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Mahdavinia M, Poole JA, Apter AJ, Pacheco SE, Pappalardo AA, Matsui EC, Davis CM, Bernstein JA. Volunteerism Addressing Environmental Disparities in Allergy (VAEDIA): The presidential initiative to combat environmental injustice in allergy and immunology-a Work Group Report of the AAAAI VAEDIA task force. J Allergy Clin Immunol 2024; 154:59-67. [PMID: 38795076 DOI: 10.1016/j.jaci.2024.04.012] [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: 02/02/2024] [Revised: 03/22/2024] [Accepted: 04/18/2024] [Indexed: 05/27/2024]
Abstract
Many vulnerable people lose their health or lives each year as a result of unhealthy environmental conditions that perpetuate medical conditions within the scope of allergy and immunology specialists' expertise. While detrimental environmental factors impact all humans globally, the effect is disproportionately more profound in impoverished neighborhoods. Environmental injustice is the inequitable exposure of disadvantaged populations to environmental hazards. Professional medical organizations such as the American Academy of Allergy, Asthma & Immunology (AAAAI) are well positioned to engage and encourage community outreach volunteer programs to combat environmental justice. Here we discuss how environmental injustices and climate change impacts allergic diseases among vulnerable populations. We discuss pathways allergists/immunologists can use to contribute to addressing environmental determinants by providing volunteer clinical service, education, and advocacy. Furthermore, allergists/immunologists can play a role in building trust within these communities, partnering with other patient advocacy nonprofit stakeholders, and engaging with local, state, national, and international nongovernmental organizations, faith-based organizations, and governments. The AAAAI's Volunteerism Addressing Environmental Disparities in Allergy (VAEDIA) is the presidential task force aiming to promote volunteer initiatives by creating platforms for discussion and collaboration and by funding community-based projects to address environmental injustice.
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Affiliation(s)
- Mahboobeh Mahdavinia
- Department of Medicine, Division of Allergy and Immunology, UT Health Houston, Houston.
| | - Jill A Poole
- Department of Internal Medicine, Division of Allergy and Immunology, University of Nebraska Medical Center, Omaha, Neb
| | - Andrea J Apter
- Section of Allergy & Immunology, Division of Pulmonary Allergy & Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Susan E Pacheco
- Department of Pediatrics, Pulmonary Division, McGovern Medical School, University of Texas, Houston, Tex
| | - Andrea A Pappalardo
- Departments of Medicine and Pediatrics, Division of Pulmonary, Critical Care, Sleep & Allergy, University of Illinois, Chicago, Ill
| | - Elizabeth C Matsui
- departments of Pediatrics and Population Health, Division of Allergy and Immunology, Dell Medical School, University of Texas at Austin, Austin, Tex
| | - Carla M Davis
- Department of Pediatrics, Division of Allergy and Immunology, Baylor College of Medicine, Houston, Tex
| | - Jonathan A Bernstein
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of Cincinnati, Cincinnati, Ohio
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Fernandes A, Avraam D, Cadman T, Dadvand P, Guxens M, Binter AC, Pinot de Moira A, Nieuwenhuijsen M, Duijts L, Julvez J, De Castro M, Fossati S, Márquez S, Vrijkotte T, Elhakeem A, McEachan R, Yang T, Pedersen M, Vinther J, Lepeule J, Heude B, Jaddoe VWV, Santos S, Welten M, El Marroun H, Mian A, Andrušaitytė S, Lertxundi A, Ibarluzea J, Ballester F, Esplugues A, Torres Toda M, Harris JR, Lucia Thorbjørnsrud Nader J, Moirano G, Maritano S, Catherine Wilson R, Vrijheid M. Green spaces and respiratory, cardiometabolic, and neurodevelopmental outcomes: An individual-participant data meta-analysis of >35.000 European children. ENVIRONMENT INTERNATIONAL 2024; 190:108853. [PMID: 38963986 DOI: 10.1016/j.envint.2024.108853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 05/17/2024] [Accepted: 06/25/2024] [Indexed: 07/06/2024]
Abstract
Studies evaluating the benefits and risks of green spaces on children's health are scarce. The present study aimed to examine the associations between exposure to green spaces during pregnancy and early childhood with respiratory, cardiometabolic, and neurodevelopmental outcomes in school-age children. We performed an Individual-Participant Data (IPD) meta-analysis involving 35,000 children from ten European birth cohorts across eight countries. For each participant, we calculated residential Normalized Difference Vegetation Index (NDVI) within a 300 m buffer and the linear distance to green spaces (meters) during prenatal life and childhood. Multiple harmonized health outcomes were selected: asthma and wheezing, lung function, body mass index, diastolic and systolic blood pressure, non-verbal intelligence, internalizing and externalizing problems, and ADHD symptoms. We conducted a two-stage IPD meta-analysis and evaluated effect modification by socioeconomic status (SES) and sex. Between-study heterogeneity was assessed via random-effects meta-regression. Residential surrounding green spaces in childhood, not pregnancy, was associated with improved lung function, particularly higher FEV1 (β = 0.06; 95 %CI: 0.03, 0.09 I2 = 4.03 %, p < 0.001) and FVC (β = 0.07; 95 %CI: 0.04, 0.09 I2 = 0 %, p < 0.001) with a stronger association observed in females (p < 0.001). This association remained robust after multiple testing correction and did not change notably after adjusting for ambient air pollution. Increased distance to green spaces showed an association with lower FVC (β = -0.04; 95 %CI: -0.07, -0.02, I2 = 4.8, p = 0.001), with a stronger effect in children from higher SES backgrounds (p < 0.001). No consistent associations were found between green spaces and asthma, wheezing, cardiometabolic, or neurodevelopmental outcomes, with direction of effect varying across cohorts. Wheezing and neurodevelopmental outcomes showed high between-study heterogeneity, and the age at outcome assessment was only associated with heterogeneity in internalizing problems.. This large European meta-analysis suggests that childhood exposure to green spaces may lead to better lung function. Associations with other respiratory outcomes and selected cardiometabolic and neurodevelopmental outcomes remain inconclusive.
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Affiliation(s)
- Amanda Fernandes
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain.
| | - Demetris Avraam
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tim Cadman
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | - Anne-Claire Binter
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Angela Pinot de Moira
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; National Heart and Lung Institute, Imperial College London, London, UK
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Liesbeth Duijts
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Jordi Julvez
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Clinical and Epidemiological Neuroscience (NeuroÈpia), Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Montserrat De Castro
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Serena Fossati
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Sandra Márquez
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Tanja Vrijkotte
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands
| | - Ahmed Elhakeem
- Population Health Science, Bristol Medical School, Bristol BS8 2BN, United Kingdom; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2PS, UK
| | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, UK
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, UK
| | - Marie Pedersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Johan Vinther
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Johanna Lepeule
- University Grenoble Alpes, Inserm U 1209, CNRS UMR 5309, Team of Environmental Epidemiology Applied to Development and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Barbara Heude
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Susana Santos
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Portugal
| | - Marieke Welten
- The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands; Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Science, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Annemiek Mian
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Sandra Andrušaitytė
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Biogipuzkoa Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain; Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
| | - Jesús Ibarluzea
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Biogipuzkoa Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain; Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013 San Sebastian, Spain; Faculty of Psychology of the University of the Basque Country (EHU-UPV), 20018, San Sebastian, Spain
| | - Ferran Ballester
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Nursing, Universitat de València, Valencia, Spain; Epidemiology Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Ana Esplugues
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Nursing, Universitat de València, Valencia, Spain; Epidemiology Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Maria Torres Toda
- Unit Medical Expertise and Data Intelligence, Department of Health Protection, National Health Laboratory (LNS), Dudelange, Luxembourg
| | - Jennifer R Harris
- Center for Fertility and Health, The Nowegian Institute of Public Health, Oslo, Norway
| | - Johanna Lucia Thorbjørnsrud Nader
- Department of Genetics and Bioinformatics, Division of Health Data and Digitalisation, Norwegian Institute of Public Health, Oslo, Norway
| | - Giovenale Moirano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Silvia Maritano
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy; University School for Advanced Studies IUSS Pavia, Pavia, Italy
| | | | - Martine Vrijheid
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
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Sañudo B, Sánchez-Oliver AJ, Fernández-Gavira J, Gaser D, Stöcker N, Peralta M, Marques A, Papakonstantinou S, Nicolini C, Sitzberger C. Physical and Psychosocial Benefits of Sports Participation Among Children and Adolescents with Chronic Diseases: A Systematic Review. SPORTS MEDICINE - OPEN 2024; 10:54. [PMID: 38750266 PMCID: PMC11096140 DOI: 10.1186/s40798-024-00722-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 05/01/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND This study aims to identify sports interventions for children and adolescents (CaA) with chronic diseases and evaluate their impact on physical, psychological, and social well-being. The findings of this study will contribute to our understanding of the potential benefits of sports interventions for CaA with chronic diseases and inform future interventions to promote their overall health and well-being. METHODS A systematic review was conducted in eight databases. This systematic review followed PRISMA guidelines and utilized a comprehensive search strategy to identify studies on sport-based interventions for CaA with chronic diseases. The review included randomized controlled trials and observational studies that focused on physical and psychosocial outcomes. RESULTS We screened 10,123 titles and abstracts, reviewed the full text of 622 records, and included 52 primary studies. A total of 2352 participants were assessed with an average of 45 ± 37 participants per study. Among the included studies involving CaA with chronic diseases with an age range from 3 to 18 years, 30% (n = 15) autism spectrum disorders, 21% (n = 11) cerebral palsy, 19% (n = 10) were attention deficit hyperactivity disorder, and 17% (n = 9) obesity. Other diseases included were cancer (n = 5), asthma (n = 1) and cystic fibrosis (n = 1). Interventions involved various sports and physical activities tailored to each chronic disease. The duration and frequency of interventions varied across studies. Most studies assessed physical outcomes, including motor performance and physical fitness measures. Psychosocial outcomes were also evaluated, focusing on behavioural problems, social competencies, and health-related quality of life. CONCLUSION Overall, sport-based interventions effectively improved physical and psychosocial outcomes in CaA with chronic diseases. Interventions are generally safe, and participants adhere to the prescribed protocols favorably. Despite that, there is little evidence that interventions are being implemented. Future studies should include interventions tailored to meet the common issues experienced by CaA with chronic conditions, providing a comprehensive understanding of the impact of sports interventions on those affected. REGISTRATION The methodology for this review was pre-determined and registered in the PROSPERO database (registration number: CRD42023397172).
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Affiliation(s)
- Borja Sañudo
- Department of Physical Education and Sport, University of Seville, Seville, Spain
| | | | | | - Dominik Gaser
- Chair of Preventive Pediatrics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Nicola Stöcker
- CRETHIDEV. Creative Thinking Development, Attiki, Greece
| | - Miguel Peralta
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Faculdade de Medicina, ISAMB, Universidade de Lisboa, Lisbon, Portugal
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
- Faculdade de Medicina, ISAMB, Universidade de Lisboa, Lisbon, Portugal
| | | | - Chiara Nicolini
- CEIPES. Centro Internazionale per la Promozione dell'Educazione e lo Sviluppo, Palermo, Italy
| | - Christina Sitzberger
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
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Balatoni I, Kiss T, Balla G, Papp Á, Csernoch L. Assessment of the Physical Activity of Children with Asthma Bronchiale. Sports (Basel) 2024; 12:114. [PMID: 38668582 PMCID: PMC11054733 DOI: 10.3390/sports12040114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
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.
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Affiliation(s)
- Ildikó Balatoni
- Clinical Center, University of Debrecen, 4032 Debrecen, Hungary;
| | - Tímea Kiss
- Clinical Center, University of Debrecen, 4032 Debrecen, Hungary;
| | - György Balla
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (G.B.); (Á.P.)
| | - Ágnes Papp
- Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary; (G.B.); (Á.P.)
| | - László Csernoch
- Department of Physiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary;
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Klain A, Giovannini M, Pecoraro L, Barni S, Mori F, Liotti L, Mastrorilli C, Saretta F, Castagnoli R, Arasi S, Caminiti L, Gelsomino M, Indolfi C, Del Giudice MM, Novembre E. Exercise-induced bronchoconstriction, allergy and sports in children. Ital J Pediatr 2024; 50:47. [PMID: 38475842 DOI: 10.1186/s13052-024-01594-0] [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: 12/26/2023] [Accepted: 01/09/2024] [Indexed: 03/14/2024] Open
Abstract
Exercise-induced bronchoconstriction (EIB) is characterized by the narrowing of airways during or after physical activity, leading to symptoms such as wheezing, coughing, and shortness of breath. Distinguishing between EIB and exercise-induced asthma (EIA) is essential, given their divergent therapeutic and prognostic considerations. EIB has been increasingly recognized as a significant concern in pediatric athletes. Moreover, studies indicate a noteworthy prevalence of EIB in children with atopic predispositions, unveiling a potential link between allergic sensitivities and exercise-induced respiratory symptoms, underpinned by an inflammatory reaction caused by mechanical, environmental, and genetic factors. Holistic management of EIB in children necessitates a correct diagnosis and a combination of pharmacological and non-pharmacological interventions. This review delves into the latest evidence concerning EIB in the pediatric population, exploring its associations with atopy and sports, and emphasizing the appropriate diagnostic and therapeutic approaches by highlighting various clinical scenarios.
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Affiliation(s)
- Angela Klain
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138, Naples, Italy.
| | - Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
- Department of Health Sciences, University of Florence, 50139, Florence, Italy
| | - Luca Pecoraro
- Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37126, Verona, Italy
| | - Simona Barni
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Francesca Mori
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
| | - Lucia Liotti
- Pediatric Unit, Department of Mother and Child Health, Salesi Children's Hospital, 60123, Ancona, Italy
| | - Carla Mastrorilli
- Pediatric and Emergency Department, Pediatric Hospital Giovanni XXIII, AOU Policlinic of Bari, 70126, Bari, Italy
| | - Francesca Saretta
- Pediatric Department, Latisana-Palmanova Hospital, Azienda Sanitaria Universitaria Friuli Centrale, 33100, Udine, Italy
| | - Riccardo Castagnoli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100, Pavia, Italy
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, 27100, Pavia, Italy
| | - Stefania Arasi
- Translational Research in Pediatric Specialties Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, 00165, Rome, Italy
| | - Lucia Caminiti
- Allergy Unit, Department of Pediatrics, AOU Policlinico Gaetano Martino, 98124, Messina, Italy
| | - Mariannita Gelsomino
- Department of Life Sciences and Public Health, Pediatric Allergy Unit, University Foundation Policlinico Gemelli IRCCS, Catholic University of the Sacred Heart, 00168, Rome, Italy
| | - Cristiana Indolfi
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138, Naples, Italy
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138, Naples, Italy
| | - Elio Novembre
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139, Florence, Italy
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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.
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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
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Gokcek O, Yurdalan U, Tugay BU, El C, Dogan S. Evaluation of the possible effect of inspiratory muscle training on inflammation markers and oxidative stress in childhood asthma. Eur J Pediatr 2023; 182:3713-3722. [PMID: 37285069 DOI: 10.1007/s00431-023-05047-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/08/2023]
Abstract
Airway inflammation characterized as asthma is one of the most common chronic diseases in the world. The aim of this study was to evaluate the possible effect of inspiratory muscle training on inflammation markers and oxidative stress levels in childhood asthma. A total of 105 children (age range 8-17 years), including 70 asthmatics and 35 healthy children, participated in the study. The 70 asthma patients were randomly assigned to the inspiratory muscle training (IMT) group (n = 35) and control group (n = 35), and healthy children were assigned to the healthy group (n = 35). The IMT group was treated with the threshold IMT device for 7 days/6 weeks at 30% of maximum inspiratory pressure. Respiratory muscle strength was evaluated with a mouth pressure measuring device, and respiratory function was evaluated with a spirometer. In addition, CRP, periostin, TGF-β, and oxidative stress levels were analyzed. The evaluation was performed only once in the healthy group and twice (at the beginning and end of 6 weeks) in asthma patients. In the study, there were significant differences between asthma patients and the healthy group in terms of MIP and MEP values, respiratory function, oxidative stress level, periostin, and TGF-β. Post-treatment, differences were observed in the oxidative stress level, periostin, and TGF-β of the IMT group (p < .05). CONCLUSION After 6 weeks of training, IMT positively contributed to reducing the inflammation level and oxidative stress. This suggests that IMT should be used as an alternative therapy to reduce inflammation and oxidative stress. (Trial Registration: The clinical trial protocol number is NCT05296707). WHAT IS KNOWN • It is known that adjunctive therapies given in addition to pharmacological treatment contribute to improving symptom control and quality of life in individuals with asthma. WHAT IS NEW • There are no studies about the effect of respiratory physiotherapy on biomarkers in asthmatic children. The sub-mechanism of improvement in individuals has not been elucidated. • In this context, inspiratory muscle training has a positive effect on inflammation and oxidative stress levels in children with asthma and IMT should be used as an alternative treatment for childhood asthma.
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Affiliation(s)
- Ozden Gokcek
- Department of Physiotherapy and Rehabilitation, Health Science Faculty, Ege University, İzmir, Turkey.
| | - Ufuk Yurdalan
- Department of Physiotherapy and Rehabilitation, Health Science Faculty, Medipol University, Istanbul, Turkey
| | - Baki Umut Tugay
- Department of Physiotherapy and Rehabilitation, Health Science Faculty, Mugla Sıtkı Kocman University, Istanbul, Turkey
| | - Cigdem El
- Department of Child Health and Diseases, Tayfur Ata Sökmen Medicine Faculty, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Serdar Dogan
- Department of Biochemistry, Tayfur Ata Sökmen Medicine Faculty, Hatay Mustafa Kemal University, Hatay, Turkey
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8
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Chaves Quirino PG, Rizzo JÂ, Hunter S, de Albuquerque Rodrigues Filho E, Sarinho E, de Almeida Santos CM, Medeiros D, Costa EC, Silva AS, Farah BQ, de Valois Correia Júnior MA. Is there cardiac autonomic dysfunction in children and adolescents with exercise-induced bronchospasm? Expert Rev Respir Med 2023; 17:823-831. [PMID: 37795708 DOI: 10.1080/17476348.2023.2265819] [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: 01/26/2023] [Accepted: 09/28/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND The pulmonary impairment in patients with bronchoconstriction induced by eucapnic voluntary hyperpnea(EVH) goes beyond the respiratory system, also impairing autonomic nervous modulation. This study aimed to evaluate the behavior of cardiac autonomic modulation in young asthmatics with and without EIB after the EVH test. RESEARCH DESIGN AND METHODS A cross-sectional study design using 54 asthmatics(51.9% female), aged between 10 and 19 years, investigated with the EVH test. Forced expiratory volume in one second(FEV1) was measured at 5, 10, 15, and 30 min after EVH. Heart rate variability(HRV) measures of time were assessed pre and 30 min-post EVH. The diagnosis of Exercise-Induced bronchoconstriction with underlying clinical asthma(EIBA) was confirmed by a fall in FEV1 ≥10% compared to baseline. RESULTS Thirty(55.5%) asthmatics had EIBA. Subjects with EIBA have reduced mean of the R-R intervals in relation to baseline until 15 minutes after EVH. Individuals without EIBA had increased parasympathetic activity compared to baseline(rMSSD) from 5 min after EVH(p < 0.05). This parasympathetic activity increase in relation to baseline was seen in individuals with EIBA after 25 minutes (rMSSD = 49.9 ± 5.3 vs 63.5 ± 7.2, p < 0.05). CONCLUSION Young asthmatics with EIBA present a delay in the increase of the parasympathetic component after EVH when compared to asthmatics without EIBA.
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Affiliation(s)
- Polyanna Guerra Chaves Quirino
- Associated Postgraduate Program in Physical Education, Universidade de Pernambuco and Universidade Federal da Paraiba, Recife, Brazil
| | - José Ângelo Rizzo
- Allergy and clinical immunology department, Hospital das Clínicas. Universidade Federal de Pernambuco, Recife, Brazil
| | - Steve Hunter
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, UK
| | | | - Emanuel Sarinho
- Allergy and clinical immunology department, Hospital das Clínicas. Universidade Federal de Pernambuco, Recife, Brazil
| | - Camila Matias de Almeida Santos
- Associated Postgraduate Program in Physical Education, Universidade de Pernambuco and Universidade Federal da Paraiba, Recife, Brazil
| | - Decio Medeiros
- Allergy and clinical immunology department, Hospital das Clínicas. Universidade Federal de Pernambuco, Recife, Brazil
| | - Emilia Chagas Costa
- Postgraduate Program in Nutrition, Universidade Federal de Pernambuco, Recife, Brazil
| | - Alexandre Sérgio Silva
- Associated Postgraduate Program in Physical Education, Universidade de Pernambuco and Universidade Federal da Paraiba, Recife, Brazil
| | - Breno Quintella Farah
- Department of Physical Education, Universidade Federal Rural de Pernambuco, Recife, Brazil
| | - Marco Aurélio de Valois Correia Júnior
- Associated Postgraduate Program in Physical Education, Universidade de Pernambuco and Universidade Federal da Paraiba, Recife, Brazil
- Allergy and clinical immunology department, Hospital das Clínicas. Universidade Federal de Pernambuco, Recife, Brazil
- Postgraduate Program in Hebiatrics, Universidade de Pernambuco, Recife, Brazil
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9
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Hashim SH, Alenezi MI, Alenezi RM, Alanazi WT, Alruwaili MM, Alali AA, Alanazi AM. Exercise-Induced Bronchoconstriction Among Adolescent Athletes With Asthma: A Systematic Review. Cureus 2023; 15:e40643. [PMID: 37476118 PMCID: PMC10355688 DOI: 10.7759/cureus.40643] [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] [Accepted: 06/19/2023] [Indexed: 07/22/2023] Open
Abstract
Exercise-induced bronchoconstriction (EIB) is a concern that frequently affects athletes and regular exercisers. The main objective of this systematic review is to study recently published literature that evaluated the risk of EIB among adolescent athletes with asthma. PubMed, Web of Science, Science Direct, EBSCO, SCOPUS, Wiley, and Cochrane Library were searched. Study articles were screened by title and abstract using Rayyan QCRI then a full-text assessment was implemented. A total of ten studies with 3129 adolescent athletic subjects were included in this review. The prevalence of EIB ranged from 2.1% to 61%. Most studies have demonstrated that athletes in their adolescence suffer from EIB, which requires regular management. Two studies have reported that low-income communities and humidity levels are risk factors for EIB. We found that EIB is frequent among adolescent athletes. The prevalence varies between countries due to different social and environmental factors.
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Affiliation(s)
- Sawsan H Hashim
- Department of Pediatrics, Northern Border University, Arar, SAU
| | - Miad I Alenezi
- Department of Pediatrics, Northern Border University, Arar, SAU
| | - Rawan M Alenezi
- Department of Pediatrics, Northern Border University, Arar, SAU
| | - Wafa T Alanazi
- Department of Pediatrics, Northern Border University, Arar, SAU
| | | | - Almaha A Alali
- Department of Pediatrics, Northern Border University, Arar, SAU
| | - Areej M Alanazi
- Department of Pediatrics, Northern Border University, Arar, SAU
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10
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Moreau J, Socchi F, Renoux MC, Requirand A, Abassi H, Guillaumont S, Matecki S, Huguet H, Avesani M, Picot MC, Amedro P. Cardiopulmonary fitness in children with asthma versus healthy children. Arch Dis Child 2023; 108:204-210. [PMID: 36446481 DOI: 10.1136/archdischild-2021-323733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 11/15/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES To evaluate, with a cardiopulmonary exercise test (CPET), the cardiopulmonary fitness of children with asthma, in comparison to healthy controls, and to identify the clinical and CPET parameters associated with the maximum oxygen uptake (VO2max) in childhood asthma. DESIGN This cross-sectional controlled study was carried out in CPET laboratories from two tertiary care paediatric centres. The predictors of VO2max were determined using a multivariable analysis. RESULTS A total of 446 children (144 in the asthma group and 302 healthy subjects) underwent a complete CPET. Mean VO2max was significantly lower in children with asthma than in controls (38.6±8.6 vs 43.5±7.5 mL/kg/min; absolute difference (abs. diff.) of -4.9 mL/kg/min; 95% CI of (-6.5 to -3.3) mL/kg/min; p<0.01) and represented 94%±9% and 107%±17% of predicted values, respectively (abs. diff. -13%; 95% CI (-17 to -9)%; p<0.01). The proportion of children with an impaired VO2max was four times higher in the asthma group (24% vs 6%, p<0.01). Impaired ventilatory efficiency with increased VE/VCO2 slope and low breathing reserve (BR) were more marked in the asthma group. The proportion of children with a decreased ventilatory anaerobic threshold (VAT), indicative of physical deconditioning, was three times higher in the asthma group (31% vs 11%, p<0.01). Impaired VO2max was associated with female gender, high body mass index (BMI), FEV1, low VAT and high BR. CONCLUSION Cardiopulmonary fitness in children with asthma was moderately but significantly altered compared with healthy children. A decreased VO2max was associated with female gender, high BMI and the pulmonary function. TRIAL REGISTRATION NUMBER NCT04650464.
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Affiliation(s)
- Johan Moreau
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France.,PhyMedExp, INSERM 1046, University of Montpellier, Montpellier, France
| | - Floriane Socchi
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France.,Paediatric Cardiopulmonary Rehabilitation Centre, Saint-Pierre Institute, Palavas-les-Flots, France
| | - Marie Catherine Renoux
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France
| | - Anne Requirand
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France
| | - Hamouda Abassi
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France.,PhyMedExp, INSERM 1046, University of Montpellier, Montpellier, France
| | - Sophie Guillaumont
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France.,Paediatric Cardiopulmonary Rehabilitation Centre, Saint-Pierre Institute, Palavas-les-Flots, France
| | - Stefan Matecki
- Unit of Paediatric Pulmonology and Cardiology, Department of Paediatrics, Montpellier University Hospital, Montpellier, France.,PhyMedExp, INSERM 1046, University of Montpellier, Montpellier, France
| | - Helena Huguet
- Department of Epidemiology and Biostatistics, Montpellier University Hospital, Montpellier, France
| | - Martina Avesani
- Paediatric and Congenital Cardiology Department, M3C National CHD Reference Centre, Bordeaux University Hospital, Bordeaux, France
| | - Marie-Christine Picot
- Department of Epidemiology and Biostatistics, Montpellier University Hospital, Montpellier, France.,CIC 1411, INSERM, University of Montpellier, Montpellier, France
| | - Pascal Amedro
- Paediatric and Congenital Cardiology Department, M3C National CHD Reference Centre, Bordeaux University Hospital, Bordeaux, France .,IHU Liryc, INSERM 1045, University of Bordeaux, Bordeaux, France
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11
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Privitera A, Privitera S. Physical exercise in asthma adolescents: a concept review. Multidiscip Respir Med 2023; 18:924. [PMID: 37753201 PMCID: PMC10519188 DOI: 10.4081/mrm.2023.924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 07/26/2023] [Indexed: 09/28/2023] Open
Abstract
Background: Asthma is a frequent pathological condition during childhood and adolescence. Young asthmatics demonstrate decreased aptitude for physical activity and a limited exercise capacity. Lower hospitalisation rates, reduced school absenteeism, fewer medical examinations, and limited use of bronchodilators have been documented in children and adolescents with bronchial asthma who engage in physical exercise regularly. Structured physical exercise protocols should be encouraged as they can work as a synergistic therapeutic option in addition to regular pharmacologic treatment. This article outlines the most suitable exercise training techniques for young patients with bronchial asthma and their effects on health status.
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Affiliation(s)
| | - Salvatore Privitera
- CPM Snc - Centro per la Prevenzione e il Monitoraggio dell’Insufficienza Respiratoria, Giarre (CT), Italy
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12
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Jing Z, Wang X, Zhang P, Huang J, Jia Y, Zhang J, Wu H, Sun X. Effects of physical activity on lung function and quality of life in asthmatic children: An updated systematic review and meta-analysis. Front Pediatr 2023; 11:1074429. [PMID: 36846162 PMCID: PMC9944457 DOI: 10.3389/fped.2023.1074429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The benefits of physical activity (PA) for asthmatic children were increasingly recognized, and as the design of studies on PA and asthma has become more refined in recent years, the latest evidence needed to be updated. We performed this meta-analysis to synthesize the evidence available from the last 10 years to update the effects of PA in asthmatic children. METHODS A systematic search was conducted in three databases, PubMed, Web of Science, and Cochrane Library. Randomized controlled trials were included, and two reviewers independently conducted the inclusion screening, data extraction, and bias assessment. RESULTS A total of 9 studies were included in this review after 3,919 articles screened. PA significantly improved the forced vital capacity (FVC) (MD 7.62; 95% CI: 3.46 to 11.78; p < 0.001), and forced expiratory flow between 25% and 75% of forced vital capacity (FEF25-75) (MD 10.39; 95% CI: 2.96 to 17.82; p = 0.006) in lung function. There was no significant difference in forced expiratory volume in the first second (FEV1) (MD 3.17; 95% CI: -2.82 to 9.15; p = 0.30) and fractional exhaled nitric oxide (FeNO) (MD -1.74; 95% CI: -11.36 to 7.88; p = 0.72). Also, PA significantly improved the quality of life as assessed by the Pediatric Asthma Quality of Life Questionnaire (all items p < 0.05). CONCLUSIONS This review suggested that PA could improve FVC, FEF25-75, and quality of life in asthmatic children, but there was insufficient evidence of improvement in FEV1 and airway inflammation. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022338984.
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Affiliation(s)
- Zenghui Jing
- Department of Pediatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Xingzhi Wang
- Department of Pediatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Panpan Zhang
- Department of Pediatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Jinli Huang
- Department of Pediatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Yuanyuan Jia
- Department of Pediatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Juan Zhang
- Department of Pediatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Huajie Wu
- Department of Pediatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Xin Sun
- Department of Pediatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
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13
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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.
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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
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14
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Klain A, Dinardo G, Salvatori A, Indolfi C, Contieri M, Brindisi G, Decimo F, Zicari AM, Miraglia del Giudice M. An Overview on the Primary Factors That Contribute to Non-Allergic Asthma in Children. J Clin Med 2022; 11:6567. [PMID: 36362795 PMCID: PMC9654665 DOI: 10.3390/jcm11216567] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 04/13/2024] Open
Abstract
The prevalence of non-allergic asthma in childhood is low, peaking in late adulthood. It is triggered by factors other than allergens, like cold and dry air, respiratory infections, hormonal changes, smoke and air pollution. In the literature, there are few studies that describe non-allergic asthma in pediatric age. Even though it is a less common disorder in kids, it is crucial to identify the causes in order to keep asthma under control, particularly in patients not responding to conventional treatments. In this review, we discuss non-IgE-mediated forms of asthma, collecting the latest research on etiopathogenesis and treatment.
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Affiliation(s)
- Angela Klain
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Giulio Dinardo
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Alessandra Salvatori
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Cristiana Indolfi
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Marcella Contieri
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Giulia Brindisi
- Department of Pediatrics, Sapienza University of Rome, 00161 Rome, Italy
| | - Fabio Decimo
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Anna Maria Zicari
- Department of Pediatrics, Sapienza University of Rome, 00161 Rome, Italy
| | - Michele Miraglia del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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15
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D'Angelo C, Jelalian E, Dunsiger S, Noga R, Kopel SJ, Boergers J, Mitchell K, Powers K, Koinis-Mitchell D. Physical Activity Among Urban Children with Asthma: Does Sleep Matter? J Clin Psychol Med Settings 2022; 29:666-677. [PMID: 34523033 DOI: 10.1007/s10880-021-09815-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
The present study examined associations between sleep and physical activity among a diverse sample of 97 urban children (ages 7-9) with persistent asthma. Differences in associations were evaluated by race/ethnicity and weight status. The extent to which sleep moderated the association between lung function and physical activity was also evaluated. Generalized linear models were utilized to examine associations. Findings indicated that, among the aggregate sample, more frequent nighttime awakenings were associated with less time spent engaging in moderate-to-vigorous physical activity (MVPA). Important differences in these associations were identified by both race/ethnicity and weight status. Better lung function was associated with, (a) higher levels of MVPA for children with better sleep efficiency and fewer nighttime awakenings, and (b) lower levels of MVPA for children with poorer sleep efficiency and more frequent nighttime awakenings. In short, sleep mattered with respect to children's physical activity levels in this sample.
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Affiliation(s)
- Christina D'Angelo
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA.
- Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Elissa Jelalian
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Shira Dunsiger
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Rebecca Noga
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA
| | - Sheryl J Kopel
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Julie Boergers
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Katherine Mitchell
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA
| | - Kate Powers
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Daphne Koinis-Mitchell
- Bradley Hasbro Children's Research Center, Rhode Island/Hasbro Children's Hospital, Providence, RI, USA
- Department of Pediatrics, Hasbro Children's Hospital, Providence, RI, USA
- Warren Alpert Medical School of Brown University, Providence, RI, USA
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16
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Brons A, Braam K, Broekema A, Timmerman A, Millenaar K, Engelbert R, Kröse B, Visser B. Translating Promoting Factors and Behavior Change Principles Into a Blended and Technology-Supported Intervention to Stimulate Physical Activity in Children With Asthma (Foxfit): Design Study. JMIR Form Res 2022; 6:e34121. [PMID: 35877162 PMCID: PMC9361148 DOI: 10.2196/34121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 11/28/2022] Open
Abstract
Background Children with asthma can decrease the impact of their disease by improving their physical activity (PA). However, health care providers lack interventions for children with asthma that effectively increase their PA levels and achieve behavior change. A technology-supported approach can positively influence PA and physical functioning in children. Objective The aims of this study were to develop a technology-supported intervention that facilitates health care providers in promoting PA for children (aged 8 to 12 years) with asthma and to systematically describe this developmental process. Methods Intervention mapping (IM) was applied to develop a blended and technology-supported intervention in cocreation with children with asthma, their parents, and health care providers. In accordance with the IM framework, the following steps were performed: conduct a needs assessment; define the intervention outcome, performance objectives, and change objectives; select theory-based intervention methods and strategies; create components of the intervention and conduct pilot tests; create an implementation plan; and create an evaluation plan. Results We developed the blended intervention Foxfit that consists of an app with a PA monitor for children (aged 8 to 12 years) with asthma and a web-based dashboard for their health care provider. The intervention focuses on PA in everyday life to improve social participation. Foxfit contains components based on behavior change principles and gamification, including goal setting, rewards, action planning, monitoring, shaping knowledge, a gamified story, personal coaching and feedback, and a tailored approach. An evaluation plan was created to assess the intervention’s usability and feasibility for both children and health care providers. Conclusions The IM framework was very useful for systematically developing a technology-supported intervention and for describing the translational process from scientific evidence, the needs and wishes of future users, and behavior change principles into this intervention. This has led to the technology-supported intervention Foxfit that facilitates health care providers in promoting PA in children with asthma. The structured description of the development process and functional components shows the way behavior change techniques are incorporated in the intervention. Trial Registration International Clinical Trial Registry Platform NTR6658; https://tinyurl.com/3rxejksf
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Affiliation(s)
- Annette Brons
- Digital Life Center, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
- Department of Information and Computing Sciences, Utrecht University, Utrecht, Netherlands
| | - Katja Braam
- Centre of Expertise Urban Vitality, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, Netherlands
| | - Aline Broekema
- Centre of Expertise Urban Vitality, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
| | | | - Karel Millenaar
- Play and Civid Media, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
| | - Raoul Engelbert
- Centre of Expertise Urban Vitality, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
- Department of Rehabilitation, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Ben Kröse
- Digital Life Center, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
- Department of Computer Science, University of Amsterdam, Amsterdam, Netherlands
| | - Bart Visser
- Centre of Expertise Urban Vitality, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
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17
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Mueller W, Milner J, Loh M, Vardoulakis S, Wilkinson P. Exposure to urban greenspace and pathways to respiratory health: An exploratory systematic review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 829:154447. [PMID: 35283125 DOI: 10.1016/j.scitotenv.2022.154447] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND/OBJECTIVE Urban greenspace may have a beneficial or adverse effect on respiratory health. Our objective was to perform an exploratory systematic review to synthesise the evidence and identify the potential causal pathways relating urban greenspace and respiratory health. METHODS We followed PRISMA guidelines on systematic reviews and searched five databases for eligible studies during 2000-2021. We incorporated a broad range of urban greenspace and respiratory health search terms, including both observational and experimental studies. Screening, data extraction, and risk of bias, assessed using the Navigation Guide criteria, were performed independently by two authors. We performed a narrative synthesis and discuss suggested pathways to respiratory health. RESULTS We identified 108 eligible papers (n = 104 observational, n = 4 experimental). The most common greenspace indicators were the overall greenery or vegetation (also known as greenness), green land use/land cover of physical area classes (e.g., parks, forests), and tree canopy cover. A wide range of respiratory health indicators were studied, with asthma prevalence being the most common. Two thirds (n = 195) of the associations in these studies were positive (i.e., beneficial) with health, with 31% (n = 91) statistically significant; only 9% (n = 25) of reported associations were negative (i.e., adverse) with health and statistically significant. The most consistent positive evidence was apparent for respiratory mortality. There were n = 35 (32%) 'probably low' and n = 73 (68%) 'probably high' overall ratings of bias. Hypothesised causal pathways for health benefits included lower air pollution, more physically active populations, and exposure to microbial diversity; suggested mechanisms with poorer health included exposure to pollen and other aeroallergens. CONCLUSION Many studies showed positive association between urban greenspace and respiratory health, especially lower respiratory mortality; this is suggestive, but not conclusive, of causal effects. Results underscore the importance of contextual factors, greenspace metric employed, and the potential bias of subtle selection factors, which should be explored further.
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Affiliation(s)
- William Mueller
- Institute of Occupational Medicine, Edinburgh, UK; London School of Hygiene & Tropical Medicine, UK.
| | - James Milner
- London School of Hygiene & Tropical Medicine, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Edinburgh, UK
| | - Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, Australian National University, Australia
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18
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Martin J, Townshend J, Brodlie M. Diagnosis and management of asthma in children. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001277. [PMID: 35648804 PMCID: PMC9045042 DOI: 10.1136/bmjpo-2021-001277] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/13/2022] [Indexed: 12/13/2022] Open
Abstract
Asthma is the the most common chronic respiratory condition of childhood worldwide, with around 14% of children and young people affected. Despite the high prevalence, paediatric asthma outcomes are inadequate, and there are several avoidable deaths each year. Characteristic asthma features include wheeze, shortness of breath and cough, which are typically triggered by a number of possible stimuli. There are several diagnostic challenges, and as a result, both overdiagnosis and underdiagnosis of paediatric asthma remain problematic.Effective asthma management involves a holistic approach addressing both pharmacological and non-pharmacological management, as well as education and self-management aspects. Working in partnership with children and families is key in promoting good outcomes. Education on how to take treatment effectively, trigger avoidance, modifiable risk factors and actions to take during acute attacks via personalised asthma action plans is essential.This review aimed to provide an overview of good clinical practice in the diagnosis and management of paediatric asthma. We discuss the current diagnostic challenges and predictors of life-threatening attacks. Additionally, we outline the similarities and differences in global paediatric asthma guidelines and highlight potential future developments in care. It is hoped that this review will be useful for healthcare providers working in a range of child health settings.
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Affiliation(s)
- Joanne Martin
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.,Northern Foundation School, Health Education England North East, Newcastle upon Tyne, UK.,James Cook University Hospital, South Tees NHS Foundation Trust, Middlesbrough, UK
| | - Jennifer Townshend
- Paediatric Respiratory Medicine, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Malcolm Brodlie
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK .,Paediatric Respiratory Medicine, Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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19
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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.
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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
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20
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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.
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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.
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21
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Klain A, Indolfi C, Dinardo G, Contieri M, Decimo F, Miraglia Del Giudice M. Exercise-Induced Bronchoconstriction in Children. Front Med (Lausanne) 2022; 8:814976. [PMID: 35047536 PMCID: PMC8761949 DOI: 10.3389/fmed.2021.814976] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Exercise-induced bronchoconstriction (EIB) is a transient airflow obstruction, typically 5-15 min after physical activity. The pathophysiology of EIB is related to the thermal and osmotic changes of the bronchial mucosa, which cause the release of mediators and the development of bronchoconstriction in the airways. EIB in children often causes an important limitation to physical activities and sports. However, by taking appropriate precautions and through adequate pharmacological control of the condition, routine exercise is extremely safe in children. This review aims to raise awareness of EIB by proposing an update, based on the latest studies, on pathological mechanisms, diagnosis, and therapeutic approaches in children.
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Affiliation(s)
- Angela Klain
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Cristiana Indolfi
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulio Dinardo
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marcella Contieri
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fabio Decimo
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
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22
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Joschtel B, Gomersall SR, Tweedy S, Petsky H, Chang AB, Trost SG. Effects of a therapeutic exercise program in children with non-cystic fibrosis bronchiectasis: A pilot randomized controlled trial. Front Pediatr 2022; 10:953429. [PMID: 36186646 PMCID: PMC9520333 DOI: 10.3389/fped.2022.953429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/29/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND In the absence of randomized controlled trials (RCTs) on the benefits of therapeutic exercise programs involving children with bronchiectasis, we undertook a pilot RCT to evaluate the effects of a play-based therapeutic exercise program on fundamental movement skill (FMS) proficiency. The effects of the program on cardiorespiratory fitness, perceived competence, and health-related quality of life (HR-QoL) were examined as secondary outcomes. METHODS Children [median (IQR) age: 6.8 (5.3-8.8) years] with bronchiectasis unrelated to cystic fibrosis were randomized to a 7-week therapeutic exercise program (n = 11) or wait-list control (n = 10). The exercise program comprised 7 × 60-min weekly sessions and was supplemented by a home-based program 2-days/week. Participants were assessed on: FMS (locomotor and object control skills) using the Test of Gross Motor Development 2nd Edition (TGMD-2); cardiovascular fitness by calculating the percent change in heart rate (%ΔHR) from rest to completion of the first stage of a submaximal treadmill test; perceived competence using Harter's athletic competence subscale; and QoL with the PedsQL. RESULTS Significant group by time interactions were observed for locomotor and object control skills. Children completing the therapeutic exercise program exhibited significant improvements in both locomotor (pre 29.0 ± 2.0, post 35.2 ± 2.2, p = 0.01) and object control (pre 27.0 ± 2.0, post 35.5 ± 2.2, p = 0.01) skills, with no significant change in controls (pre 31.6 ± 2.1, post 31.8 ± 2.3 and pre 31.0 ± 2.1, post 32.3 ± 2.3, respectively). Among children completing the program, %ΔHR declined by 6% points, while %ΔHR declined only marginally among controls (0.9% points), but the group by time interaction was not statistically significant. The program had a small positive impact on competence perceptions (Cohen's d = 0.2) and HR-QoL (Cohen's d = 0.3). CONCLUSION This pilot RCT provides preliminary evidence for the efficacy of a play-based therapeutic exercise program to improve proficiency in FMS and fitness in children with bronchiectasis. The results are sufficiently positive to warrant conducting a larger RCT testing the efficacy of the exercise program in children with bronchiectasis and/or other chronic respiratory conditions.
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Affiliation(s)
- Barbara Joschtel
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Sjaan R Gomersall
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.,School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Sean Tweedy
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Helen Petsky
- Faculty of Health, Centre for Children's Health Research, Queensland University of Technology, Brisbane, QLD, Australia.,Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Children's Health Queensland, Brisbane, QLD, Australia
| | - Anne B Chang
- Faculty of Health, Centre for Children's Health Research, Queensland University of Technology, Brisbane, QLD, Australia.,Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Children's Health Queensland, Brisbane, QLD, Australia.,Child Health Division, Menzies School of Health Research, Charles Darwin University, Tiwi, NT, Australia
| | - Stewart G Trost
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.,Faculty of Health, Centre for Children's Health Research, Queensland University of Technology, Brisbane, QLD, Australia
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23
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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.
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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
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24
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Zhang Z, Wang L, Wang J, Jia Y, Yi M, Chen O. Physical activity and childhood asthma control: Mediation and moderation role of body mass index. Pediatr Pulmonol 2021; 56:3720-3727. [PMID: 34516730 DOI: 10.1002/ppul.25662] [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: 07/03/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Physical activity (PA) may be associated with asthma management. Whether PA is associated with childhood asthma control is not well studied, and the role of body mass index (BMI) in this association remains unclarified. This study aimed to evaluate the association between PA and childhood asthma control and investigate the potential mediating and modifying role of BMI in the association. METHODS This cross-sectional study involved 303 asthmatic children aged 5-14 years. Information on PA was collected from children. Asthma control was assessed using a valid questionnaire by children and their parents. Height and weight were objectively measured and BMI was calculated and classified. Multiple linear regression, mediation, and moderation analyses were performed. RESULTS There was a positive association between PA and childhood asthma control with adjustment for variates (B = 0.144, p = .012). Mediation analysis indicated that BMI status negatively mediated the association (estimate = -0.656, 95% credit interval: -1.645, -0.006), and such indirect effect is lower than the direct effect (indirect effect/direct effect = 58.3%). No evidence of effect modification by BMI was observed (Pinteraction = 0.516). Stratified analyses showed that the significant association was only observed in children with overweight/obesity (normal weight: B = 0.863, p = .189; overweight/obese: B = 1.494, p = .044). CONCLUSIONS Increased PA is associated with improved childhood asthma control, especially for children with higher BMI. BMI exhibited a negative effect but not effect modification in this association. PA should be encouraged to improve asthma control for asthmatic children. Besides, mechanisms other than weight loss may explain the association.
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Affiliation(s)
- Zeyi Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Liwen Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China.,Intensive Care Unit, Qingdao Municipal Hospital, Qingdao, China
| | - Jingjing Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yuanmin Jia
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Mo Yi
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ou Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
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25
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New Technologies for Promoting Physical Activity in Healthy Children and in Children with Chronic Respiratory Diseases: A Narrative Review. SUSTAINABILITY 2021. [DOI: 10.3390/su132111661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Physical activity (PA) is proven to benefit children and adolescents in several ways. New technologies may provide children with stimulating modalities for organizing their leisure time, accessing fitness programs, and obtaining daily goal reminders and peer support. Due to the current COVID-19 pandemic, following WHO recommendations for PA is difficult for many children, especially for those living in urban areas. Therefore, the use of digital tools to support and maintain PA could be useful in healthy children, as well as in those with chronic respiratory diseases (CRDs). This narrative review aims to summarize the most recent evidence about the role of new technologies in promoting PA in healthy children and in those with CRDs, in supporting PA during the COVID-19 pandemic, and in enhancing psychological wellbeing in this age group. The use of technological devices for promoting PA, such as web/mobile apps and games, has been proven to be effective both in healthy children and in those with CRDs. In conclusion, new technologies are very promising in terms of feasibility, acceptability, and efficacy in promoting PA. Further studies are required to evaluate the long-term health benefits of using these technologies.
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26
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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.
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Affiliation(s)
- Fang Liu
- Department of Respiratory Medicine, Xuyi People's Hospital, Huai'an, Jiangsu 211700, China (Liu L, )
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27
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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.
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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.
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28
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Del Giacco S, Couto M, Firinu D, Garcia-Larsen V. Management of Intermittent and Persistent Asthma in Adolescent and High School Athletes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 8:2166-2181. [PMID: 32620431 DOI: 10.1016/j.jaip.2020.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 01/06/2023]
Abstract
Asthma is the most common chronic condition during childhood and adolescence, affecting an estimated 8% of children and youngsters below 18 years in the United States and the United Kingdom. In adolescent athletes, asthma-like symptoms may represent a common consequence of regular sport practice. Asthma in young athletes poses several challenges, including the ambiguity of definitions and diagnosis of asthma resulting from exercise-induced symptoms, the best pharmacological treatments, and the nonpharmacological options for the management of disease and the challenges inherent to this age group. At a time when the regular practice of sports is increasingly being recommended for a healthy living, the support network around the young athletes is crucial to reduce the impact of asthma on their physical and emotional well-being. In this review, we examine the main issues around the definitions and clinical differentiations of asthma in young sport athletes. We discuss best practice approaches to improve the adherence to the clinical management, including nonpharmacological strategies directed at the family and trainers of athlete adolescents.
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Affiliation(s)
- Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Mariana Couto
- Immunoallergology, Hospital CUF Descobertas, Lisbon, Portugal
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Vanessa Garcia-Larsen
- Program in Human Nutrition, Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Md
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Lyan NA, Khan MA, Turova EA, Ivanova II, Petrova MS, Bokova IA. [Medical rehabilitation of children with bronchial asthma]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOĬ FIZICHESKOĬ KULTURY 2021; 98:70-78. [PMID: 33899455 DOI: 10.17116/kurort20219802170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Medical rehabilitation of children suffering from bronchial asthma is based on the complex use of natural therapeutic factors, drug, non-drug therapy and other methods in order to achieve control over the disease and long-term remission. The use of non-drug technologies is necessary taking into account the pathogenesis of the bronchial asthma development and is aimed at relieving bronchospasm, reducing the activity of allergic inflammation in the bronchi, improving their drainage function, strengthening the respiratory muscles and increasing exercise tolerance. When carrying out rehabilitation measures it is important to observe the basic principles of medical rehabilitation. An individual medical rehabilitation program is drawn up taking into account the assessment of the child's clinical condition at each stage with the diagnosis of the initial rehabilitation status, the establishment of a rehabilitation diagnosis and an assessment of the rehabilitation potential. The article presents the data of the analysis of scientific publications and our own research allowing to draw up an algorithm for the formation of an individual program of medical rehabilitation for children with bronchial asthma.
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Affiliation(s)
- N A Lyan
- Moscow Scientific Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - M A Khan
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,N.F. Filatov Children's Municipal Clinical Hospital, Moscow, Russia
| | - E A Turova
- Moscow Scientific Practical Center of Medical Rehabilitation, Restorative and Sports Medicine, Moscow, Russia.,I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - I I Ivanova
- The Chief Medical Department of the RF President's Administration, Moscow, Russia
| | - M S Petrova
- The Chief Medical Department of the RF President's Administration, Moscow, Russia
| | - I A Bokova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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30
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Ramachandran HJ, Jiang Y, Shan CH, Tam WWS, Wang W. A systematic review and meta-analysis on the effectiveness of swimming on lung function and asthma control in children with asthma. Int J Nurs Stud 2021; 120:103953. [PMID: 34051586 DOI: 10.1016/j.ijnurstu.2021.103953] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/02/2021] [Accepted: 04/14/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Swimming has been considered the most appropriate activity for children with asthma for its lower asthmogenicity compared to land-based activities. However, the benefits of swimming have been hampered by reports of increased asthma risks, airway inflammation and bronchial hyper-responsiveness from exposure to chlorine by-products in swimming pools. Thus, the role of swimming for children with asthma remains unclear. OBJECTIVES To determine the effectiveness of swimming as an intervention on lung function and asthma control in children below the age of 18 years. Any adverse effects from swimming on asthma were also examined. METHODS Searches were performed across six databases systematically (PubMed, CINAHL, Embase, CENTRAL, Scopus, and PsycINFO). Randomized controlled trials (RCTs), quasi-experimental studies and interventional studies with at least one control/comparator group that were published in English were included. All eligible studies were screened with risk of bias examined by two independent reviewers. Meta-analyses were conducted using Review Manager 5.4 software while narrative syntheses were performed where meta-analysis was inappropriate and heterogeneity was present. RESULTS 1710 records were retrieved from the search. A total of 9 studies with 387 participants were included in this review after screening. Swimming was found to have favourable effects on forced expiratory volume in one second (L) and forced vital capacity (%), but not for forced expiratory volume in one second (%) and peak expiratory flow (%). Narrative synthesis on asthma control and adverse effects were in favour of the swimming group. CONCLUSION Future studies that are adequately powered, involve swimming interventions of sufficient intensity, frequency and duration, examine cumulative exposures to chlorine by-products and take into account potential cofounders are warranted.
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Affiliation(s)
- Hadassah Joann Ramachandran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
| | - Ying Jiang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
| | - Coral Hui Shan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
| | - Wilson Wai San Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
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31
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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.
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32
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Mackintosh KA, McNarry MA, Berntsen S, Steele J, Sejersted E, Westergren T. Physical activity and sedentary time in children and adolescents with asthma: A systematic review and meta-analysis. Scand J Med Sci Sports 2021; 31:1183-1195. [PMID: 33576534 DOI: 10.1111/sms.13937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/27/2021] [Accepted: 02/08/2021] [Indexed: 12/18/2022]
Abstract
The influence of asthma on physical activity (PA) in youth remains equivocal. This review synthesizes the evidence regarding the influence of asthma on PA and sedentary time and evaluates the role of key moderators for this relationship. In accordance with PRISMA guidelines, six electronic databases and gray literature were searched. Primary studies in English were included if they reported device-assessed PA in youth with and without asthma. Random effects meta-analyses examined the effect of asthma on PA and, separately, sedentary time. Mixed-effect meta-regression analyses were conducted using age and sex as moderators, with sub-group comparisons for study quality and asthma diagnosis criteria. Overall, of 3944 citations retrieved, 2850 were screened after the removal of supplication and 2743 citations excluded. Of the 107 full-text publications reviewed, 16 were included in data extraction and analysis, with 15 and five studies included in the PA and sedentary time meta-analyses, respectively. The robust effect size estimate for the influence of asthma on PA and sedentary time was -0.04 [95% CI = -0.11, 0.03] and -0.09 [95% CI = -0.12, -0.06], indicating a non-significant and significant trivial effect, respectively. The effect of asthma on PA levels or sedentary time was not associated with age or sex. Youth with controlled asthma are equally physically (in)active as their healthy peers, with asthma associated with less sedentary time. However, methodological limitations and a paucity of clear methodological reporting temper these conclusions. More rigorous device-based assessments, with a particular focus on sedentary time, and more robust diagnoses of asthma, especially with regard to severity, are needed.
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Affiliation(s)
| | | | - Sveinung Berntsen
- Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
| | - James Steele
- School of Sport, Health and Social Sciences, Solent University, Southampton, UK.,Ukactive Research Institute, London, UK
| | - Ellen Sejersted
- University Library, University of Agder, Kristiansand, Norway
| | - Thomas Westergren
- Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
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33
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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.
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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
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34
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Vollsæter M, Stensrud T, Maat R, Halvorsen T, Røksund OD, Sandnes A, Clemm H. Exercise Related Respiratory Problems in the Young-Is It Exercise-Induced Bronchoconstriction or Laryngeal Obstruction? Front Pediatr 2021; 9:800073. [PMID: 35047465 PMCID: PMC8762363 DOI: 10.3389/fped.2021.800073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/09/2021] [Indexed: 11/13/2022] Open
Abstract
Complaints of breathlessness during heavy exercise is common in children and adolescents, and represent expressions of a subjective feeling that may be difficult to verify and to link with specific diagnoses through objective tests. Exercise-induced asthma and exercise-induced laryngeal obstruction are two common medical causes of breathing difficulities in children and adolescents that can be challenging to distinguish between, based only on the complaints presented by patients. However, by applying a systematic clinical approach that includes rational use of tests, both conditions can usually be diagnosed reliably. In this invited mini-review, we suggest an approach we find feasible in our everyday clinical work.
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Affiliation(s)
- Maria Vollsæter
- Department of Paediatrics and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, Section for Paediatrics, University of Bergen, Bergen, Norway
| | - Trine Stensrud
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Robert Maat
- Department of Otorhinolaryngology, Saxenburgh Medical Center, Hardenberg, Netherlands
| | - Thomas Halvorsen
- Department of Paediatrics and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, Section for Paediatrics, University of Bergen, Bergen, Norway.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Ola Drange Røksund
- Department of Paediatrics and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway.,Faculty of Health and Social Sciences, Bergen University College, Bergen, Norway
| | - Astrid Sandnes
- Department of Internal Medicine, Innlandet Hospital Trust, Gjøvik, Norway
| | - Hege Clemm
- Department of Paediatrics and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, Section for Paediatrics, University of Bergen, Bergen, Norway
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35
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Dimitri P, Joshi K, Jones N. Moving more: physical activity and its positive effects on long term conditions in children and young people. Arch Dis Child 2020; 105:1035-1040. [PMID: 32198161 DOI: 10.1136/archdischild-2019-318017] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 11/04/2022]
Abstract
While the benefits of regular participation in physical activity in children and young people are clear, misconceptions have developed about the possible negative effects and potential complications of exercise on long-term conditions such as epilepsy, asthma and diabetes. Over the last decade evidence has emerged supporting the positive impact that physical activity has on long-term conditions. Previous concerns were raised about the risks of hypoglycaemia in children with type 1 diabetes mellitus (T1DM) thus limiting participation in sports. Importantly, physical activity improves the metabolic profile, bone mineral density, cardiorespiratory fitness and insulin sensitivity while lowering mortality risk in children with T1DM. Children with asthma were prevented from doing exercise due to concerns about precipitating an acute asthmatic episode. To the contrary, physical activity interventions have consistently shown an increase in cardiovascular fitness, physical capacity, asthma-free days and quality of life in childhood asthmatics. Children with epilepsy are often excluded from sports due to concerns relating to increased seizure frequency, yet evidence suggests that this is not the case. The evidence supporting physical activity in childhood survivors of cancer is growing but still primarily confined to patients with acute lymphoblastic leukaemia. Participation in sports and physical activity also reduces mental health problems developing in adolescence. While further research is required to investigate benefits of physical activity on specific aspects of long-term conditions in children, in general this group should be advised to increase participation in sports and exercise as a means of improving long-term physical and mental health.
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Affiliation(s)
- Paul Dimitri
- Paediatric Endocrinology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Kush Joshi
- Faculty of Sports and Exercise Medicine, Oxford University Hospitals NHS Trust, Oxford, Oxfordshire, UK
| | - Natasha Jones
- Faculty of Sports and Exercise Medicine, Oxford University Hospitals NHS Trust, Oxford, Oxfordshire, UK
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36
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Schindel CS, Schiwe D, Heinzmann-Filho JP, Gheller MF, Campos NE, Pitrez PM, Donadio MVF. Determinants of exercise capacity in children and adolescents with severe therapy-resistant asthma. J Asthma 2020; 59:115-125. [PMID: 33026845 DOI: 10.1080/02770903.2020.1833915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To evaluate the exercise capacity of children and adolescents with severe therapy resistant asthma (STRA) aiming to identify its main determinants. METHODS Cross-sectional study including individuals aged 6-18 years with a diagnosis of STRA. Clinical (age and gender), anthropometric (weight, height and body mass index) and disease control data were collected. Lung function (spirometry), cardiopulmonary exercise testing (CPET) and exercise-induced bronchoconstriction (EIB) test were performed. RESULTS Twenty-four patients aged 11.5 ± 2.6 years were included. The mean forced expiratory volume in one second (FEV1) was 91.3 ± 9.2%. EIB occurred in 54.2% of patients. In CPET, the peak oxygen uptake (VO2peak) was 34.1 ± 7.8 mL kg-1 min-1. A significant correlation between ventilatory reserve and FEV1 (r = 0.57; p = 0.003) was found. Similarly, there was a significant correlation between CPET and percent of FEV1 fall in the EIB test for both VE/VO2 (r = 0.47; p = 0.02) and VE/VCO2 (r = 0.46; p = 0.02). Patients with FEV1<80% had lower ventilatory reserve (p = 0.009). In addition, resting heart rate correlated with VO2peak (r=-0.40; p = 0.04), VE/VO2 (r = 0.46; p = 0.02) and VE/VCO2 (r = 0.48; p = 0.01). CONCLUSIONS Exercise capacity is impaired in approximately 30% of children and adolescents with STRA. The results indicate that different aspects of aerobic fitness are influenced by distinct determinants, including lung function and EIB.
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Affiliation(s)
- Cláudia Silva Schindel
- Laboratório de Atividade Física em Pediatria, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Daniele Schiwe
- Laboratório de Atividade Física em Pediatria, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - João Paulo Heinzmann-Filho
- Laboratório de Atividade Física em Pediatria, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Mailise Fátima Gheller
- Laboratório de Atividade Física em Pediatria, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Natália Evangelista Campos
- Laboratório de Atividade Física em Pediatria, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Paulo Márcio Pitrez
- Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) and Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Márcio Vinícius Fagundes Donadio
- Laboratório de Atividade Física em Pediatria, Centro Infant, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Hartmann-Boyce J, Gunnell J, Drake J, Otunla A, Suklan J, Schofield E, Kinton J, Inada-Kim M, Hobbs FDR, Dennison P. Asthma and COVID-19: review of evidence on risks and management considerations. BMJ Evid Based Med 2020; 26:bmjebm-2020-111506. [PMID: 32883705 DOI: 10.1136/bmjebm-2020-111506] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Respiratory illnesses typically present increased risks to people with asthma (PWA). However, data on the risks of COVID-19 to PWA have presented contradictory findings, with implications for asthma management. OBJECTIVE To assess the risks and management considerations of COVID-19 in people with asthma (PWA). METHOD We conducted a rapid literature review. We searched PubMed, medRxiv, LitCovid, TRIP, Google and Google Scholar for terms relating to asthma and COVID-19, and for systematic reviews related to specific management questions within our review, in April 2020. References were screened and data were extracted by one reviewer. RESULTS We extracted data from 139 references. The evidence available is limited, with some sources suggesting an under-representation of PWA in hospitalised cases and others showing an increased risk of worse outcomes in PWA, which may be associated with disease severity. Consensus broadly holds that asthma medications should be continued as usual. Almost all aspects of asthma care will be disrupted during the pandemic due not only to limits in face-to-face care but also to the fact that many of the diagnostic tools used in asthma are considered aerosol-generating procedures. Self-management and remote interventions may be of benefit for asthma care during this time but have not been tested in this context. CONCLUSIONS Evidence on COVID-19 and asthma is limited and continuing to emerge. More research is needed on the possible associations between asthma and COVID-19 infection and severity, as well as on interventions to support asthma care in light of constraints and disruptions to healthcare systems. We found no evidence regarding health inequalities, and this urgently needs to be addressed in the literature as the burdens of asthma and of COVID-19 are not equally distributed across the population.
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Affiliation(s)
- Jamie Hartmann-Boyce
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - James Gunnell
- Medical Sciences Division, University of Oxford, Oxford, Oxfordshire, UK
| | - Jonny Drake
- Medical Sciences Division, University of Oxford, Oxford, Oxfordshire, UK
| | - Afolarin Otunla
- Medical Sciences Division, University of Oxford, Oxford, Oxfordshire, UK
| | - Jana Suklan
- Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
| | - Ella Schofield
- Medical Sciences Division, University of Oxford, Oxford, Oxfordshire, UK
| | - Jade Kinton
- Medical Sciences Division, University of Oxford, Oxford, Oxfordshire, UK
| | - Matt Inada-Kim
- Royal Hampshire County Hospital, Winchester, Hampshire, UK
| | - F D Richard Hobbs
- Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Paddy Dennison
- University Hospital Southampton NHS Foundation Trust, Southampton, Southampton, UK
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38
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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.
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Affiliation(s)
| | - Ignacio Diez-Vega
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
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39
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Lipej M, Plavec D, Živković J, Malev O, Nogalo B, Magdić R, Lulić Jurjević R, Turkalj M. Effect of pulmonary rehabilitation in an allergen safe outdoor environment on children and adolescents with mild to moderate persistent allergic asthma. J Asthma 2020; 58:1377-1383. [PMID: 32546077 DOI: 10.1080/02770903.2020.1784192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Environmental interactions are very complex in childhood asthma, and we hypothesized that even a short-term exposure to an allergy safe outdoor environment (AllSOE) combined with pulmonary rehabilitation program (PRP) could exert significant beneficial effects. Our aim was to test the effects of 2-week PRP provided in an AllSOE in children with mild to moderate asthma.Methods: 110 children (aged 7.5-17 years, 46% girls), with partially or totally controlled asthma, attended the PRP at the Island of Lošinj (Croatia) supervised by a multidisciplinary team (pediatric pulmonologist, sports medicine specialist, physiotherapist and kinesiologist). Each child had an adjusted intensity of physical activity with at least 2 h of exercise per day. Body height and weight, spirometry, fraction of exhaled nitric oxide (FeNO), running distance during free running test (FRT) and the decline in lung function after FRT (exercise-induced bronchoconstriction- EIB) were measured at baseline and after PRP.Results: A significant improvement in running distance (from 903 ± 272 m to 968 ± 289 m; p < 0.001), a decrease of FeNO (from 37 ± 32 ppb to 25 ± 17 ppb; p < 0.001) were determined after PRP. There were no significant changes in lung function and EIB, except EIB in the fourth quartile (significant EIB at baseline) where EIB significantly decreased (p < 0.001) after PRP.Conclusion: Two weeks of PRP in an AllSOE significantly improved exercise capacity and reduced airway inflammation and airway hyperreactivity showing that even a short-term PRP within a proper environment could be effective and affordable management strategy for children and adolescents with mild to moderate asthma.
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Affiliation(s)
- M Lipej
- Srebrnjak Children's Hospital, Zagreb, Croatia
| | - D Plavec
- Srebrnjak Children's Hospital, Zagreb, Croatia.,Faculty of Medicine, J.J. Strossmayer University of Osijek, Osijek, Croatia
| | - J Živković
- Srebrnjak Children's Hospital, Zagreb, Croatia
| | - O Malev
- Srebrnjak Children's Hospital, Zagreb, Croatia.,Department of Biology, Faculty of Science, University of Zagreb, Zagreb, Croatia
| | - B Nogalo
- Srebrnjak Children's Hospital, Zagreb, Croatia.,Faculty of Dental Medicine and Health Osijek, Osijek, Croatia
| | - R Magdić
- Hotel and tourism management high school, Zagreb, Croatia
| | - R Lulić Jurjević
- Srebrnjak Children's Hospital, Zagreb, Croatia.,Faculty of Medicine, J.J. Strossmayer University of Osijek, Osijek, Croatia
| | - M Turkalj
- Srebrnjak Children's Hospital, Zagreb, Croatia.,Faculty of Medicine, J.J. Strossmayer University of Osijek, Osijek, Croatia.,Catholic University of Croatia, Zagreb, Croatia
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40
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Brynjulfsen T, Demmelmaier I, Berntsen S, Foyn TH, Andersen OK, Stang J, Sigdestad JB, Stensrud T, Tufte K, Nielsen A, Westergren T. Motivation for physical activity in adolescents with asthma. J Asthma 2020; 58:1247-1255. [PMID: 32493080 DOI: 10.1080/02770903.2020.1778025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE We explored motivation for physical activity (PA) and exercise in adolescents with asthma who entered and continued a 10-week play-based exercise intervention. METHODS Eighteen adolescents with asthma, aged 13-17 years, participated in a 10-week play- and interval-based indoor exercise intervention during winter and autumn months. Semi-structured focus group interviews were conducted in weeks 2 and 8, focusing on motivation for PA and exercise, as well as field observations of exercise sessions in weeks 2, 6, and 8. The first interview was analyzed separately from the second one and descriptive observational data were obtained using thematic analysis and self-determination theory as a framework. RESULTS In the first round of focus group interviews, participants (n = 18) described amotivation and motivation for PA within the following five themes: "teachers' lack of asthma knowledge", "embarrassment over asthma symptoms", "not being able to keep pace with peers", "seasonal challenges", and "mastering fun physical activities". Based on the second interview (n = 14) and descriptive observational data (n = 18), participants reported and revealed amotivation and motivation for PA within the following four themes: "understanding and relatedness", "social support", "competition", and "mastering fun activities". CONCLUSION We conclude that play-based exercises designed for groups of adolescents with asthma can support motivation for PA and exercise and reduce social and asthma-specific barriers.
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Affiliation(s)
- Trine Brynjulfsen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Ingrid Demmelmaier
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Sveinung Berntsen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Tonje Hellum Foyn
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | | | - Julie Stang
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Trine Stensrud
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Kristine Tufte
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | | | - Thomas Westergren
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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41
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Phan HT, Vu GV, Vu GT, Ha GH, Pham HQ, Latkin CA, Tran BX, Ho CS, Ho RC. Global Mapping of Research Trends on Interventions to Improve Health-Related Quality of Life in Asthma Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103540. [PMID: 32438571 PMCID: PMC7277612 DOI: 10.3390/ijerph17103540] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 12/14/2022]
Abstract
Globally, approximately 335 million people are being affected by asthma. Given that asthma is a chronic airway condition that cannot be cured, the disease negatively impacts physical health and results in losses of productivity of people experiencing asthma, leading to decrease in quality of life. This study aims at demonstrating the research trends worldwide and identifying the research gaps in interventions for improving quality of life of patients with asthma. Bibliometric approach and content analysis, which can objectively evaluate the productivity and research landscapes in this field, were utilized. In this study, we systematically quantified the development of research landscapes associated with interventions for improving quality of life of people experiencing asthma. Along with the gradual growth in the number of publications, these research topics have relatively expanded in recent years. While the understanding of the pathophysiology, diagnosis and treatment of asthma has been well-established, recent research has showed high interest in the control and management of asthma. Findings of this study suggest the need for more empirical studies in developing countries and further investigation into the effects of environment factors on asthma outcomes, as well as the economic burden of asthma.
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Affiliation(s)
- Hai Thanh Phan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (H.T.P.); (B.X.T.)
| | - Giap Van Vu
- Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam;
- Respiratory Center, Bach Mai Hospital, Hanoi 100000, Vietnam
| | - Giang Thu Vu
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam;
| | - Giang Hai Ha
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Pharmacy, Duy Tan University, Da Nang 550000, Vietnam
- Correspondence: ; Tel.: +84-6954-8561
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam;
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (H.T.P.); (B.X.T.)
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Cyrus S.H. Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore;
| | - Roger C.M. Ho
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore;
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam
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42
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Abstract
PURPOSE OF REVIEW Asthma is one of the most common chronic diseases in children and adults in developed countries around the world. Despite international treatment guidelines, poor asthma control remains a frequent problem leading to missed school and work, and emergency room visits and hospitalizations. Many patients with asthma report exercise as a trigger for their asthma, which likely leads to exercise avoidance as a means to control symptoms. Evolving research has suggested that routine exercise may actually help improve some aspects of asthma control. This review discusses the recent research addressing how routine exercise affects important asthma-related outcomes including symptoms, lung function and quality of life. RECENT FINDINGS Several systematic reviews and meta-analyses have been conducted in recent years, which strongly support the safety of routine exercise in children and adults with asthma. Exercise appears to favor improvements in aerobic fitness, asthma symptoms and quality of life, but results so far are less consistent in demonstrating improvements to lung function and airway hyperresponsiveness. SUMMARY In addition to routine management guidelines, clinicians should recommend for their patients with asthma routine exercise for its general health benefits and likely improvement in asthma symptoms and quality of life.
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43
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Lopes WA, Porto FE, Leite N. EFFECT OF PHYSICAL TRAINING ON EXERCISE-INDUCED BRONCHOSPASM IN YOUNG ASTHMATICS. REV BRAS MED ESPORTE 2020. [DOI: 10.1590/1517-869220202601201675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
ABSTRACT Introduction: Asthma is the most common chronic disease in childhood and its prevalence has increased in recent years. Although regular physical activity (PA) is considered to be beneficial for the health of asthmatics, especially children and adolescents, it can also be one of the elements that triggers asthma. This is known as exercise-induced bronchospasm (EIB), and is considered one of the factors that limits asthmatics’ participation in PA. Objective: This study aims to review the effects of physical conditioning on EIB in asthmatic children and adolescents. Methods: A systematic review was carried out on the Pubmed, Bireme and Web of Science databases, considering publications from 1998 to April 2019. Results: Eight articles were retrieved; five of the articles presented no significant difference in EIB parameters after physical training, and three demonstrated significant benefits in EIB. Conclusion: There is insufficient evidence that physical training helps reduce the frequency and severity of EIB in young asthmatics. There are still few studies that seek to show the effect of a physical training program on the improvement of EIB in children and adolescents. It is suggested that further randomized clinical trials be conducted, to investigate the effects of physical training on EIB parameters in children and adolescents. Level of Evidence II; Systematic review.
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44
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Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss the most recent studies on lifestyle interventions in pediatric asthma. We include studies on physical activity and exercise, sedentary time, nutrition, behavioral therapy and the role of schools. RECENT FINDINGS Several small studies in children with asthma suggest that exercise interventions can improve aerobic fitness, asthma symptoms or control and quality of life. Existing evidence supports recommending higher intake of fruits and vegetables for asthma risk and control. In contrast, the 'Western diet' - high in refined grains, highly processed foods, red meats and fried foods with low intake of fruits and vegetables - has a proinflammatory effect and may alter microbiota composition leading to worse asthma outcomes. Finally, there are opportunities to utilize schools to promote physical activity, though standardization of asthma management in the schools is needed. SUMMARY Assessing physical activity/fitness levels, sedentary time and nutritional status is important in the management of children with asthma, as they are modifiable factors. Larger rigorous studies evaluating lifestyle interventions are needed to better inform current asthma guidelines as well as to understand the underlying mechanism(s) related to physical activity and diet in asthma.
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Affiliation(s)
- Kim D. Lu
- Pediatric Exercise and Genomics Research Center (PERC), Department of Pediatrics, University of California, Irvine School of Medicine, Irvine, CA
| | - Erick Forno
- University of Pittsburgh School of Medicine, Pittsburgh, PA
- Division of Pediatric Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
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45
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Abstract
Asthma is a chronic lower respiratory disease that is very common worldwide, and its incidence is increasing year by year. Since the 1970s, asthma has become widespread, with approximately 300 million people affected worldwide and about 250,000 people have lost their lives. Asthma seriously affects people's physical and mental health, resulting in reduced learning efficiency, limited physical activities, and decreased quality of life. Therefore, raising awareness of the risk of asthma and how to effectively treat asthma have become important targets for the prevention and management of asthma in recent years. For patients with asthma, exercise training is a widely accepted adjunct to drug-based and non-pharmacological treatment. It has been recommended abroad that exercise prescriptions are an important part of asthma management.
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Affiliation(s)
- Shengguang Ding
- Department of Thoracic and Cardiovascular Surgery, The Second Affiliated Hospital of Nantong University, Nantong, China
| | - Chongjun Zhong
- Department of Thoracic and Cardiovascular Surgery, The Second Affiliated Hospital of Nantong University, Nantong, China
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46
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Winn CON, Mackintosh KA, Eddolls WTB, Stratton G, Wilson AM, Davies GA, McNarry MA. Asthma, body mass and aerobic fitness, the relationship in adolescents: The exercise for asthma with commando Joe's® (X4ACJ) trial. J Sports Sci 2019; 38:288-295. [PMID: 31774371 DOI: 10.1080/02640414.2019.1696729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Although an association has been suggested between asthma, obesity, fitness and physical activity, the relationship between these parameters remains to be elucidated in adolescents. Six-hundred and sixteen adolescents were recruited (334 boys; 13.0 ± 1.1years; 1.57 ± 0.10m; 52.6 ± 12.9kg), of which 155 suffered from mild-to-moderate asthma (78 boys). Participants completed a 20-metre shuttle run test, lung function and 7-day objective physical activity measurements and completed asthma control and quality of life questionnaires. Furthermore, 69 adolescents (36 asthma; 21 boys) completed an incremental ramp cycle ergometer test. Although participants with asthma completed significantly fewer shuttle runs than their peers, peak V̇O2 did not differ between the groups. However, adolescents with asthma engaged in less physical activity (53.9 ± 23.5 vs 60.5 ± 23.6minutes) and had higher BMI (22.2 ± 4.8 vs 20.4 ± 3.7kg·m-2), than their peers. Whilst a significant relationship was found between quality of life and cardiorespiratory fitness according to peak V̇O2, only BMI was revealed as a significant predictor of asthma status. The current findings highlight the need to use accurate measures of cardiorespiratory fitness rather than indirect estimates to assess the influence of asthma during adolescence. Furthermore, the present study suggests that BMI and fitness may be key targets for future interventions seeking to improve asthma quality of life.
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Affiliation(s)
- Charles O N Winn
- Swansea University Medical School, Singleton Campus, Swansea University, Swansea, UK.,Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Bay Campus, Swansea University, Swansea, UK
| | - Kelly A Mackintosh
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Bay Campus, Swansea University, Swansea, UK
| | - William T B Eddolls
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Bay Campus, Swansea University, Swansea, UK
| | - Gareth Stratton
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Bay Campus, Swansea University, Swansea, UK
| | - Andrew M Wilson
- Norwich Medical School, University of East Anglia, Norwich, England, UK
| | - Gwyneth A Davies
- Swansea University Medical School, Singleton Campus, Swansea University, Swansea, UK
| | - Melitta A McNarry
- Applied Sports Technology, Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Bay Campus, Swansea University, Swansea, UK
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47
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Promoting Factors for Physical Activity in Children with Asthma Explored through Concept Mapping. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224467. [PMID: 31766299 PMCID: PMC6888103 DOI: 10.3390/ijerph16224467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 01/07/2023]
Abstract
For children with asthma, physical activity (PA) can decrease the impact of their asthma. Thus far, effective PA promoting interventions for this group are lacking. To develop an intervention, the current study aimed to identify perspectives on physical activity of children with asthma, their parents, and healthcare providers. Children with asthma between 8 and 12 years old (n = 25), their parents (n = 17), and healthcare providers (n = 21) participated in a concept mapping study. Participants generated ideas that would help children with asthma to become more physically active. They sorted all ideas and rated their importance on influencing PA. Clusters were created with multidimensional scaling and cluster analysis. The researchers labelled the clusters as either environmental or personal factors using the Physical Activity for people with a Disability model. In total, 26 unique clusters were generated, of which 17 were labelled as environmental factors and 9 as personal factors. Important factors that promote physical activity in children with asthma according to all participating groups are asthma control, stimulating environments and relatives, and adapted facilities suiting the child’s needs. These factors, supported by the future users, enable developing an intervention that helps healthcare providers to promote PA in children with asthma.
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48
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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.
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49
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Comorbidity Among Chronic Physical Health Conditions and Neurodevelopmental Disorders in Childhood. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2019. [DOI: 10.1007/s40474-019-00173-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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50
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Pike KC, Griffiths LJ, Dezateux C, Pearce A. Physical activity among children with asthma: Cross-sectional analysis in the UK millennium cohort. Pediatr Pulmonol 2019; 54:962-969. [PMID: 30887727 PMCID: PMC6617805 DOI: 10.1002/ppul.24314] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Revised: 01/31/2019] [Accepted: 02/19/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND Although beneficial for health and well-being, most children do not achieve recommended levels of physical activity. Evidence for children with asthma is mixed, with symptom severity rarely considered. This paper aimed to address this gap. METHODS We analyzed cross-sectional associations between physical activity and parent-reported asthma symptoms and severity for 6497 UK Millennium Cohort Study 7-year-old participants (3321, [49%] girls). Primary outcomes were daily moderate-to-vigorous physical activity (MVPA, minutes) and proportion of children achieving recommended minimum daily levels of 60 minutes of MVPA. Daily steps, sedentary time, and total activity counts per minute (cpm) were recorded, as were parent-reported asthma symptoms, medications, and recent hospital admissions. Associations were investigated using quantile (continuous outcomes) and Poisson (binary outcomes) regression, adjusting for demographic, socioeconomic, health, and environmental factors. RESULTS Neither asthma status nor severity was associated with MVPA; children recently hospitalized for asthma were less likely to achieve recommended daily MVPA (risk ratio [95% confidence interval [CI]]: 0.67 [0.44, 1.03]). Recent wheeze, current asthma, and severe asthma symptoms were associated with fewer sedentary hours (difference in medians [95% CI]: -0.18 [-0.27, -0.08]; -0.14 [-0.24, -0.05]; -0.15, [-0.28, -0.02], respectively) and hospital admission with lower total activity (-48 cpm [-68, -28]). CONCLUSION Children with asthma are as physically active as their asthma-free counterparts, while those recently hospitalized for asthma are less active. Qualitative studies are needed to understand the perceptions of children and families about physical activity following hospital admission and to inform support and advice needed to maintain active lifestyles for children with asthma.
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Affiliation(s)
- Katharine C Pike
- Infection, Immunity and Inflammation Academic Programme, Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Lucy J Griffiths
- Health Data Research UK, Wales and Northern Ireland, Swansea University Medical School, Swansea, UK
| | - Carol Dezateux
- Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anna Pearce
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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