SGRQ scores and constant work-rate sub-maximal cycling, with similar amplitude as with COPD.
Collapse
Affiliation(s)
- Agnès Bellocq
- Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service d'Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée du Département R3S, Paris, France.,Sorbonne Université, INSERM, UMRS1158, Paris, France
| | - Wanda Gaspard
- Service des Maladies Respiratoires, Hôpital d'Instruction des Armées Percy, Clamart, France
| | - Camille Couffignal
- Assistance Publique-Hôpitaux de Paris, Department of Epidemiology, Biostatistic and Clinical Research, Bichat Hospital, Paris, France
| | - Marie Vigan
- Assistance Publique-Hôpitaux de Paris, Department of Epidemiology, Biostatistic and Clinical Research, Bichat Hospital, Paris, France
| | - Antoine Guerder
- Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et de Réanimation Médicale du Département R3S, Paris, France
| | - Julien Ambard
- Réseau Recup'Air, Agence Régionale de Santé Ile de France, Paris, France
| | - Sylvie Caruana
- Réseau Recup'Air, Agence Régionale de Santé Ile de France, Paris, France
| | - Thomas Similowski
- Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et de Réanimation Médicale du Département R3S, Paris, France
| | - Gilles Garcia
- Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service de Pneumologie, Le Kremlin-Bicetre, France
| | - Camille Taillé
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, DHU FIRE, Service de Pneumologie, INSERM UMR1152, Université Paris Diderot, Labex Inflamex, Paris, France
| |
Collapse
|
24
|
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: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 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.
Collapse
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
| |
Collapse
|
25
|
Doğruel D, Altıntaş DU, Yılmaz M. Astımlı çocuklarda fiziksel egzersizin klinik ve fonksiyonel parametrelere etkisi. CUKUROVA MEDICAL JOURNAL 2018. [DOI: 10.17826/cumj.366166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
|
26
|
Effects of physical exercise training on nocturnal symptoms in asthma: Systematic review. PLoS One 2018; 13:e0204953. [PMID: 30346958 PMCID: PMC6197640 DOI: 10.1371/journal.pone.0204953] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 09/16/2018] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Nocturnal worsening of asthma symptoms is a common feature of asthma. Physical exercise training improves general asthma control; however, there is no evidence showing the effects of physical exercise on nocturnal asthma symptoms. Indeed, asthma patients with daytime and nighttime symptoms are physiologically different, and thus the effects of physical exercise on asthma may also be different in these two groups. The objective of this systematic review is to explore the effects of physical exercise on nocturnal asthma symptoms. METHODS Searches were conducted in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL and SPORTdiscus (last search on November 2017). Authors from studies that did not report nocturnal symptoms but used questionnaires and/or diaries were contacted for detailed information. Studies that provided results on nocturnal symptoms before and after physical activity intervention were included. Prevalence of nocturnal symptoms was calculated for each study from the percentage of study participants with nocturnal symptoms before and after intervention. RESULTS Eleven studies were included (5 with children and 6 with adults). The prevalence of nocturnal symptoms at baseline ranged from 0% to 63% among children and from 50-73% among adults. In children and adults with nocturnal asthma, aerobic physical exercise reduced the prevalence and frequency of nocturnal symptoms. CONCLUSIONS Aerobic physical exercise improves nocturnal asthma in children and adults by reducing the prevalence and frequency of nocturnal symptoms. Physical exercise training could be used with conventional treatments to improve quality of life and asthma control in patients with nocturnal worsening of asthma.
Collapse
|
27
|
Joschtel B, Gomersall SR, Tweedy S, Petsky H, Chang AB, Trost SG. Effects of exercise training on physical and psychosocial health in children with chronic respiratory disease: a systematic review and meta-analysis. BMJ Open Sport Exerc Med 2018; 4:e000409. [PMID: 30305925 PMCID: PMC6173241 DOI: 10.1136/bmjsem-2018-000409] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2018] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Chronic disease in children is increasing, including the prevalence of chronic respiratory diseases such as asthma, cystic fibrosis (CF), bronchiectasis and bronchopulmonary dysplasia (BPD). The aim of this systematic review and meta-analysis was to evaluate the effects of exercise training on health outcomes in children with chronic respiratory disease. METHOD Five databases were searched for randomised controlled trials investigating the effects of exercise training on children with chronic respiratory disease. Following the PRISMA guidelines, eligible studies were identified and data were extracted. A meta-analysis was conducted for the outcomes cardiovascular fitness, lung function and quality of life (QoL). RESULTS The initial search returned 3688 papers. Twenty-seven (17 in children with asthma, 10 in children with CF) were included in the systematic review and 24 of these were included in the meta-analysis. No studies were identified in children with bronchiectasis or BPD. Included papers had a total of 1009 participants aged 8-20 years. In addition to cardiovascular fitness, lung function and QoL, studies also assessed pulmonary function, respiratory muscle strength, muscular strength and inflammation. Meta-analysis showed a large significant effect size in favour of exercise for cardiovascular fitness (peak VO2) (standard mean difference (SMD)=1.16, 95% CI 0.61 to 1.70) and QoL (SMD=1.27, 95% CI 0.72 to 1.82) as well as a small, non-significant effect size for lung function (FEV1) (SMD=0.02, 95% CI -0.38 to 0.42). CONCLUSION Exercise training significantly improves cardiovascular fitness and QoL in children with asthma and CF. Further research is needed, particularly in children with bronchiectasis and BPD.
Collapse
Affiliation(s)
- Barbara Joschtel
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Sjaan R Gomersall
- School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Sean Tweedy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Helen Petsky
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Tiwi, Australia
- Institute of Health and Biomedical Innovation, Centre for Children’s Health Research, Queensland University of Technology, Brisbane, Queensland, Australia
- Department of Respiratory Medicine, Lady Cilento Children’s Hospital, Children’s Health Queensland, Brisbane, Queensland, Australia
| | - Stewart G Trost
- Institute of Health and Biomedical Innovation, Centre for Children’s Health Research, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
28
|
Scalco JC, Martins R, Keil PMR, Mayer AF, Schivinski CIS. PSYCHOMETRIC PROPERTIES OF FUNCTIONAL CAPACITY TESTS IN CHILDREN AND ADOLESCENTS: SYSTEMATIC REVIEW. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2018; 36:500-510. [PMID: 30462776 PMCID: PMC6322795 DOI: 10.1590/1984-0462/;2018;36;4;00002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 09/01/2017] [Indexed: 12/03/2022]
Abstract
OBJECTIVES To identify studies that evaluated psychometric properties of functional capacity tests in children and adolescents, and to verify which of these have satisfactory properties of measurement. DATA SOURCES Searches on MEDical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scientific Electronic Library Online (SciELO) databases without limiting period or language. Two investigators independently selected articles based on the following inclusion criteria: children and/or adolescent population (healthy or with cardiorespiratory diseases); and assessment of psychometric properties of functional capacity tests. Studies with (I) adult samples, (II) sample with neurological diseases, and (III) on reference values or prediction equations only were excluded. DATA SYNTHESIS From the total of 677 articles identified, 11 were selected. These evaluated the psychometric properties of the following tests: 6-minute walk test (6MWT) (n=7); 6MWT and the 3-minute step test (3MST) (n=1); and Incremental Shuttle Walk Test (ISWT) (n=3). Reproducibility and reliability were good for 6MWT and ISWT, and moderate for 3MST. The ISWT showed high validity measures for both healthy children and children with chronic respiratory disease. The validity of 6MWT varied across studies, and should be analyzed according to the health conditions of test takers. The validity of 3MST is unclear, and further studies in pediatric population are required. CONCLUSIONS Most studies investigated 6MWT measurement properties. Validity of 6MWT varied according to different pediatric populations. The use of 6MWT, ISWT and 3MST tests to measure clinically important changes in children and adolescents with cardiorespiratory diseases is still unclear.
Collapse
Affiliation(s)
| | - Renata Martins
- Universidade do Estado de Santa Catarina, Florianópolis, SC,
Brasil
| | | | | | | |
Collapse
|
29
|
De-Paula CR, Magalhães GS, Jentzsch NS, Botelho CF, Mota CDCC, Murça TM, Ramalho LFC, Tan TC, Capuruço CAB, Rodrigues-Machado MDG. Echocardiographic Assessment of Ventricular Function in Young Patients with Asthma. Arq Bras Cardiol 2018; 110:231-239. [PMID: 29694547 PMCID: PMC5898772 DOI: 10.5935/abc.20180052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 11/16/2017] [Indexed: 11/20/2022] Open
Abstract
Background Despite significant advances in understanding the pathophysiology and
management of asthma, some of systemic effects of asthma are still not well
defined. Objectives To compare heart function, baseline physical activity level, and functional
exercise capacity in young patients with mild-to-moderate asthma and healthy
controls. Methods Eighteen healthy (12.67 ± 0.39 years) and 20 asthmatics (12.0 ±
0.38 years) patients were enrolled in the study. Echocardiography parameters
were evaluated using conventional and tissue Doppler imaging (TDI). Results Although pulmonary acceleration time (PAT) and pulmonary artery systolic
pressure (PASP) were within normal limits, these parameters differed
significantly between the control and asthmatic groups. PAT was lower (p
< 0.0001) and PASP (p < 0.0002) was higher in the asthma group (114.3
± 3.70 ms and 25.40 ± 0.54 mmHg) than the control group
(135.30 ± 2.28 ms and 22.22 ± 0.40 mmHg). The asthmatic group
had significantly lower early diastolic myocardial velocity (E', p = 0.0047)
and lower E' to late (E'/A', p = 0.0017) (13.75 ± 0.53 cm/s and 1.70
± 0.09, respectively) compared with control group (15.71 ±
0.34 cm/s and 2.12 ± 0.08, respectively) at tricuspid valve. In the
lateral mitral valve tissue Doppler, the asthmatic group had lower E'
compared with control group (p = 0.0466; 13.27 ± 0.43 cm/s and 14.32
± 0.25 cm/s, respectively), but there was no statistic difference in
the E'/A' ratio (p = 0.1161). Right isovolumetric relaxation time was higher
(p = 0.0007) in asthmatic (57.15 ± 0.97 ms) than the control group
(52.28 ± 0.87 ms), reflecting global myocardial dysfunction. The
right and left myocardial performance indexes were significantly higher in
the asthmatic (0.43 ± 0.01 and 0.37 ± 0.01, respectively)
compared with control group (0.40 ± 0.01 and 0.34 ± 0.01,
respectively) (p = 0.0383 and p = 0.0059, respectively). Physical activity
level, and distance travelled on the six-minute walk test were similar in
both groups. Conclusion Changes in echocardiographic parameters, evaluated by conventional and TDI,
were observed in mild-to-moderate asthma patients even with normal
functional exercise capacity and baseline physical activity level. Our
results suggest that the echocardiogram may be useful for the early
detection and evoluation of asthma-induced cardiac changes.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Timothy C Tan
- Westmead Hospital, Faculty of Medicine, University of Sydney, Sidney, Australia
| | | | | |
Collapse
|
30
|
Kirkby S, Rossetti A, Hayes D, Allen E, Sheikh S, Kopp B, Patel A. Benefits of pulmonary rehabilitation in pediatric asthma. Pediatr Pulmonol 2018; 53:1014-1017. [PMID: 29736958 DOI: 10.1002/ppul.24041] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/17/2018] [Indexed: 11/11/2022]
Abstract
INTRODUCTION There are limited studies evaluating the role of pulmonary rehabilitation (PR) in pediatric asthma. METHODS A retrospective chart review was performed of all pediatric patients with a diagnosis of asthma enrolled in PR. Demographics, medications, and clinical records were reviewed. In addition, PFTs, 6-min walk test (6MWT), and patient/parent symptom and quality of life surveys before and after PR were evaluated. RESULTS A total of 38 patients were enrolled in PR; 18 (47%) female and 20 (53%) male. Mean participant age was 11.33 ± 3.37 (range 4-19) years. Twenty-two (58%) were Caucasian and nine (24%) African American. Chart review was limited by incomplete data sets for many participants. Following PR, significant improvement was noted in mean 6MWT distance (1541 vs 1616 feet, P = 0.05) and FEV1 (89.9% of predicted versus 96.4%, P = 0.04). Survey instruments demonstrated improvement in several clinical factors, however, there was no significant change in weight following PR despite scheduled cardiovascular exercise and dietary counseling. CONCLUSIONS Structured PR for pediatric patients with asthma can improve 6MWT distance and FEV1 as well as subjective measures of SOB and QOL, suggesting a role for PR in the chronic management of pediatric asthma. Further prospective investigation is needed to determine if PR has positive effects on other clinical parameters of asthma control and its overall impact on childhood obesity.
Collapse
Affiliation(s)
- Stephen Kirkby
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio.,Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Allison Rossetti
- Section of General Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | - Don Hayes
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio.,Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Elizabeth Allen
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Shahid Sheikh
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Benjamin Kopp
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio
| | - Alpa Patel
- Section of Pulmonary Medicine, Nationwide Children's Hospital, Columbus, Ohio
| |
Collapse
|
31
|
Abdelbasset WK, Alsubaie SF, Tantawy SA, Abo Elyazed TI, Kamel DM. Evaluating pulmonary function, aerobic capacity, and pediatric quality of life following a 10-week aerobic exercise training in school-aged asthmatics: a randomized controlled trial. Patient Prefer Adherence 2018; 12:1015-1023. [PMID: 29942118 PMCID: PMC6007206 DOI: 10.2147/ppa.s159622] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND It has been documented that aerobic exercise may increase pulmonary functions and aerobic capacity, but limited data has evaluated a child's satisfaction and pediatric quality of life (PQoL) with exercise training. OBJECTIVES This study aimed to investigate the effects of moderate-intensity exercise training on asthmatic school-aged children. SUBJECTS AND METHODS This study included 38 school-aged children with asthma (23 males and 15 females) aged between 8-12 years. They were randomly assigned to two groups, aerobic exercise (AE) and conventional treatment (Con ttt) groups. The AE group received a program of moderate-intensity aerobic exercise for 10 weeks with asthma medications and the Con ttt group received only asthma medications without exercise intervention. A home respiratory exercise was recommended for the two groups. Aerobic capacity was investigated using maximal oxygen uptake (VO2max), 6-minute walk test (6MWT), and fatigue index. PQoL was evaluated using Pediatric Quality of Life Questionnaire (PQoLQ). Also, pulmonary function tests were performed, and the results recorded. RESULTS The findings of this study showed significant improvements in pulmonary functions and VO2max in the two groups; however, this improvement was significantly higher in the AE group than in the Con ttt group (p<0.05). The 6MWT and fatigue index improved in the AE group (p<0.05) but not in the Con ttt group (p>0.05). All dimensions of PQoL significantly improved in the AE group (p<0.05), but there was no significant improvement in the Con ttt group after the 10-week intervention period (p>0.05). CONCLUSION Ten weeks of physical exercise had beneficial effects on pulmonary functions, aerobic capacity, and PQoL in school-aged children with asthma. Effort and awareness should be dedicated to encouraging the active lifestyle among different populations, especially asthmatic children.
Collapse
Affiliation(s)
- Walid K Abdelbasset
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
- Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
| | - Saud F Alsubaie
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Sayed A Tantawy
- Department of Physiotherapy, College of Medical and Health Sciences, Ahlia University, Manama, Kingdom of Bahrain
| | - Tamer I Abo Elyazed
- Department of Physical Therapy for Internal Medicine, Faculty of Physical Therapy, Beni-Suef University, Beni-Suef, Egypt
| | - Dalia M Kamel
- Department of Physiotherapy, College of Medical and Health Sciences, Ahlia University, Manama, Kingdom of Bahrain
- Department of Physiotherapy for Womens Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| |
Collapse
|
32
|
Gonçalves RM, Ferreira LG, Assumpção MSD, Schivinski CIS. Impact of sports activities on respiratory function and mechanics in children. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.003.ao06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Being physically active in childhood may improve the quality of life in adulthood. So, it is extremely important to evaluate the respiratory function and mechanics of children who participate in sports activities, in order to determine the impact of physical activity on airway resistance. Objective: To analyze measures of respiratory function and mechanics in children who participate (PG) and who do not participate (CG) in sports activities regularly, as well as to compare and correlate the results. Methods: This is a cross-sectional analytical study of healthy school-aged children aged 6 to 12 years, assessed by impulse oscillometry tests (IOS) and spirometry. The sample was divided into PG and CG. The Student’s t-Test or Mann-Whitney test was used to compare the groups according to normality of data tested by the Shapiro-Wilk test. The correlation between the tests and age, sex, weight, height and body mass index (BMI) was performed using Pearson’s and Spearman correlation coefficient. Statistical data were processed by the SPSS® software, considering significance level at p < 0.05. Results: Forty children participated in the study, 20 in each group, with no differences regarding age, sex, weight, height and BMI. There were significant differences in FEF25-75% (CG: 94.19% ± 13.08 x PG: 101.75% ± 17.44, p = 0.049), and oscillometry data did not differ between both groups. Sex correlated with total airway resistance (R5 - p = 0.049, r = 0.314). Conclusion: In the group with children who participated in sports activities, FEF25-75% was higher, compared to the control group.
Collapse
|
33
|
Bian J, Guo Y, Xie M, Parish AE, Wardlaw I, Brown R, Modave F, Zheng D, Perry TT. Exploring the Association Between Self-Reported Asthma Impact and Fitbit-Derived Sleep Quality and Physical Activity Measures in Adolescents. JMIR Mhealth Uhealth 2017; 5:e105. [PMID: 28743679 PMCID: PMC5548986 DOI: 10.2196/mhealth.7346] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/18/2017] [Accepted: 07/04/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Smart wearables such as the Fitbit wristband provide the opportunity to monitor patients more comprehensively, to track patients in a fashion that more closely follows the contours of their lives, and to derive a more complete dataset that enables precision medicine. However, the utility and efficacy of using wearable devices to monitor adolescent patients' asthma outcomes have not been established. OBJECTIVE The objective of this study was to explore the association between self‑reported sleep data, Fitbit sleep and physical activity data, and pediatric asthma impact (PAI). METHODS We conducted an 8‑week pilot study with 22 adolescent asthma patients to collect: (1) weekly or biweekly patient‑reported data using the Patient-Reported Outcomes Measurement Information System (PROMIS) measures of PAI, sleep disturbance (SD), and sleep‑related impairment (SRI) and (2) real-time Fitbit (ie, Fitbit Charge HR) data on physical activity (F-AM) and sleep quality (F‑SQ). To explore the relationship among the self-reported and Fitbit measures, we computed weekly Pearson correlations among these variables of interest. RESULTS We have shown that the Fitbit-derived sleep quality F-SQ measure has a moderate correlation with the PROMIS SD score (average r=-.31, P=.01) and a weak but significant correlation with the PROMIS PAI score (average r=-.18, P=.02). The Fitbit physical activity measure has a negligible correlation with PAI (average r=.04, P=.62). CONCLUSIONS Our findings support the potential of using wrist-worn devices to continuously monitor two important factors-physical activity and sleep-associated with patients' asthma outcomes and to develop a personalized asthma management platform.
Collapse
Affiliation(s)
- Jiang Bian
- Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States
| | - Yi Guo
- Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States
| | - Mengjun Xie
- Department of Computer Science, University of Arkansas at Little Rock, Little Rock, AR, United States
| | - Alice E Parish
- Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States
| | - Isaac Wardlaw
- Department of Computer Science, University of Arkansas at Little Rock, Little Rock, AR, United States
| | - Rita Brown
- Arkansas Children's Research Institute, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - François Modave
- Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States
| | - Dong Zheng
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, United States
| | - Tamara T Perry
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Arkansas Children's Hospital, Arkansas Children's Research Institute, Little Rock, AR, United States
| |
Collapse
|
34
|
Reznik M, Islamovic F, Choi J, Leu CS, Rowlands AV. Factors associated with in-school physical activity among urban children with asthma. J Asthma 2017; 55:492-501. [PMID: 28696842 DOI: 10.1080/02770903.2017.1340482] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE A cross-sectional study was conducted to determine if in-school physical activity (PA) varied by age, gender, weight and asthma status, participation in physical education (PE), outdoor recess, and other in-school PA among urban schoolchildren with asthma. METHODS PA was measured by tri-axial accelerometers. Height and mass were measured and overweight defined as BMI ≥85th percentile. Asthma impairment and risk were assessed as per national guidelines, and asthma status variable with three categories (mild, moderate, and severe) was created. Multivariable generalized linear mixed models adjusting for clustering due to school and student were fitted to identify variables predictive of PA. RESULTS 108 children with asthma participated. Children spent 374 minutes in school, of which 253 minutes were sedentary, 105 minutes in light PA, and 16 minutes in moderate-to-vigorous PA (MVPA). Only 3 participants reached the recommended ≥30 minutes/day of MVPA. Multivariable analysis revealed age, gender, participation in PE class, outdoor recess, and other in-school PA as independent predictors of PA. BMI and asthma status were not associated with PA. CONCLUSIONS Children with asthma were mostly sedentary at school. Older children and girls were particularly at risk for inactivity. PE, recess, and other in-school PA participation are modifiable factors that should be targeted in school-based interventions aimed at increasing PA in this population.
Collapse
Affiliation(s)
- Marina Reznik
- a Department of Pediatrics , Children's Hospital at Montefiore, Albert Einstein College of Medicine , Bronx , NY , USA
| | - Florinda Islamovic
- a Department of Pediatrics , Children's Hospital at Montefiore, Albert Einstein College of Medicine , Bronx , NY , USA.,b St. George's University School of Medicine , True Blue, Grenada , West Indies
| | - Jaeun Choi
- c Department of Epidemiology and Population Health , Albert Einstein College of Medicine , Bronx , NY , USA
| | - Cheng-Shiun Leu
- d Department of Biostatistics , Columbia University , New York , NY , USA
| | - Alex V Rowlands
- e Diabetes Research Centre , University of Leicester, Leicester General Hospital , Leicester , UK.,f NIHR Leicester Biomedical Research Centre , Leicester , UK.,g Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, Division of Health Sciences , University of South Australia , Adelaide , Australia
| |
Collapse
|
35
|
Soares AADA, Barros CM, Santos CGC, Dos Santos MRA, Silva JRS, Silva Junior WMD, Simões SDM. Respiratory muscle strength and pulmonary function in children with rhinitis and asthma after a six-minute walk test. J Asthma 2017; 55:259-265. [PMID: 28488885 DOI: 10.1080/02770903.2017.1326133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Rhinitis and asthma decrease quality of life. Few studies have assessed the performance of children with asthma or rhinitis under submaximal exercise. We evaluated maximal respiratory pressures, spirometric parameters, and ability to sustain submaximal exercise in these children before and after the 6-minute walk test (6MWT), compared to healthy children. METHODS This cross-sectional, analytical study included 89 children aged 6-12 years in outpatient follow-up: 27 healthy (H), 31 with rhinitis (R), and 31 with mild asthma under control (A). Pulmonary function parameters and maximal respiratory pressures were measured before and 5, 10, and 30 minutes after the 6MWT. Wilcoxon test was used to compare numerical numerical variables between two groups and analysis of variance or Kruskal-Wallis test for comparison among three groups. RESULTS Total distance traveled in the 6MWT was similar among the three groups. Compared to pre-test values, VEF1 (Forced Expiratory Volume in 1 second), VEF0.75 (Forced Expiratory Volume in 0.75 second), and FEF25-75 (Forced Expiratory Flow 25-75% of the Forced Vital Capacity - CVF - curve) decreased significantly after the 6MWT in group A, and VEF0.75, FEF25-75, and VEF1/CVF decreased significantly in group R. Groups A and R had lower Maximum Inspiratory Pressure values than group H before and after the 6MWT at all time points assessed. CONCLUSIONS The findings suggest that children with rhinitis and mild asthma present with alterations in respiratory muscle strength and pulmonary function not associated with clinical complaints, reinforcing the concept of the united airways.
Collapse
Affiliation(s)
| | - Camila Moraes Barros
- a University Hospital, Federal University of Sergipe , Aracaju , Sergipe , Brazil
| | | | | | | | | | | |
Collapse
|
36
|
|
37
|
Westergren T, Fegran L, Nilsen T, Haraldstad K, Kittang OB, Berntsen S. Active play exercise intervention in children with asthma: a PILOT STUDY. BMJ Open 2016; 6:e009721. [PMID: 26733570 PMCID: PMC4716232 DOI: 10.1136/bmjopen-2015-009721] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 12/08/2015] [Accepted: 12/14/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Increased physical activity (PA) may be beneficial for children with asthma. Knowledge about how to intervene and encourage children with asthma to be physically active is required. In the present study, we aimed to pilot a 6-week exercise intervention designed as active play and examine attendance rate, exercise intensity and children's perceptions of participating. METHODS 6 children with asthma (4 boys, 2 girls) aged 10-12 years, participated in 60 min of active play exercise twice weekly. A mixed-methods design was applied. The data analysed included attendance rate, exercise intensity assessed by heart rate (HR) monitoring during exercise sessions, registration and description of the active play exercise programme, 3 semistructured focus groups, field observations of 5 exercise sessions, and preintervention and postintervention testing. FINDINGS The average attendance rate was 90%. Intensity ≥ 80% of maximal HR (HRmax) was recorded for a median (IQR) time of 22 (8) out of 60 min per session. Median (IQR) HR during the sessions was 146 (9; 74% of HRmax) bpm. Children reported increased health-related quality of life (HRQoL) post-test compared with baseline. Children enjoyed participating and reported no limitations by asthma or serious asthma attacks. Instead, they perceived that their asthma and fitness had improved after the programme. The instructors created an inclusive atmosphere that was characterised by easy-to-master games, fair competition, humour and mutual participation. CONCLUSIONS The exercise intervention pilot focusing on active play had a high attendance rate, relatively high exercise intensity, and satisfaction; the children perceived that their fitness and asthma had improved, and reported increased HRQoL. A randomised controlled trial of active play exercise including children with asthma should be conducted to evaluate effect on PA level, physical fitness, asthma control and HRQoL.
Collapse
Affiliation(s)
- Thomas Westergren
- Faculty of Health and Sports Science, University of Agder, Kristiansand, Norway
| | - Liv Fegran
- Faculty of Health and Sports Science, University of Agder, Kristiansand, Norway
- Department of Paediatrics, Sørlandet Hospital, Kristiansand, Norway
| | - Tonje Nilsen
- Faculty of Health and Sports Science, University of Agder, Kristiansand, Norway
- Department of Physical Therapy, Sørlandet Hospital, Kristiansand, Norway
| | - Kristin Haraldstad
- Faculty of Health and Sports Science, University of Agder, Kristiansand, Norway
| | | | - Sveinung Berntsen
- Faculty of Health and Sports Science, University of Agder, Kristiansand, Norway
| |
Collapse
|
38
|
Latorre-Román PÁ, Martínez AVN, García-Pinillos F. Effect of a physical activity program on sport enjoyment, physical activity participation, physical self-concept and quality of life in children with asthma. MOTRIZ: REVISTA DE EDUCACAO FISICA 2015. [DOI: 10.1590/s1980-65742015000400007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract This study aims to analyse the effects of indoor physical training program on the enjoyment and the willingness to participate in sports activities, physical self-concept and the quality of life in children with asthma. Participants were randomized in an experimental group (EG) (n=58, age=11.55±1.01 years old) and, a control group (CG) (n = 47, age=11.51±1.42 years old). An indoor training program was executed for 12-week, with each week containing three sessions of 60 minutes. Enjoyment in physical activity questionnaire, participation in physical activities, physical self-concept questionnaire, 6 minute walking test, and paediatric asthma quality of life questionnaire were employed. After the intervention, EG showed a significant reduction in the body mass index as well as a significant improvement in physical fitness test and the score obtained in questionnaires compared to the CG. A12-week indoor training program targeted towards asthmatic children improved the sport enjoyment, physical activity participation, physical self-concept, and quality of life.
Collapse
|
39
|
Reimberg MM, Castro RAS, Selman JPR, Meneses AS, Politti F, Mallozi MC, Wandalsen GF, Solé D, De Angelis K, Dal Corso S, Lanza FC. Effects of a pulmonary rehabilitation program on physical capacity, peripheral muscle function and inflammatory markers in asthmatic children and adolescents: study protocol for a randomized controlled trial. Trials 2015; 16:346. [PMID: 26268930 PMCID: PMC4535608 DOI: 10.1186/s13063-015-0876-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/17/2015] [Indexed: 01/06/2023] Open
Abstract
Background Individuals with chronic lung disease are more susceptible to present reduction in exercise tolerance and muscles strength not only due to pulmonary limitations but also due systemic repercussions of the pulmonary disease. The aim of this study is to assess the physical capacity, peripheral muscle function, physical activity in daily life, and the inflammatory markers in children and adolescents with asthma after pulmonary rehabilitation program. Method This is a study protocol of randomized controlled trial in asthmatic patients between 6 to 18 years old. The assessments will be conducted in three different days and will be performed at the beginning and at the end of the protocol. First visit: quality of life questionnaire, asthma control questionnaire, pre- and post-bronchodilator spirometry (400 μcg salbutamol), inflammatory assessment (blood collection), and cardiopulmonary exercise test on a cycle ergometer to determine aerobic capacity. Second visit: assessment of strength and endurance of the quadriceps femoris and biceps brachii muscles with concomitant electromyography to assess peripheral muscle strength. Third visit: incremental shuttle walk test (ISWT) and accelerometer to evaluate functional capacity and physical activity in daily life during 7 days. Then, the volunteers will be randomized to receive pulmonary rehabilitation program (intervention group) or chest physiotherapy + stretching exercises (control group). Both groups will have a supervised session, twice a week, each session will have 60 minutes duration, with minimum interval of 24 hours, for a period of 8 weeks. Intervention group: aerobic training (35 minutes) intensity between 60 to 80 % of the maximum workload of cardiopulmonary exercise testing or of ISWT; strength muscle training will be applied to the quadriceps femoris, biceps brachii and deltoid muscles (intensity: 40 to 70 % of maximal repetition, 3 x 8 repetition); finally the oral high-frequency oscillation device (Flutter®) will be used for 5 minutes. The control group: oral high-frequency oscillation device (Flutter®) for 10 minutes followed by the stretching of upper and lower limbs for 40 minutes. It is expected to observe the improvement in aerobic capacity, physical activity in daily life, muscle strength and quality of life of patients in the intervention group, and reduction in inflammatory markers. Trial registration Clinical Trial Number: NCT02383069. Data of registration: 03/03/2015
Collapse
Affiliation(s)
- Mariana Mazzuca Reimberg
- Master Degree in progress at Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Rejane Agnelo Silva Castro
- Master Degree in progress at Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Jessyca Pachi Rodrigues Selman
- Master Degree in progress at Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Aline Santos Meneses
- Master Degree in progress at Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Fabiano Politti
- Affiliated with the Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Márcia Carvalho Mallozi
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo/SP, Brazil.
| | - Gustavo Falbo Wandalsen
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo/SP, Brazil.
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo/SP, Brazil.
| | - Kátia De Angelis
- Affiliated with the Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Simone Dal Corso
- Affiliated with the Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Fernanda Cordoba Lanza
- Affiliated with the Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil. .,Post Graduation Department, Universidade Nove de Julho - UNINOVE, Vergueiro St, 235/249, São Paulo, SP, 01504-001, Brazil.
| |
Collapse
|
40
|
Meyer A, Günther S, Volmer T, Taube K, Baumann HJ. A 12-month, moderate-intensity exercise training program improves fitness and quality of life in adults with asthma: a controlled trial. BMC Pulm Med 2015; 15:56. [PMID: 25947010 PMCID: PMC4431028 DOI: 10.1186/s12890-015-0053-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 04/22/2015] [Indexed: 12/31/2022] Open
Abstract
Background Physical training has been shown to improve exercise capabilities in patients with asthma. Most studies focused on children and younger adults. Previously, the maximum program duration was six months. It is not known whether the same results may be obtained with lower intensity programs and sustained for time periods longer than 6 months. This controlled study was undertaken to investigate the effects of a moderate intensity outpatient training program of one year duration on physical fitness and quality of life in adults with asthma. Methods 21 adult asthmatics (mean age 56 ± 10 years) were allocated to outpatient training (n = 13) or standard care (n = 8). Exercise consisted of once weekly, 60-minute sessions of moderate intensity. Assessments at baseline and after one year included cardiopulmonary exercise testing and Short Form-36 and Asthma Quality of Life Questionnaires. Results Following one year of exercise, relevant improvements were observed in the training group for maximum work capacity (p = 0.005), peak oxygen uptake (p < 0.005), O2pulse (p < 0.05), maximum ventilation (p < 0.005), and most of the quality of life domains. No changes were observed in the control group. Conclusions A physiotherapist-led, long-term, moderate-intensity exercise program of one year duration can induce clinically relevant improvements in exercise capabilities and health-related quality of life in well-motivated adults with asthma. Trial registration clinicaltrials.gov NCT01097473. Date trial registered: 31.03.2010.
Collapse
Affiliation(s)
- Andreas Meyer
- Department of Pneumology, Kliniken Mariahilf GmbH, Mönchengladbach, Germany.
| | - Sabine Günther
- Department of Pneumology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
| | | | | | - Hans J Baumann
- Department of Pneumology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
| |
Collapse
|
41
|
Teng YK, Huang JL, Yeh KW, Fu LS, Lin CH, Ma WF, Lee SD, Chiang LC. Influential factors of insufficient physical activity among adolescents with asthma in Taiwan. PLoS One 2014; 9:e116417. [PMID: 25551759 PMCID: PMC4281071 DOI: 10.1371/journal.pone.0116417] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 12/09/2014] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Little research has been reported concerning insufficient physical activity in Taiwanese adolescents with asthma. The aims of this paper are to compare the amount of physical activity between asthmatic and non-asthmatic adolescents in Taiwan, as well as to investigate the influential factors associated with insufficient physical activity in asthmatic adolescents. METHODS Self-reporting structured questionnaires (socio-economic status, scale of family support for physical activity, amount of physical activity) and peak expiratory flow were assessed from 286 adolescents with asthma and 588 non-asthmatic adolescents in a cross-sectional design. Insufficient amount of physical activity was based on less than 300 minutes per week of moderate and vigorous physical activity. RESULTS Adolescents with asthma have a greater amount of physical activity and a higher level of family support than those who are non-asthmatic. In Taiwan, adolescents with asthma, girls relative to boys, obesity relative to average weight, and low family support relative to high family support were found to be associated with insufficient physical activity. CONCLUSION Physical activity in adolescents with asthma is insufficient especially in girls, in asthmatics with obesity, and in those with low family support. We suggest that physical activity programs should be applied to Taiwan adolescents with asthma in order to match the criteria of 300 minutes per week of moderate and vigorous physical activity, especially for girls, the obese and those with a low level of family support.
Collapse
Affiliation(s)
- Yu-Kuei Teng
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
- School of Nursing, China Medical University, Taichung, Taiwan
| | - Jing-Long Huang
- Division of Allergy Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, and Chang Gung University, Taoyuan, Taiwan
| | - Kuo-Wei Yeh
- Division of Allergy Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, and Chang Gung University, Taoyuan, Taiwan
| | - Lin-Shien Fu
- Division of Pediatric Immunology and Nephrology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chia-Huei Lin
- Graduate Institute of Medical Science, Taipei, Taiwan
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
- Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Wei-Fen Ma
- School of Nursing, China Medical University, Taichung, Taiwan
| | - Shin-Da Lee
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
- * E-mail: (L-CC); (S-DL)
| | - Li-Chi Chiang
- School of Nursing, China Medical University, Taichung, Taiwan
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
- * E-mail: (L-CC); (S-DL)
| |
Collapse
|
42
|
Hughes D. Childhood asthma and exercise. Paediatr Child Health 2014; 19:467-8. [PMID: 25414580 DOI: 10.1093/pch/19.9.467] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2014] [Indexed: 11/14/2022] Open
|
43
|
Tiggelman D, van de Ven MOM, van Schayck OCP, Engels RCME, van Sluijs EMF. Maternal and paternal beliefs, support and parenting as determinants of sport participation of adolescents with asthma. J Asthma 2014; 52:492-7. [PMID: 25402625 DOI: 10.3109/02770903.2014.984844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
RATIONALE Few studies have examined determinants of physical activity in patients with chronic illnesses, like asthma. The aim of this study was to examine whether baseline maternal and paternal beliefs, support and parenting were associated with changes in sport participation of adolescents with asthma, and investigate the moderating effect of sex. METHODS In a population-based cohort study, during home visits in 2012 and 2013, 253 adolescents completed a questionnaire assessing their sport participation. Both parents reported their sport-specific parenting (support, general and asthma-specific beliefs, self-efficacy to encourage sport participation). The collected data was described using descriptive statistics. Path and multi-group analyses were used to examine whether baseline parental factors predicted change in adolescent sport participation, multi-group analyses examined the moderating effect of sex. For all analyses probability p value less than the accepted level of significance α = 0.05 (p < 0.05) were taken as significant effects. RESULTS Few parental factors associated with changes in sport participation of the adolescents, sex did not moderate the associations. In the fully adjusted models, only maternal asthma-specific beliefs about sport participation were significantly positively associated with change in adolescent sport participation. CONCLUSION Sport-specific parenting does not appear to be a determinant of sport participation in adolescents with asthma. Future research should consider other individual, social and environmental determinants to inform intervention development.
Collapse
Affiliation(s)
- Dana Tiggelman
- Faculty of Social Sciences, Behavioural Science Institute (BSI), Radboud University Nijmegen , Nijmegen , The Netherlands
| | | | | | | | | |
Collapse
|
44
|
Tiggelman D, van de Ven MOM, van Schayck OCP, Kleinjan M, Engels RCME. Sport club participation of adolescents with asthma: maternal factors and adolescent cognitions. Pediatr Pulmonol 2014; 49:835-41. [PMID: 24574428 DOI: 10.1002/ppul.22902] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 08/13/2013] [Indexed: 11/10/2022]
Abstract
RATIONALE Sport participation is especially important for patients with asthma in that it decreases psychosocial and physiological problems associated with inactivity. However, adolescents with asthma seem to participate less in sports compared to their non-asthmatic peers. The current study tested the direct associations between maternal sport-specific factors and sport club participation of early adolescents with asthma and the indirect effect through adolescent's sport-specific cognitions. METHODS During home visits, 261 adolescents (aged 10-15) completed questionnaires about self-efficacy, beliefs regarding sport participation, and their actual sport club participation. Their mothers reported their sport-specific support, beliefs about offspring's and own sport participation, their own levels of physical activity, and their self-efficacy to stimulate offspring to participate in sports. Path analyses were used to examine the direct and indirect associations of maternal sport-specific factors with adolescents sport club participation via adolescent sport-specific cognitions. RESULTS Analyses showed that maternal sport-specific support (β = 0.20, P = 0.007) and self-efficacy to stimulate offspring to participate in sports (β = 0.20, P = 0.027) related positively to adolescents' sport club participation. Adolescents' self-efficacy (indirect effect = 0.09, SE = 3.01, P < 0.001) mediated the positive relation between maternal self-efficacy to stimulate offspring to participate in sport and adolescents' participation in sport clubs. CONCLUSION Maternal sport-specific factors related to adolescents' sport club participation directly and indirectly through adolescents' sport-specific cognitions. Intervention programs should focus on maternal sport-specific support and self-efficacy and adolescents' self-efficacy to increase sport participation of adolescents with asthma.
Collapse
Affiliation(s)
- Dana Tiggelman
- Behavioural Science Institute (BSI), Faculty of Social Sciences, Radboud University Nijmegen, Nijmegen, The Netherlands
| | | | | | | | | |
Collapse
|
45
|
Effects of the Fitkids exercise therapy program on health-related fitness, walking capacity, and health-related quality of life. Phys Ther 2014; 94:1306-18. [PMID: 24786945 DOI: 10.2522/ptj.20130315] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Children with disabilities have an increased risk for reduced fitness and reduced health-related quality of life (HRQoL). Fitkids, a nationwide exercise therapy program in the Netherlands, was developed to improve fitness and HRQoL in children with disabilities. OBJECTIVE The study objective was to determine the effects of the Fitkids program on health-related fitness, walking capacity, and HRQoL in children with disabilities or chronic conditions. DESIGN This was a quasi-experimental single-group longitudinal study. METHODS Fifty-two children and adolescents who were referred to the Fitkids program participated in this study. Participants received a graded exercise training program for 6 months, with frequencies of 1 hour 2 times per week in the first 3 months and 1 hour per week during months 4 to 6. Health-related fitness (aerobic fitness, anaerobic fitness, and muscle strength), walking capacity, and HRQoL were evaluated at baseline and after 3 and 6 months of training. Multilevel modeling was used to quantify the contributions of repeated measures, participants, and Fitkids centers to variations in health-related fitness, walking capacity, and HRQoL during the intervention period. The models were adjusted for sex, height, and weight. RESULTS After 6 months of training, significant intervention effects were found for aerobic fitness, anaerobic fitness, and muscle strength. A significant effect also was found for walking capacity. On the HRQoL measure, significant improvements were found for the self-reported and parent-reported physical and emotion domains and for the parent-reported total score for HRQoL. LIMITATIONS No control group was included in this study. CONCLUSIONS The Fitkids exercise therapy program has significantly improved health-related fitness, walking capacity, and HRQoL in children and adolescents with chronic conditions or disabilities.
Collapse
|
46
|
The efficacy of aerobic training in improving the inflammatory component of asthmatic children. Randomized trial. Respir Med 2014; 108:1438-45. [PMID: 25231109 DOI: 10.1016/j.rmed.2014.07.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 06/21/2014] [Accepted: 07/07/2014] [Indexed: 11/24/2022]
Abstract
Few studies have been conducted on the effects of aerobic exercise in children with asthma, particularly on the inflammatory component and functional outcomes. This study evaluated the effect of aerobic exercise on inflammation, functional capacity, respiratory muscle strength, quality of life and symptoms scores in asthmatic children. This was a 6-week randomized trial (NCT0192052) of 33 moderately asthmatic children (6-17 years). Patients were randomized aerobic training (exercise group; n = 14), while another group did not exercise (control; n = 19). Primary endpoint was evaluations serum cytokines (IL-17, IFN, TNF, IL-10, IL-6, IL-4 and IL-2) assessed by flow cytometry. The six-minute walk test, pulmonary function, quality of life and symptoms (asthma-free days) were secondary endpoint. The Mann-Whitney test was used to evaluate the independent variables and the Wilcoxon test for paired variables. The t-test was used for the remaining calculations. Significance was determined at 5%. Aerobic training failed to modify the inflammatory component. In the exercise group, an increase occurred in functional capacity (p < 0.01) and peak expiratory flow (p = 0.002), and maximal inspiratory (p = 0.005) and expiratory pressure (p < 0.01) improved. Furthermore, there was a significant increase in all the domains of the PAQLQ. The children who exercised had more asthma-free days than the controls (p = 0.012) and less sensation of dyspnea at the end of the study (p < 0.01). In conclusion, six weeks of aerobic exercise no changes in plasma cytokine patterns in asthmatic children and adolescents; however, an improvement was found in functional capacity, maximal respiratory pressure, quality of life and asthma-related symptoms. ClinicalTrials.gov Identifier: NCT0192052.
Collapse
|
47
|
Effects of exercise training on airway hyperreactivity in asthma: a systematic review and meta-analysis. Sports Med 2014; 43:1157-70. [PMID: 23846823 DOI: 10.1007/s40279-013-0077-2] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although physical exercise is recommended for asthmatics, evidence on the effects of exercise on clinical key factors is still missing. OBJECTIVES We performed a systematic review and meta-analysis to determine the effect of exercise training (EXT) on quality of life (QoL), bronchial hyperresponsiveness (BHR), exercise-induced bronchoconstriction (EIB), lung function and exercise capacity, plus the factors affecting changes in QoL and exercise capacity in asthmatics after a period of EXT. DATA SOURCES A computerized search was conducted in MEDLINE, EMBASE, and CINAHL (last search on 15 November 2012), without language restriction, and references of original studies and reviews were searched for further relevant studies. STUDY SELECTION Two independent investigators screened full-text studies with asthmatic subjects undertaking EXT (defined as training for ≥7 days, ≥2 times per week, ≥5 training sessions in total) that assessed at least one of the following outcomes: QoL, airway hyperreactivity, forced expiratory volume in one second (FEV₁), peak expiratory flow (PEF), inflammatory parameters, exercise capacity, or exercise endurance. Potentially relevant studies were excluded if only respiratory muscle training, breathing exercises or yoga was performed, if asthmatic subjects with co-morbidities were investigated, if only data of mixed patient groups without separate results for asthmatics were presented, if training regimens were not sufficiently specified, if no numerical outcome data were presented, and if new long-term medication was introduced in addition to physical training. Of 500 potentially relevant articles, 13.4 % (67 studies including 2,059 subjects) met the eligibility criteria and were included for further analyses. STUDY APPRAISAL AND SYNTHESIS METHODS Data extraction and risk of bias assessment was performed according to the Cochrane Handbook for Systematic Reviews of Interventions. A meta-analysis of all randomized controlled trials (RCTs) was performed to determine the effect of EXT on asthma symptoms, BHR, EIB, FEV₁, exercise capacity and exercise endurance compared with control training. In addition, relative pre/post changes were analysed in all RCTs and controlled trials. Finally, multiple linear regression models were used to identify effects of relative changes in airway hyperreactivity (BHR or EIB), lung function (FEV₁ or PEF) and training hours on QoL and exercise performance. RESULTS In a total of 17 studies including 599 subjects, meta-analyses showed a significant improvement in days without asthma symptoms, FEV1 and exercise capacity while BHR only tended to improve. The analysis of relative within-group changes after EXT showed, however, significant improvements in QoL (17 %), BHR (53 %), EIB (9 %), and FEV1 (3 %) compared with control conditions. Multiple linear regression models revealed that changes in airway hyperreactivity and lung function significantly contributed to the change in QoL, while mainly the changes in airway hyperreactivity contributed to the change in exercise capacity. CONCLUSION EXT was shown to improve asthma symptoms, QoL, exercise capacity, BHR, EIB, and FEV1 in asthmatics and improvements in BHR explained part of the improvement in QoL and exercise capacity. Thus, physical activity should be recommended as a supplementary therapy to medication. However, more well controlled studies should be performed assessing the relationship of physical activity, QoL, airway hyperreactivity, lung function and especially airway inflammation as well as medication intake.
Collapse
|
48
|
Walker TJ, Reznik M. In-school asthma management and physical activity: children's perspectives. J Asthma 2014; 51:808-13. [PMID: 24796650 DOI: 10.3109/02770903.2014.920875] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Regular physical activity (PA) is an important component of pediatric asthma management. No studies have examined how in-school asthma management influences PA from children's perspectives. The aim of this study was to explore children's perceptions of the impact of in-school asthma management on PA. METHODS Qualitative interviews with 23 inner-city minority children with asthma (aged 8-10 yrs; 12 girls, 11 boys) were conducted in 10 Bronx, New York elementary schools. Sampling continued until saturation was reached. Interviews were recorded, transcribed and independently coded for common themes. RESULTS Interviews produced five themes representing students' perceptions about (1) asthma symptoms during in-school PA; (2) methods to control asthma episodes during school PA; (3) methods to prevent asthma episodes during school; (4) limited accessibility of asthma medications; and (5) negative feelings about asthma and medication use. The majority of students experienced asthma symptoms while performing PA during school. Primary methods of managing asthma symptoms were sitting out during activity, drinking water, and visiting the nurse. Students lacked awareness or adherence to action plans to prevent or control asthma. Students reported limited access to medication during school and feelings of embarrassment and/or concerns of teasing when medicating in front of others. CONCLUSIONS Our results indicate inappropriate in-school management of asthma symptoms, poor asthma control, lack of accessible medication, and stigma around publicly using asthma medication. Thus, students often missed or were withheld from PA. Interventions to improve in-school asthma care must consider ways to address these issues.
Collapse
Affiliation(s)
- Timothy J Walker
- Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine , Bronx, New York , USA
| | | |
Collapse
|
49
|
Andrade LBD, Silva DARG, Salgado TLB, Figueroa JN, Lucena-Silva N, Britto MCA. Comparison of six-minute walk test in children with moderate/severe asthma with reference values for healthy children. J Pediatr (Rio J) 2014; 90:250-7. [PMID: 24184268 DOI: 10.1016/j.jped.2013.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 08/05/2013] [Accepted: 08/21/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE to compare physical performance and cardiorespiratory responses in the six-minute walk test (6MWT) in asthmatic children with reference values for healthy children in the same age group, and to correlate them with intervening variables. METHODS this was a cross-sectional, prospective study that evaluated children with moderate/severe asthma, aged between 6 and 16 years, in outpatient follow-up. Demographic and spirometric test data were collected. All patients answered the pediatric asthma quality of life (QoL) questionnaire (PAQLQ) and level of basal physical activity. The 6MWT was performed, following the American Thoracic Society recommendations. Comparison of means was performed using Student's t-test and Pearson's correlation to analyze the 6MWT with study variables. The significance level was set at 5%. RESULTS 40 children with moderate or severe asthma were included, 52.5% males, 70% with normal weight and sedentary. Mean age was 11.3±2.1 years, mean height was 1.5±0.1 m, and mean weight was 40.8±12.6 Kg. The mean distance walked in the 6MWT was significantly lower, corresponding to 71.9%±19.7% of predicted values; sedentary children had the worst values. The difference between the distance walked on the test and the predicted values showed positive correlation with age (r=0.373, p=0.018) and negative correlation with cardiac rate at the end of the test (r=-0.518, p<0.001). Regarding QoL assessment, the values in the question about physical activity limitations showed the worst scores, with a negative correlation with walked distance difference (r=-0.311, p=0.051). CONCLUSIONS asthmatic children's performance in the 6MWT evaluated through distance walked is significantly lower than the predicted values for healthy children of the same age, and is directly influenced by sedentary life style.
Collapse
Affiliation(s)
| | - Diogo A R G Silva
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil
| | - Taíza L B Salgado
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil
| | - José N Figueroa
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil
| | - Norma Lucena-Silva
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil
| | - Murilo C A Britto
- Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil
| |
Collapse
|
50
|
Andrade LBD, Silva DA, Salgado TL, Figueroa JN, Lucena-Silva N, Britto MC. Comparison of six-minute walk test in children with moderate/severe asthma with reference values for healthy children. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2014. [DOI: 10.1016/j.jpedp.2013.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|