Physical activity and sedentary time in children and adolescents with asthma: A systematic review and meta-analysis

Assessment of the Physical Activity of Children with Asthma Bronchiale

Physical activity is an especially important part of everyday life for children with chronic diseases. The aim of the study was to show whether asthma is a barrier to physical activity in our society. The correlations between the severity of the disease, body mass index, and physical activity were analyzed, and parents' opinions on whether children should participate in active sports were assessed. Physical activity of children with asthma was analyzed by questionnaires; 93 parents and their 93 children were involved in the survey. The age of children was 12.6 ± 3.5 years (mean ± SD), 69.9% were boys, 30.1% were girls. A total of 93.4% of the respondents participated in a physical education program and 56.5% also attended sporting activities on a regular basis. In terms of disease severity, 61.2% of the children had mild asthma, 37.6% moderate, and 1.2% severe, and 6.5% of the respondents also stated that their children's illness had been consistently or frequently limiting their performance concerning their school or home duties over the past four weeks. Of the parents surveyed, 12% felt that physical activity was not appropriate in the context of this disease. We concluded that fear of the consequences of physical activity depends largely on education, which should involve parents, teachers, and coaches.

The effect of pulmonary rehabilitation on childhood asthma: a systematic review and meta-analysis

INTRODUCTION

Pulmonary rehabilitation (PR) is a comprehensive nursing intervention for lung function improvement in patients with respiratory diseases. This systematic review focused on further exploration of the unclear impacts of PR on childhood asthma.

EVIDENCE ACQUISITION

Web of Science, Cochrane Library, Embase, PubMed, and other databases were searched until May 2021. Randomized controlled trials (RCTs) comparing the effects of PR (including exercise training and education) and routine care on childhood asthma were included. Study selection, data extraction, and bias risk assessment were performed independently by two investigators.

EVIDENCE SYNTHESIS

Fourteen RCTs involving 1401 patients were included. Relative to the control group, the total scores of the asthma quality of life questionnaire were evidently improved in the experimental group, including motor domain scores (MD=0.88, 95% CI: 0.67-1.09), symptom domain scores (MD=1.23, 95% CI: 0.61-1.85), and affective domain scores (MD=1.38, 95% CI: 0.63-2.14). Besides, 6-min walk distance (MD=2.01, 95% CI: 0.86-3.15) and asthma control test (MD=0.31, 95% CI: 0.02-0.60) were prominently improved. However, the maximum oxygen uptake (MD=0.81, 95% CI: -0.2 to 1.82) was not markedly improved. The forced expiratory volume in 1 s (MD=0.42, 95% CI: -0.29 to 1.13), and forced vital capacity (MD=0.07, 95% CI: -0.14 to 0.28) were not remarkably improved. There was an evident improvement in the peak expiratory flow (MD=1.22, 95% CI: 0.15-2.30).

CONCLUSIONS

PR improves some lung functions, exercise tolerance and the quality of life of children with asthma, and it might work as a supplementary therapy for the treatment of childhood asthma. Moreover, more RCTs of high quality and in large sample size are needed for further confirmation.

Can the Childhood Physical Activity Questionnaire Be Used to Identify Physical Activity Levels in Children With Asthma?

Objective: Children with asthma who are physically active have a better quality of life, emphasizing the importance of activity monitoring and promotion in daily life. The validity of self-reported activity measurements has been questioned in pediatric populations. In this study, we aim to compare the Physical Activity Questionnaire for Children (PAQ-C) with objectively measured PA using accelerometry. Design: In this comparison study, the pooled dataset of two cross-sectional studies was used, which prospectively home-monitored PA using the alternative self-report PAQ-C questionnaire as well as with the criterion standard accelerometry (Actigraph wGT3X-BT and GT1M). Participants:Ninety children with pediatrician-diagnosed asthma participated in the study. Main Outcome Measures:Correlation coefficients were calculated to determine the relation between the PAQ-C and accelerometer data. The predictive value of the PAQ-C in differentiating between achieving and failing the recommended daily level of moderate-to-vigorous activity (MVPA) was evaluated with receiver operator characteristic (ROC) analysis. Results: The results showed weak to moderate correlations of the PAQ-C with the accelerometer data (r = 0.29-0.47). A PAQ-C cutoff of 3.09 showed the best performance on predicting whether the recommended level of MVPA was achieved. With this cutoff, 21 of the 39 children that did achieve their daily MVPA level (53.8% sensitivity) and 33 of the 46 children that did fail their daily MVPA level (71.7% specificity) were correctly classified. A PAQ-C score of 3.5 revealed a negative predictive value of 100% for assessing physical inactivity. Conclusion: This study revealed a weak relation between the PAQ-C and PA assessed with accelerometry. However, a PAQ-C score of 3.5 or higher might be used as a low-cost and easy-to-use PA screening tool for ruling out physical inactivity in a portion of the pediatric asthma population. Clinical Trial Registration: Netherlands Trial Register: Trial NL6087.

Recent Trends in Sedentary Time: A Systematic Literature Review

This paper systematically reviews and synthesizes the relevant literature on sedentary time research. A bibliometric analysis was conducted to evaluate the publications from 2010 to 2020 in the Web of Science (WoS) core collection database. Derwent Data Analyzer software was used for the cleaning, mining, and visualization of the data. Historical trends of the topics, main contributors, leading countries, leading institutions, leading research areas, and journals were explored. A total of 3020 publications were studied. The United States, the United Kingdom, and Australia are the three most productive countries. The Australian institution Baker Heart and Diabetes Institute led the list of productive institutions, and Ekelund U published the most papers. Sedentary time raised the concerns of scholars from 106 research areas, and public health was the dominant field. Physical activity, accelerometer, children, and obesity were the most frequently used keywords. The findings suggest that sedentary time is rapidly emerging as a global issue that has detrimental effects on public health. The hotspots shifted in the past 10 years, and COVID-19 was the most popular topic of sedentary time research.

COVID-19 Pandemic and Reduced Physical Activity: Is There an Impact on Healthy and Asthmatic Children?

Physical activity (PA) has been seen to improve asthma symptoms, lung function, and quality of life, as well as to reduce airway inflammation and bronchial responsiveness. As a consequence of the COVID-19 pandemic, the minimal amount of PA recommended by the World Health Organization-i.e., about 60 min/day of moderate-to-high intensity-is difficult to achieve for many children, particularly those living in urban areas. Short-term changes in PA because of the COVID-19 pandemic may become habitual, increasing the risk of adverse asthma outcomes in children. Indeed, prolonged home confinement during the COVID-19 pandemic reduces PA levels and increases sedentary behaviors, possibly impairing immune system function and increasing susceptibility to inflammatory diseases. However, there is limited evidence regarding the effects of lockdown due to COVID-19 on PA and sedentary behaviors in asthmatic children. Given that children stay longer indoors, indoor air pollution represents a major issue to consider during home confinement. This narrative review aims to summarize the available evidence about the impact of decreased PA and increased sedentary behaviors on children with asthma during the COVID-19 pandemic. In addition, strategies for supporting PA in children with asthma during the COVID-19 pandemic are suggested, also looking at the issue of indoor air quality.