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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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Siegel C, Tecce E, Vaile JR, Maheu A, Close J. Asthma Prevalence among Athletes in an Urban Adolescent Population. J Community Health 2023; 48:898-902. [PMID: 37219790 DOI: 10.1007/s10900-023-01239-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To identify individuals at risk of asthma by assessing the prevalence of asthma in an urban, athletic adolescent population using preparticipation physical evaluation (PPE) data. STUDY DESIGN Using the Athlete Health Organization (AHO) PPE data from 2016 to 2019, asthma prevalence was collected by reported diagnosis in the history or physical. Chi-square tests and logistic regression were performed to characterize the relationship between asthma and social factors such as race, ethnicity, and income. Control variables such as age, body mass index, blood pressure, sex, and family history were also collected. RESULTS Over 2016-2019, 1,400 athletes ranging from 9 to 19 years of age had completed PPEs (Table 1). A large percentage of student-athletes were found to have asthma (23.4%), of whom a majority 86.3% resided in low-income zip-codes. Additionally, 65.5% of athletes with asthma identified as Black, with race being associated with asthma prevalence (p < 0.05). Demographic factors like income, age, and gender were not significantly associated with asthma prevalence. CONCLUSIONS Self-identified Black individuals reported higher prevalence of asthma when compared to the general population. Identifying factors like race and income that place adolescent athletes at risk of asthma is a key step to understanding the complex relationship between asthma and social determinants of health. This work advances the conversation for establishing best practices for serving vulnerable populations, as seen in this urban population of children with asthma.
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Affiliation(s)
- Charles Siegel
- Sidney Kimmel Medical College, Thomas Jefferson University, 1015 Walnut St. Suite 401, Philadelphia, PA, 19107, USA.
| | - Eric Tecce
- Sidney Kimmel Medical College, Thomas Jefferson University, 1015 Walnut St. Suite 401, Philadelphia, PA, 19107, USA
| | - John R Vaile
- Sidney Kimmel Medical College, Thomas Jefferson University, 1015 Walnut St. Suite 401, Philadelphia, PA, 19107, USA
| | - Arlene Maheu
- Sidney Kimmel Medical College, Thomas Jefferson University, 1015 Walnut St. Suite 401, Philadelphia, PA, 19107, USA
| | - Jeremy Close
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA, USA
- Athlete Health Organization, Philadelphia, PA, USA
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3
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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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4
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A Meta-Analysis of Sampled Maximal Aerobic Capacity Data for Boys Aged 11 Years Old or Less Obtained by Cycle Ergometry. Life (Basel) 2023; 13:life13020276. [PMID: 36836634 PMCID: PMC9967809 DOI: 10.3390/life13020276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/14/2022] [Accepted: 12/22/2022] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to develop distributions of VO2max based on measured values that exist in the literature in prepubertal boys using cycle ergometry. PRISMA guidelines were followed in conducting this research. One database was searched for peak and maximal VO2 values in healthy boys with mean age under 11 years old. Data were split into articles reporting absolute and relative VO2max values and analyzed accordingly. Multilevel models grounded in Bayesian principles were used. We investigated associations between VO2max and body mass, year of the study, and country of origin. Differences in "peak" and "maximal" VO2 were assessed. Absolute VO2max (Lmin-1) increases with age (P ~100%) but mean relative VO2max does not change (P ~100%). Absolute VO2max is higher in more recent studies (P = 95.7 ± 0.3%) and mean relative VO2max is lower (P = 99.6 ± 0.1%). Relative VO2max in the USA is lower compared with boys from other countries (P = 98.8 ± 0.2%), but there are no differences in absolute values. Mean aerobic capacity estimates presented as "peak" values are higher than "maximal" values on an absolute basis (P = 97.5 ± 0.3%) but not on a relative basis (P = 99.6 ± 0.1%). Heavier boys have lower cardiorespiratory fitness (P ≈ 100%), and body mass seems to be increasing faster with age in the USA compared with other countries (P = 92.3 ± 0.3%). New reference values for cardiorespiratory fitness are presented for prepubertal boys obtained with cycle ergometry. This is new, as no reference values have been determined so far based on actual measured values in prepubertal boys. Aerobic capacity normalized to body weight does not change with age. Cardiorespiratory fitness in prepubertal boys is declining, which is associated with increasing body mass over the last few decades. Lastly, this study did not find any statistically significant difference in the sample's mean aerobic capacity estimates using the "peak" and "maximum" distinctions identified in the literature.
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Deeney BT, Cao G, Orfanos S, Lee J, Kan M, Himes BE, Parikh V, Koziol-White CJ, An SS, Panettieri RA. Epinephrine evokes shortening of human airway smooth muscle cells following β 2 adrenergic receptor desensitization. Am J Physiol Lung Cell Mol Physiol 2022; 323:L142-L151. [PMID: 35787178 PMCID: PMC9359643 DOI: 10.1152/ajplung.00444.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 06/14/2022] [Accepted: 06/28/2022] [Indexed: 11/22/2022] Open
Abstract
Epinephrine (EPI), an endogenous catecholamine involved in the body's fight-or-flight responses to stress, activates α1-adrenergic receptors (α1ARs) expressed on various organs to evoke a wide range of physiological functions, including vasoconstriction. In the smooth muscle of human bronchi, however, the functional role of EPI on α1ARs remains controversial. Classically, evidence suggests that EPI promotes bronchodilation by stimulating β2-adrenergic receptors (β2ARs). Conventionally, the selective β2AR agonism of EPI was thought to be, in part, due to a predominance of β2ARs and/or a sparse, or lack of α1AR activity in human airway smooth muscle (HASM) cells. Surprisingly, we find that HASM cells express a high abundance of ADRA1B (the α1AR subtype B) and identify a spontaneous "switch-like" activation of α1ARs that evokes intracellular calcium, myosin light chain phosphorylation, and HASM cell shortening. The switch-like responses, and related EPI-induced biochemical and mechanical signals, emerged upon pharmacological inhibition of β2ARs and/or under experimental conditions that induce β2AR tachyphylaxis. EPI-induced procontractile effects were abrogated by an α1AR antagonist, doxazosin mesylate (DM). These data collectively uncover a previously unrecognized feed-forward mechanism driving bronchospasm via two distinct classes of G protein-coupled receptors (GPCRs) and provide a basis for reexamining α1AR inhibition for the management of stress/exercise-induced asthma and/or β2-agonist insensitivity in patients with difficult-to-control, disease subtypes.
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Affiliation(s)
- Brian T Deeney
- Rutgers Institute for Translational Medicine and Science, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Gaoyuan Cao
- Rutgers Institute for Translational Medicine and Science, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Sarah Orfanos
- Rutgers Institute for Translational Medicine and Science, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Jordan Lee
- The Joint Graduate Program in Toxicology, Department of Pharmacology and Toxicology, Rutgers-Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Mengyuan Kan
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Blanca E Himes
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Vishal Parikh
- Rutgers Institute for Translational Medicine and Science, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Cynthia J Koziol-White
- Rutgers Institute for Translational Medicine and Science, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Steven S An
- Rutgers Institute for Translational Medicine and Science, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
- The Joint Graduate Program in Toxicology, Department of Pharmacology and Toxicology, Rutgers-Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, New Jersey
- Department of Pharmacology, Rutgers-Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Reynold A Panettieri
- Rutgers Institute for Translational Medicine and Science, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
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6
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Maurer DJ, Liu C, Xepapadaki P, Stanic B, Bachert C, Finotto S, Gao Y, Graser A, Jartti T, Kistler W, Kowalski M, Lukkarinen H, Pasioti M, Tan G, Villiger M, Zhang L, Zhang N, Akdis M, Papadopoulos NG, Akdis CA. Physical activity in asthma control and its immune modulatory effect in asthmatic preschoolers. Allergy 2022; 77:1216-1230. [PMID: 34547110 PMCID: PMC9291774 DOI: 10.1111/all.15105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/06/2021] [Accepted: 09/13/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND The impact of physical activity on immune response is a hot topic in exercise immunology, but studies involving asthmatic children are scarce. Our aims were to examine whether there were any differences in the level of physical activity and daily TV attendance, to assess its role on asthma control and immune responses to various immune stimulants. METHODS Weekly physical activity and daily television attendance were obtained from questionnaires at inclusion of the PreDicta study. PBMC cultures were stimulated with phytohemagglutinin (PHA), R848, poly I:C, and zymosan. A panel of cytokines was measured and quantified in cell culture supernatants using luminometric multiplex immunofluorescence beads-based assay. RESULTS Asthmatic preschoolers showed significantly more TV attendance than their healthy peers (58.6% vs. 41.5% 1-3 h daily and only 25.7% vs. 47.2% ≤1 h daily) and poor asthma control was associated with less frequent physical activity (PA) (75% no or occasional activity in uncontrolled vs. 20% in controlled asthma; 25% ≥3 times weekly vs. 62%). Asthmatics with increased PA exhibited elevated cytokine levels in response to polyclonal stimulants, suggesting a readiness of circulating immune cells for type 1, 2, and 17 cytokine release compared to subjects with low PA and high TV attendance. This may also represent a proinflammatory state in high PA asthmatic children. Low physical activity and high TV attendance were associated with a decrease in proinflammatory cytokines. Proinflammatory cytokines were correlating with each other in in vitro immune responses of asthmatic children, but not healthy controls, this correlation was more pronounced in children with sedentary behavior. CONCLUSION Asthmatic children show more sedentary behavior than healthy subjects, while poor asthma control is associated with a substantial decrease in physical activity. Our results suggest that asthmatic children may profit from regular exercise, as elevated cytokine levels in stimulated conditions indicate an immune system prepared for responding strongly in case of different types of infections. However, it has to be considered that a hyperinflammatory state in high PA may not be beneficial in asthmatic children.
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Affiliation(s)
- Debbie J. Maurer
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Swiss Research Institute for Sports Medicine (SRISM) Davos Switzerland
- Department of Sports Medicine Davos Hospital Davos Switzerland
| | - Chengyao Liu
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital Capital Medical University Beijing China
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
| | - Barbara Stanic
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Claus Bachert
- Upper Airway Research Laboratory Ghent University Hospital Ghent Belgium
| | - Susetta Finotto
- Department of Molecular Pneumology Friedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg, Universitätsklinikum Erlangen Erlangen Germany
| | - Ya‐Dong Gao
- Department of Allergology Zhongnan Hospital of Wuhan University Wuhan China
| | - Anna Graser
- Department of Molecular Pneumology Friedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg, Universitätsklinikum Erlangen Erlangen Germany
| | - Tuomas Jartti
- Department of Pediatrics and Adolescent Medicine University of Turku and Turku University Hospital Turku Finland
- PEDEGO Research Unit, Medical Research Center University of Oulu Oulu Finland
- Department of Pediatrics and Adolescent Medicine Oulu University Hospital Oulu Finland
| | - Walter Kistler
- Swiss Research Institute for Sports Medicine (SRISM) Davos Switzerland
- Department of Sports Medicine Davos Hospital Davos Switzerland
| | - Marek Kowalski
- Department of Immunology, Rheumatology and Allergy Central University Hospital Lodz Poland
| | - Heikki Lukkarinen
- Department of Pediatrics and Adolescent Medicine University of Turku and Turku University Hospital Turku Finland
| | - Maria Pasioti
- Allergy Department, 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
| | - Ge Tan
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Michael Villiger
- Swiss Research Institute for Sports Medicine (SRISM) Davos Switzerland
- Department of Sports Medicine Davos Hospital Davos Switzerland
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital Capital Medical University Beijing China
- Department of Allergy, Beijing TongRen Hospital Capital Medical University Beijing China
| | - Nan Zhang
- Upper Airway Research Laboratory Ghent University Hospital Ghent Belgium
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
| | - Nikolaos G. Papadopoulos
- Allergy Department, 2nd Pediatric Clinic National and Kapodistrian University of Athens Athens Greece
- Division of Infection, Immunity & Respiratory Medicine University of Manchester Manchester UK
| | - Cezmi A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Swiss Research Institute for Sports Medicine (SRISM) Davos Switzerland
- Christine Kühne‐Center for Allergy Research and Education Davos Switzerland
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7
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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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8
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Sanz-Santiago V, Diez-Vega I, Donadio MVF, Schiwe D, Lopez-Nuevo C, Vendrusculo FM, Santana-Sosa E, Burgos S, Escribano-Ceruelo E, Villa-Asensi JR, Perez-Ruiz M. Comparison of physical fitness between healthy and mild-to-moderate asthmatic children with exercise symptoms: A cross-sectional study. Pediatr Pulmonol 2021; 56:2512-2521. [PMID: 34061472 DOI: 10.1002/ppul.25506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/15/2021] [Accepted: 05/17/2021] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Asthma is a chronic disease that may affect physical fitness, although its primary effects on exercise capacity, muscle strength, functionality and lifestyle, in children and adolescents, are still poorly understood. This study aimed to evaluate the differences in cardiorespiratory fitness, muscle strength, lifestyle, lung function, and functionality between asthmatics with exercise symptoms and healthy children. In addition, we have analyzed the association between clinical history and the presence of asthma. STUDY DESIGN Cross-sectional study including 71 patients with a diagnosis of asthma and 71 healthy children and adolescents (7-17 years of age). Anthropometric data, clinical history, disease control, lifestyle (KIDMED and physical activity questionnaires), lung function (spirometry), exercise-induced bronchoconstriction test, aerobic fitness (cardiopulmonary exercise test), muscle strength and functionality (timed up and go; timed up and down stairs) were evaluated. RESULTS Seventy-one patients with asthma (mean age 11.5 ± 2.7) and 71 healthy subjects (mean age 10.7 ± 2.5) were included. All asthmatic children had mild to moderate and stable asthma. EIB occurred in 56.3% of asthmatic children. Lung function was significantly (p < .05) lower in the asthmatic group when compared to healthy peers, as well as the cardiorespiratory fitness, muscle strength, lifestyle and functionality. Moreover, asthmatic children were more likely to have atopic dermatitis, allergic reactions, food allergies, and a family history of asthma when compared to healthy children. CONCLUSIONS Children with mild-to-moderate asthma presenting exercise symptoms show a reduction in cardiorespiratory fitness, muscle strength, lung function, functionality, and lifestyle when compared to healthy peers. The study provides data for pediatricians to support exercise practice aiming to improve prognosis and quality of life in asthmatic children.
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Affiliation(s)
| | - Ignacio Diez-Vega
- Department of Nursing and Physiotherapy, Faculty of Health Sciences, Universidad de León, Ponferrada, León, Spain
| | - Márcio Vinícius Fagundes Donadio
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Daniele Schiwe
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | | | - Fernanda M Vendrusculo
- Laboratory of Pediatric Physical Activity, Infant Center, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | | | - Silvia Burgos
- Faculty of Sport Sciences, European University of Madrid, Madrid, Spain
| | | | - Jose R Villa-Asensi
- Section of Pulmonology, Niño Jesús Children's University Hospital, Madrid, Spain
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9
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The Association between Vigorous Physical Activity and Stress in Adolescents with Asthma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073467. [PMID: 33810531 PMCID: PMC8036664 DOI: 10.3390/ijerph18073467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 01/14/2023]
Abstract
Asthma is a very common condition that affects 5-10% of the global population, and its prevalence is increasing. Vigorous physical activity (PA) is effective in improving cardiorespiratory fitness and managing stress. This study aimed to investigate the association between vigorous PA and stress among Korean adolescents with asthma using large-scale survey data. The questionnaire data of 57,303 adolescents were analyzed using raw data from the 2019 Korea Youth Risk Behavior Web-Based Survey. We performed logistic regression analysis to calculate the stress odds ratios (ORs) and 95% confidence intervals (CIs) for asthma and non-asthma groups using models 1 and 2. We also performed logistic regression analysis to calculate the stress OR for the asthma group with vigorous PA and non-vigorous PA using models 1, 2, and 3. Model 1 was adjusted for age, sex, obesity, smoking, and alcohol status; model 2 was further adjusted for household income, academic achievement, and comorbidities. Model 3 was further adjusted for moderate activity and resistance exercise. The OR of stress was 20% higher in the asthma group than in the non-asthma group (p < 0.05). In the fully adjusted models, the OR for the non-asthma group with vigorous PA versus non-vigorous PA was 0.89 (95% CI: 0.84-0.94). However, the OR for the asthma group with vigorous PA versus non-vigorous PA was 0.70 (95% CI: 0.57-0.86), indicating that adolescents who engage in vigorous PA had lower stress in the asthma group (p < 0.05). This study demonstrated that adolescents with asthma had higher stress levels than those without asthma; however, vigorous PA was associated with lower stress. These effects were more pronounced in adolescents with asthma.
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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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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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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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Reimberg MM, Pachi JRS, Scalco RS, Serra AJ, Fernandes L, Politti F, Wandalsen GF, Solé D, Dal Corso S, Lanza FC. Patients with asthma have reduced functional capacity and sedentary behavior. J Pediatr (Rio J) 2020; 96:53-59. [PMID: 30240630 PMCID: PMC9432245 DOI: 10.1016/j.jped.2018.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/30/2018] [Accepted: 07/03/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The modified shuttle test is a field test that avoids the ceiling effect, and there are no reports of a multidimensional assessment concerning physical activity in asthmatic patients. Thus, the aim was to evaluate functional capacity by MST, additionally to perform a multidimensional assessment as physical activity in daily life, muscle strength, and cytokine levels in children and adolescents with asthma, and to correlate these variables. METHOD This cross-sectional study included volunteers aged between 6 and 18 years who were divided into two groups: asthma group (n=43) that received regular treatment and control group (n=24). Functional capacity was evaluated by distance walked during the MST; physical activity in daily life was evaluated using an accelerometer by the number of steps. Quadriceps femoris strength was evaluated by load cell. RESULTS Distance walked was lower for the asthma group (790m [222m]) when compared with the control group (950m [240m]; p=0.007); however, the number of steps was similar between the two groups (asthma group: 7743 [3075]; control group: 7181 [3040]; p=0.41), and both groups were classified as sedentary behavior. There was no difference in muscle strength. Tumor necrosis factor-α differed, but interleukin levels were similar between groups. Quadriceps strength was correlated to distance walked (r=0.62; p<0.001) and tumor necrosis factor-α to the number of steps taken (r=-0.54, p=0.005). CONCLUSION Children and adolescents undergoing regular asthma treatment showed reduced functional capacity and sedentary behavior. The lower the quadriceps strength, the shorter the distance walked; the higher the tumor necrosis factor-α levels, the lower their daily physical activity levels.
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Affiliation(s)
- Mariana Mazzuca Reimberg
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | | | - Rebeca Souza Scalco
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Andrey Jorge Serra
- Universidade Federal de São Paulo (UNIFESP), Departamento de Cardiologia, São Paulo, SP, Brazil; Universidade Nove de Julho, Programa de Pós-Graduação em Biofotônica Aplicada à Ciência da Saúde, São Paulo, SP, Brazil
| | - Leandro Fernandes
- Universidade Federal de São Paulo (UNIFESP), Programa de Pós-Graduação em Psicobiologia, São Paulo, SP, Brazil
| | - Fabiano Politti
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Gustavo Falbo Wandalsen
- Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Alergia, Imunologia Clínica e Reumatologia, São Paulo, SP, Brazil
| | - Dirceu Solé
- Universidade Federal de São Paulo (UNIFESP), Departamento de Pediatria, Disciplina de Alergia, Imunologia Clínica e Reumatologia, São Paulo, SP, Brazil
| | - Simone Dal Corso
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil
| | - Fernanda Cordoba Lanza
- Universidade Nove de Julho, Programa de Pós-Graduação em Ciências da Reabilitação, São Paulo, SP, Brazil.
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Reimberg MM, Pachi JRS, Scalco RS, Serra AJ, Fernandes L, Politti F, Wandalsen GF, Solé D, Dal Corso S, Lanza FC. Patients with asthma have reduced functional capacity and sedentary behavior. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2020. [DOI: 10.1016/j.jpedp.2018.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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15
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Román PÁL, Martínez AVN, Sánchez JS, Pinillos FG, Sánchez JÁH. PSYCHOSOCIAL CHARACTERISTICS IN CHILDREN WITH ASTHMA REGARDING PHYSICAL ACTIVITY. REV BRAS MED ESPORTE 2019. [DOI: 10.1590/1517-869220192505189863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction Children who are more active enjoy sports, have confidence in their ability to engage in physical activity, feel competent and perceive fewer barriers to physical activity. Objective Psychosocially characterize the asthmatic child’s relationship with enjoyable physical activity, physical self-concept, health and perceived quality of life. Method Eighty asthmatic children (age = 11.33 ± 1.10 years, body mass index [BMI] = 20.52 ± 3.83 kg/m2) and 80 healthy children (age = 11.18 ± 1.00 years, BMI = 20.81 ± 4.24 kg/m2) participated in the study. The Physical Activity Enjoyment Scale (PACES), Physical Activity Questionnaire for Children (PAQ-C), the Physical Self-concept Questionnaire (CAF) and the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) were used. Results In the PACES questionnaire, healthy children had a better level of general physical activity while in the CAF questionnaire, significant differences were found in ability, physical fitness and general self-concept, which were higher in healthy children. There is a significant correlation between the PAQ-C and ability, general physical self-concept, PACES and total PAQLQ in asthmatic children. Conclusion Asthmatic children had lower levels of physical activity, physical self-concept and enjoyment in physical activity than healthy children. Level of evidence II; Retrospective study.
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Islamovic F, Silver EJ, Reznik M. Do Urban Minority Parents and Children Agree on Asthma Symptoms with Exercise, Worries, and Confidence in Disease Management? Acad Pediatr 2019; 19:624-630. [PMID: 31103884 PMCID: PMC6684356 DOI: 10.1016/j.acap.2019.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 05/06/2019] [Accepted: 05/11/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Providers commonly rely on parent reports of a child's asthma symptoms; however, children as young as 7 years can report on their own health. Our study compared parent and child reports of asthma symptoms with exercise, worries about developing an asthma attack, and confidence in disease management. METHODS We recruited children ages 7 to 10 years with asthma from 4 Bronx, NY, schools, as well as their parents. The parents and children completed interview surveys with parallel questions regarding perceived asthma symptoms, asthma-related worries, and confidence in disease management. We used McNemar tests for paired data to compare parent and child responses. RESULTS We analyzed data for 105 parent-child pairs. Mean child age was 8.5 years (standard deviation, 0.99); 53% were male, and 82% were Hispanic. Children were more likely than their parents to report ever having an exercise-induced asthma attack (85% vs 48%; P < .001) and that they "worry a lot" about developing an asthma attack during exercise (63% vs 45%; P = .01). Children felt more confident about using an inhaler correctly (76% of the children were "very sure" vs 60% of the parents; P = .009) and were more likely to report having an inhaler available in case of an attack (38% of the children were "very sure" vs 20% of the parents; P = .003). CONCLUSIONS In this school-based sample of urban children with asthma, we found disagreement between parent and child reports of symptoms with exercise, worry about developing an attack, and confidence in medication use. These findings suggest that including child reports during history taking could help providers identify children in need of enhanced asthma management.
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Affiliation(s)
- Florinda Islamovic
- Department of Pediatrics, Division of Academic General Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY; F Islamovic is now a medical student at St Georges University School of Medicine, Grenada, West Indies
| | - Ellen Johnson Silver
- Department of Pediatrics, Division of Academic General Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY; F Islamovic is now a medical student at St Georges University School of Medicine, Grenada, West Indies
| | - Marina Reznik
- Department of Pediatrics, Division of Academic General Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY; F Islamovic is now a medical student at St Georges University School of Medicine, Grenada, West Indies.
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Westergren T, Berntsen S, Ludvigsen MS, Aagaard H, Hall EOC, Ommundsen Y, Uhrenfeldt L, Fegran L. Relationship between physical activity level and psychosocial and socioeconomic factors and issues in children and adolescents with asthma: a scoping review. ACTA ACUST UNITED AC 2018; 15:2182-2222. [PMID: 28800060 DOI: 10.11124/jbisrir-2016-003308] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Asthma is a heterogeneous chronic airway disease which may reduce capability for physical activity. In healthy peers, physical activity is influenced by psychosocial and socioeconomic factors. Knowledge about the role of these factors has not been mapped in children and adolescents with asthma. OBJECTIVE The main objective of this scoping review was to identify psychosocial and socioeconomic factors associated with physical activity level in children and adolescents with asthma in the literature. The specific objectives were to map the instruments used to measure these factors, report on the construction and validation of these instruments, map psychosocial and socioeconomic issues related to physical activity level reported in qualitative studies, and identify gaps in knowledge about the relationship between psychosocial and socioeconomic factors and physical activity level in children and adolescents with asthma. INCLUSION CRITERIA TYPES OF PARTICIPANTS Children and adolescents with asthma aged six to 18 years. CONCEPT Psychosocial and socioeconomic factors related to physical activity level and participation. CONTEXT All physical activity contexts. TYPES OF SOURCES Quantitative and qualitative primary studies in English, with no date limit. SEARCH STRATEGY The databases searched included nine major databases for health and sports science, and five databases for unpublished studies. After screening and identification of studies, the reference lists of all identified reports were searched, and forward citation searches were conducted using four databases. EXTRACTION OF THE RESULTS The following data were extracted: (a) relevant study characteristics and assessment of physical activity level, (b) instruments used to assess psychosocial and socioeconomic factors, (c) association between physical activity level and these factors, (d) construction and validation of instruments, and (e) psychosocial and socioeconomic issues related to physical activity participation. PRESENTATION OF THE RESULTS Twenty-one quantitative and 13 qualitative studies were included. In cross-sectional studies, enjoyment, physical self-concept, self-efficacy, attitudes and beliefs about physical activity and health, psychological distress, health-related quality of life, and social support were more often reported as being correlated with physical activity level. In three studies, the construct validity was assessed by factor analysis and construct reliability tests for the study population. Qualitative studies reported 10 issues related to physical activity participation, and capability and being like peers were most commonly reported. There was no direct evidence that qualitative research informed the development or adjustment of instruments in quantitative studies. CONCLUSIONS Seven psychosocial factors correlated with physical activity level; capability and being like peers were the most commonly reported issues. Reports of the construction and validation of instruments were sparse.
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Affiliation(s)
- Thomas Westergren
- 1Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway 2Clinical Research Unit, Randers Regional Hospital, Randers, Denmark 3Department of Clinical Medicine, Aarhus University, Aarhus, Denmark 4Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark 5Section of Nursing, Department of Public Health, Health, Aarhus University, Aarhus, Denmark 6Department of Coaching and Psychology, Norwegian School of Sports Science, Oslo, Norway 7Danish Centre of Systematic Reviews: a Joanna Briggs Institute Center of Excellence, The Center of Clinical Guidelines - Clearing house, Aalborg University, Aalborg, Denmark 8Faculty of Nursing and Health Sciences, Nord University, Bodo, Norway 9Department of Pediatrics, Sørlandet Hospital, Kristiansand, Norway
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Parental Perspectives of Barriers to Physical Activity in Urban Schoolchildren With Asthma. Acad Pediatr 2018; 18:310-316. [PMID: 29309846 PMCID: PMC5889757 DOI: 10.1016/j.acap.2017.12.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 12/27/2017] [Accepted: 12/29/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Physical activity (PA) levels are low in today's youth and may even be lower in those with asthma. Barriers to PA have not been well studied in inner-city minority children with asthma. We conducted a qualitative study to characterize parental perceptions of barriers to PA and ways to improve PA levels in children with asthma. METHODS We used the socioecologic model to inform development of our interview guide. Questions fell into 2 socioecologic model domains: interpersonal (parent, family) barriers and community (neighborhood, school) barriers. Qualitative semistructured interviews were conducted with 23 parents (21 mothers, 2 fathers) of inner-city children with asthma (aged 8-10 years) from 10 Bronx, New York, elementary schools. Sampling continued until thematic saturation was reached. Interviews were recorded, transcribed, and independently coded for common themes. Emerging themes were discussed and agreed on by investigators. RESULTS Three themes surrounding interpersonal barriers to PA emerged: 1) parental fear of exercise-induced asthma due to lack of child symptom awareness, 2) nonadherence and refusal to take medications, and 3) challenges with asthma management. Four themes around community barriers to PA emerged: 1) lack of trust in school management of asthma, 2) lack of school PA facilities, 3) unsafe neighborhoods, and 4) financial burden of PA. CONCLUSIONS A complex, multilevel set of barriers to PA exist in children with asthma. Addressing these barriers by involving stakeholders at the family, school, and community levels may improve PA levels in children with asthma.
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Gould CF, Perzanowski MS, Evans D, Bruzzese JM. Association of exercise-induced wheeze and other asthma symptoms with emergency department visits and hospitalizations in a large cohort of urban adolescents. Respir Med 2018; 135:42-50. [PMID: 29414452 PMCID: PMC5806151 DOI: 10.1016/j.rmed.2018.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 12/08/2017] [Accepted: 01/09/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Exercise-induced wheeze (EIW) has been found to be associated with asthma-related urgent care in school-aged children. Despite asthma's high prevalence and morbidity among adolescents, this association has not been examined in adolescents. We tested the association of EIW and other asthma symptoms to asthma-related ED visits and hospitalizations in urban adolescents with probable asthma. We hypothesized that EIW would be associated with urgent care. METHODS In this cross-sectional study 30,467 high school students (mean age = 16.0) from 49 NYC schools completed two brief validated measures, one assessing probable asthma and the other the frequency of six asthma symptoms over the past year. Adolescents also reported if in the past year they had an asthma-related ED visit or hospitalization. Analyses presented here included students with probable asthma (n = 9149). Using logistic regression, we modeled each asthma symptom as a function of ED visits and hospitalizations adjusting for sex, age, race/ethnicity and asthma severity. Multivariable models included all symptoms to account for the potential interaction between symptoms. RESULTS Among adolescents with probable asthma, EIW was associated with ED visits and hospitalizations. In multivariable models wheeze without a cold, chest tightness, night wakening, but not EIW, were significantly associated with both ED visits and hospitalizations. CONCLUSIONS Unlike findings with younger children, EIW does not appear to be associated with ED visits and hospitalizations among urban adolescents with probable asthma. Instead, symptoms, such as chest tightness and night wakening, appear to be important at identifying adolescents at risk for asthma-related urgent care.
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Affiliation(s)
- Carlos F Gould
- Columbia University, Mailman School of Public Health, Department of Environmental Health Sciences, 722 West 168th Street, New York, NY 10032, USA
| | - Matthew S Perzanowski
- Columbia University, Mailman School of Public Health, Department of Environmental Health Sciences, 722 West 168th Street, New York, NY 10032, USA
| | - David Evans
- Columbia University Medical Center, Pediatric Pulmonary Division, 3959 Broadway, Room CHC-745, New York, NY 10032, USA
| | - Jean-Marie Bruzzese
- Columbia University Medical Center, School of Nursing, 630 West 168th Street, Mail Code 6, New York, NY 10032, USA.
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Bian J, Guo Y, Xie M, Parish AE, Wardlaw I, Brown R, Modave F, Zheng D, Perry TT. Exploring the Association Between Self-Reported Asthma Impact and Fitbit-Derived Sleep Quality and Physical Activity Measures in Adolescents. JMIR Mhealth Uhealth 2017; 5:e105. [PMID: 28743679 PMCID: PMC5548986 DOI: 10.2196/mhealth.7346] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 05/18/2017] [Accepted: 07/04/2017] [Indexed: 12/31/2022] Open
Abstract
Background Smart wearables such as the Fitbit wristband provide the opportunity to monitor patients more comprehensively, to track patients in a fashion that more closely follows the contours of their lives, and to derive a more complete dataset that enables precision medicine. However, the utility and efficacy of using wearable devices to monitor adolescent patients’ asthma outcomes have not been established. Objective The objective of this study was to explore the association between self‑reported sleep data, Fitbit sleep and physical activity data, and pediatric asthma impact (PAI). Methods We conducted an 8‑week pilot study with 22 adolescent asthma patients to collect: (1) weekly or biweekly patient‑reported data using the Patient-Reported Outcomes Measurement Information System (PROMIS) measures of PAI, sleep disturbance (SD), and sleep‑related impairment (SRI) and (2) real-time Fitbit (ie, Fitbit Charge HR) data on physical activity (F-AM) and sleep quality (F‑SQ). To explore the relationship among the self-reported and Fitbit measures, we computed weekly Pearson correlations among these variables of interest. Results We have shown that the Fitbit-derived sleep quality F-SQ measure has a moderate correlation with the PROMIS SD score (average r=−.31, P=.01) and a weak but significant correlation with the PROMIS PAI score (average r=−.18, P=.02). The Fitbit physical activity measure has a negligible correlation with PAI (average r=.04, P=.62). Conclusions Our findings support the potential of using wrist-worn devices to continuously monitor two important factors—physical activity and sleep—associated with patients’ asthma outcomes and to develop a personalized asthma management platform.
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Affiliation(s)
- Jiang Bian
- Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States
| | - Yi Guo
- Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States
| | - Mengjun Xie
- Department of Computer Science, University of Arkansas at Little Rock, Little Rock, AR, United States
| | - Alice E Parish
- Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States
| | - Isaac Wardlaw
- Department of Computer Science, University of Arkansas at Little Rock, Little Rock, AR, United States
| | - Rita Brown
- Arkansas Children's Research Institute, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - François Modave
- Department of Health Outcomes and Policy, University of Florida, Gainesville, FL, United States
| | - Dong Zheng
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, FL, United States
| | - Tamara T Perry
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,Arkansas Children's Hospital, Arkansas Children's Research Institute, Little Rock, AR, United States
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Reznik M, Islamovic F, Choi J, Leu CS, Rowlands AV. Factors associated with in-school physical activity among urban children with asthma. J Asthma 2017; 55:492-501. [PMID: 28696842 DOI: 10.1080/02770903.2017.1340482] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE A cross-sectional study was conducted to determine if in-school physical activity (PA) varied by age, gender, weight and asthma status, participation in physical education (PE), outdoor recess, and other in-school PA among urban schoolchildren with asthma. METHODS PA was measured by tri-axial accelerometers. Height and mass were measured and overweight defined as BMI ≥85th percentile. Asthma impairment and risk were assessed as per national guidelines, and asthma status variable with three categories (mild, moderate, and severe) was created. Multivariable generalized linear mixed models adjusting for clustering due to school and student were fitted to identify variables predictive of PA. RESULTS 108 children with asthma participated. Children spent 374 minutes in school, of which 253 minutes were sedentary, 105 minutes in light PA, and 16 minutes in moderate-to-vigorous PA (MVPA). Only 3 participants reached the recommended ≥30 minutes/day of MVPA. Multivariable analysis revealed age, gender, participation in PE class, outdoor recess, and other in-school PA as independent predictors of PA. BMI and asthma status were not associated with PA. CONCLUSIONS Children with asthma were mostly sedentary at school. Older children and girls were particularly at risk for inactivity. PE, recess, and other in-school PA participation are modifiable factors that should be targeted in school-based interventions aimed at increasing PA in this population.
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Affiliation(s)
- Marina Reznik
- a Department of Pediatrics , Children's Hospital at Montefiore, Albert Einstein College of Medicine , Bronx , NY , USA
| | - Florinda Islamovic
- a Department of Pediatrics , Children's Hospital at Montefiore, Albert Einstein College of Medicine , Bronx , NY , USA.,b St. George's University School of Medicine , True Blue, Grenada , West Indies
| | - Jaeun Choi
- c Department of Epidemiology and Population Health , Albert Einstein College of Medicine , Bronx , NY , USA
| | - Cheng-Shiun Leu
- d Department of Biostatistics , Columbia University , New York , NY , USA
| | - Alex V Rowlands
- e Diabetes Research Centre , University of Leicester, Leicester General Hospital , Leicester , UK.,f NIHR Leicester Biomedical Research Centre , Leicester , UK.,g Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, Division of Health Sciences , University of South Australia , Adelaide , Australia
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Cassim R, Koplin JJ, Dharmage SC, Senaratna BCV, Lodge CJ, Lowe AJ, Russell MA. The difference in amount of physical activity performed by children with and without asthma: A systematic review and meta-analysis. J Asthma 2016; 53:882-92. [PMID: 27144654 DOI: 10.1080/02770903.2016.1175474] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Despite the benefits of a physically active lifestyle, some studies suggest fear of exacerbations by both children and their parents limit physical activity in children with asthma. We undertook a systematic review to quantify the difference in objectively measured physical activity levels of children and adolescents with and without asthma. DATA SOURCES MEDLINE, PubMed and EMBASE. STUDY SELECTION English language observational studies of children and adolescents to the age of 18 that compared objectively measured physical activity (accelerometer or pedometer devices) between those with asthma and without asthma. RESULTS Overall 22,285 articles were retrieved with 12 studies being included in the review: 1 cohort, 1 case-control and 10 cross-sectional. A meta-analysis of accelerometry data from the single cohort study and 8 cross-sectional studies produced an overall mean difference of 0.01 (95% CI: -0.09-0.11) activity counts per minute in children and adolescents without asthma compared to those with asthma. CONCLUSION We did not find any evidence that children and adolescents with and without asthma engaged in different amounts of physical activity when measured objectively by accelerometers. Children and adolescents with asthma may not require differentially targeted policies to encourage more physical activity, however further longitudinal studies are needed.
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Affiliation(s)
- Raisa Cassim
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,b Murdoch Childrens Research Institute , Parkville , Victoria , Australia
| | - Jennifer J Koplin
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,b Murdoch Childrens Research Institute , Parkville , Victoria , Australia
| | - Shyamali C Dharmage
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,b Murdoch Childrens Research Institute , Parkville , Victoria , Australia
| | - Baddewithana C V Senaratna
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,c Department of Community Medicine , University of Sri Jayewardenepura , Nugegoda , Sri Lanka
| | - Caroline J Lodge
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,b Murdoch Childrens Research Institute , Parkville , Victoria , Australia
| | - Adrian J Lowe
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,b Murdoch Childrens Research Institute , Parkville , Victoria , Australia
| | - Melissa A Russell
- a Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Heath , University of Melbourne , Parkville , Victoria , Australia.,b Murdoch Childrens Research Institute , Parkville , Victoria , Australia
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Heinzmann-Filho JP, Vendrusculo FM, Woszezenki CT, Piva TC, Santos AN, Barcellos AB, Vagliatti BB, Corrêa DG, Mattiello R, Donadio MVF. Inspiratory muscle function in asthmatic and healthy subjects: influence of age, nutrition and physical activity. J Asthma 2016; 53:893-9. [PMID: 27057823 DOI: 10.3109/02770903.2016.1165698] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To compare inspiratory muscle function (strength and endurance) between asthmatics and healthy controls, and the influence of age, nutritional status and physical activity on them. METHODS This is a cross-sectional study. Asthmatic and healthy subjects, aged 6 to 18 years old, recruited from two public schools in Southern Brazil were included in the study. Asthmatic subjects were selected using the criteria presented by the International Study on Asthma and Allergies in Children and control subjects based on the absence of respiratory symptoms. Anthropometric data was measured, body mass index calculated and subjects classified as normal weight, overweight or obese. Physical activity levels, maximum inspiratory pressure (MIP) and inspiratory muscle endurance (IME) were also evaluated. RESULTS A total of 314 participants were included, separated into control group (181) and asthmatics (133), with a total mean age of 11 years. When both groups were compared, there were no significant differences in both MIP and IME. However, when groups were analyzed subdivided in children and adolescents, IME was significantly reduced (p = 0.003) in asthmatic adolescents. Indeed, when groups were also stratified considering the nutritional status, IME showed a reduction in asthmatic adolescents with overweight (p = 0.042) and obesity (p = 0.041) when compared to healthy controls. No effects of physical activity levels between groups were found. CONCLUSIONS Results demonstrate a reduction in the IME in asthmatic adolescents with overweight and obesity, indicating an association between asthma, nutritional status and respiratory muscle function.
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Affiliation(s)
- João Paulo Heinzmann-Filho
- a Graduate Program in Pediatrics and Child Health , Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Fernanda Maria Vendrusculo
- a Graduate Program in Pediatrics and Child Health , Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Cristhiele Taís Woszezenki
- a Graduate Program in Pediatrics and Child Health , Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Taila Cristina Piva
- b School of Nursing , Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Andressa Nunes Santos
- b School of Nursing , Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Andressa Bombardi Barcellos
- b School of Nursing , Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Bruna Brufatto Vagliatti
- b School of Nursing , Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Débora Gonzales Corrêa
- b School of Nursing , Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Rita Mattiello
- a Graduate Program in Pediatrics and Child Health , Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil.,c Centro Infant , Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
| | - Márcio Vinícius Fagundes Donadio
- a Graduate Program in Pediatrics and Child Health , Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil.,b School of Nursing , Nutrition and Physiotherapy, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil.,c Centro Infant , Institute of Biomedical Research, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) , Porto Alegre , Rio Grande do Sul , Brazil
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Latorre-Román PÁ, Martínez AVN, García-Pinillos F. Effect of a physical activity program on sport enjoyment, physical activity participation, physical self-concept and quality of life in children with asthma. MOTRIZ: REVISTA DE EDUCACAO FISICA 2015. [DOI: 10.1590/s1980-65742015000400007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract This study aims to analyse the effects of indoor physical training program on the enjoyment and the willingness to participate in sports activities, physical self-concept and the quality of life in children with asthma. Participants were randomized in an experimental group (EG) (n=58, age=11.55±1.01 years old) and, a control group (CG) (n = 47, age=11.51±1.42 years old). An indoor training program was executed for 12-week, with each week containing three sessions of 60 minutes. Enjoyment in physical activity questionnaire, participation in physical activities, physical self-concept questionnaire, 6 minute walking test, and paediatric asthma quality of life questionnaire were employed. After the intervention, EG showed a significant reduction in the body mass index as well as a significant improvement in physical fitness test and the score obtained in questionnaires compared to the CG. A12-week indoor training program targeted towards asthmatic children improved the sport enjoyment, physical activity participation, physical self-concept, and quality of life.
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25
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Groth S, Rhee H, Kitzman H. Relationships among obesity, physical activity and sedentary behavior in young adolescents with and without lifetime asthma. J Asthma 2015; 53:19-24. [PMID: 26288155 PMCID: PMC4827268 DOI: 10.3109/02770903.2015.1063646] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To examine the inter-relationships among body mass index (BMI), physical activity, sedentary behavior and gender in urban, low-income, primarily African American young adolescents with or without lifetime asthma. METHODS Data were collected in 2002-2004 from 626 12-year old adolescents who were children of women who participated in the New Mother's Study in Memphis, TN (1990-1991). Adolescents with and without asthma were compared on BMI, physical activity and sedentary behavior. Multiple linear regression models were used to examine the association of asthma, gender and BMI with physical activity and sedentary behavior. RESULTS Complete data were available for 545 adolescents. Eleven percent of adolescents had lifetime asthma. Asthma and gender were associated with high-intensity physical activity (p < 0.001). Adolescents with asthma participated in less physical activity and girls participated less than boys. Gender was associated with sedentary behavior (p < 0.001): boys used personal computer (pc)/video after school more than girls. Girls with asthma had a higher BMI than girls without asthma (p = 0.027). Boys with asthma were less physically active than boys without asthma (p < 0.05). CONCLUSIONS Adolescents with asthma are less physically active than those without asthma and girls are less active than boys. Clinicians who provide care for adolescents with asthma are encouraged to assess physical activity/sedentary behavior and provide guidance that promotes active lifestyles. A longitudinal study is needed to shed light on the unique contribution of asthma separated from the effects of overweight/obesity on physical activity and sedentary behaviors.
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Affiliation(s)
- Susan Groth
- University of Rochester, 601 Elmwood Ave., Box SON, Rochester, NY 14642, 585-275-8895, Fax: 1-585-273-1270,
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26
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Reimberg MM, Castro RAS, Selman JPR, Meneses AS, Politti F, Mallozi MC, Wandalsen GF, Solé D, De Angelis K, Dal Corso S, Lanza FC. Effects of a pulmonary rehabilitation program on physical capacity, peripheral muscle function and inflammatory markers in asthmatic children and adolescents: study protocol for a randomized controlled trial. Trials 2015; 16:346. [PMID: 26268930 PMCID: PMC4535608 DOI: 10.1186/s13063-015-0876-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 07/17/2015] [Indexed: 01/06/2023] Open
Abstract
Background Individuals with chronic lung disease are more susceptible to present reduction in exercise tolerance and muscles strength not only due to pulmonary limitations but also due systemic repercussions of the pulmonary disease. The aim of this study is to assess the physical capacity, peripheral muscle function, physical activity in daily life, and the inflammatory markers in children and adolescents with asthma after pulmonary rehabilitation program. Method This is a study protocol of randomized controlled trial in asthmatic patients between 6 to 18 years old. The assessments will be conducted in three different days and will be performed at the beginning and at the end of the protocol. First visit: quality of life questionnaire, asthma control questionnaire, pre- and post-bronchodilator spirometry (400 μcg salbutamol), inflammatory assessment (blood collection), and cardiopulmonary exercise test on a cycle ergometer to determine aerobic capacity. Second visit: assessment of strength and endurance of the quadriceps femoris and biceps brachii muscles with concomitant electromyography to assess peripheral muscle strength. Third visit: incremental shuttle walk test (ISWT) and accelerometer to evaluate functional capacity and physical activity in daily life during 7 days. Then, the volunteers will be randomized to receive pulmonary rehabilitation program (intervention group) or chest physiotherapy + stretching exercises (control group). Both groups will have a supervised session, twice a week, each session will have 60 minutes duration, with minimum interval of 24 hours, for a period of 8 weeks. Intervention group: aerobic training (35 minutes) intensity between 60 to 80 % of the maximum workload of cardiopulmonary exercise testing or of ISWT; strength muscle training will be applied to the quadriceps femoris, biceps brachii and deltoid muscles (intensity: 40 to 70 % of maximal repetition, 3 x 8 repetition); finally the oral high-frequency oscillation device (Flutter®) will be used for 5 minutes. The control group: oral high-frequency oscillation device (Flutter®) for 10 minutes followed by the stretching of upper and lower limbs for 40 minutes. It is expected to observe the improvement in aerobic capacity, physical activity in daily life, muscle strength and quality of life of patients in the intervention group, and reduction in inflammatory markers. Trial registration Clinical Trial Number: NCT02383069. Data of registration: 03/03/2015
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Affiliation(s)
- Mariana Mazzuca Reimberg
- Master Degree in progress at Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Rejane Agnelo Silva Castro
- Master Degree in progress at Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Jessyca Pachi Rodrigues Selman
- Master Degree in progress at Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Aline Santos Meneses
- Master Degree in progress at Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Fabiano Politti
- Affiliated with the Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Márcia Carvalho Mallozi
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo/SP, Brazil.
| | - Gustavo Falbo Wandalsen
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo/SP, Brazil.
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo/SP, Brazil.
| | - Kátia De Angelis
- Affiliated with the Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Simone Dal Corso
- Affiliated with the Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil.
| | - Fernanda Cordoba Lanza
- Affiliated with the Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho - UNINOVE, Sao Paulo/SP, Brazil. .,Post Graduation Department, Universidade Nove de Julho - UNINOVE, Vergueiro St, 235/249, São Paulo, SP, 01504-001, Brazil.
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Yiallouros PK, Economou M, Kolokotroni O, Savva SC, Gavatha M, Ioannou P, Karpathios T, Middleton N. Gender differences in objectively assessed physical activity in asthmatic and non-asthmatic children. Pediatr Pulmonol 2015; 50:317-26. [PMID: 24678058 DOI: 10.1002/ppul.23045] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 03/03/2014] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To compare objectively assessed physical activity levels, between asthmatic children and non-asthmatic controls. METHODS From a random community sample of 794 children aged 8-9 years, in a case-control design, 104 children with ever doctor's diagnosis of asthma and 99 non-asthmatic controls were recruited and had assessment of physical activity with biaxial accelerometers for 7 days. RESULTS Children with active (also reporting at least one episode of wheezing in the last 12 months) and inactive (no wheezing in past 12 months) asthma appeared to have similar physical activity and sedentary activity levels compared to non-asthmatic children. However, girls with active asthma had significantly lower moderate-to-vigorous physical activity (MVPA) levels than their peers with adjusted geometric mean ratio of 0.59 (95% CI: 0.369, 0.929, P-value = 0.024). No difference in physical and sedentary activity levels was observed between asthmatic and non-asthmatic boys. The difference between genders in the comparison of MVPA levels in asthmatics and controls was statistically significant (P-value of likelihood ratio test [LRT] for effect modification by gender = 0.034). CONCLUSIONS Unlike boys, girls with active asthma appear to be less active than their healthy peers, and this gender difference might explain the inconsistent evidence from previous reports on physical activity levels in asthmatic children. Further studies are needed to confirm the gender interaction in the childhood asthma-physical activity relation and the implications on current guidelines for physical exercise prescriptions in asthmatic children.
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Affiliation(s)
- Panayiotis K Yiallouros
- Cyprus International Institute for Environmental & Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus; Department of Pediatrics, Hospital "Archbishop Makarios III", Nicosia, Cyprus
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28
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Hiemstra I, Heijsman SM, Koers NF, Bocca G, van der Veen BS, Veeger NJGM, Kamps AWA. Attenuated salivary cortisol response after exercise test in children with asthma. J Pediatr Endocrinol Metab 2015; 28:359-65. [PMID: 25210752 DOI: 10.1515/jpem-2014-0061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 08/05/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The clinical relevance of lower basal cortisol levels in children with asthma is unclear. We compared the salivary cortisol response after a standardized exercise test in children with asthma versus the salivary cortisol response in healthy children. METHODS Nineteen prepubertal children with asthma and 20 prepubertal healthy children performed a standardized exercise test twice. Salivary cortisol levels were determined before exercise and immediately and 15 min after exercise. Morning salivary cortisol levels were determined from saliva collected at home. RESULTS Salivary cortisol levels increased in 84.2% of the healthy children compared to 35.0% in children with asthma after the 20-m shuttle-run test. Median increase in salivary cortisol levels was 200.3% [95% confidence interval (CI), 141.8-346.1] in healthy children compared to 89.8% (95% CI, 56.9-181.6) in children with asthma. The response was not related to the morning salivary cortisol level or maintenance dose of inhaled corticosteroids. The mean time to exhaustion of both shuttle-run tests was significantly shorter in children with asthma (mean difference 1.4 min; 95% CI, 0.7-2.3). None of the children had to stop because of dyspnea. CONCLUSION Our study demonstrates that children with asthma using a maintenance dose of inhaled corticosteroids (ICS) have an attenuated salivary cortisol response compared with healthy children.
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Effects of exercise training on airway hyperreactivity in asthma: a systematic review and meta-analysis. Sports Med 2014; 43:1157-70. [PMID: 23846823 DOI: 10.1007/s40279-013-0077-2] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Although physical exercise is recommended for asthmatics, evidence on the effects of exercise on clinical key factors is still missing. OBJECTIVES We performed a systematic review and meta-analysis to determine the effect of exercise training (EXT) on quality of life (QoL), bronchial hyperresponsiveness (BHR), exercise-induced bronchoconstriction (EIB), lung function and exercise capacity, plus the factors affecting changes in QoL and exercise capacity in asthmatics after a period of EXT. DATA SOURCES A computerized search was conducted in MEDLINE, EMBASE, and CINAHL (last search on 15 November 2012), without language restriction, and references of original studies and reviews were searched for further relevant studies. STUDY SELECTION Two independent investigators screened full-text studies with asthmatic subjects undertaking EXT (defined as training for ≥7 days, ≥2 times per week, ≥5 training sessions in total) that assessed at least one of the following outcomes: QoL, airway hyperreactivity, forced expiratory volume in one second (FEV₁), peak expiratory flow (PEF), inflammatory parameters, exercise capacity, or exercise endurance. Potentially relevant studies were excluded if only respiratory muscle training, breathing exercises or yoga was performed, if asthmatic subjects with co-morbidities were investigated, if only data of mixed patient groups without separate results for asthmatics were presented, if training regimens were not sufficiently specified, if no numerical outcome data were presented, and if new long-term medication was introduced in addition to physical training. Of 500 potentially relevant articles, 13.4 % (67 studies including 2,059 subjects) met the eligibility criteria and were included for further analyses. STUDY APPRAISAL AND SYNTHESIS METHODS Data extraction and risk of bias assessment was performed according to the Cochrane Handbook for Systematic Reviews of Interventions. A meta-analysis of all randomized controlled trials (RCTs) was performed to determine the effect of EXT on asthma symptoms, BHR, EIB, FEV₁, exercise capacity and exercise endurance compared with control training. In addition, relative pre/post changes were analysed in all RCTs and controlled trials. Finally, multiple linear regression models were used to identify effects of relative changes in airway hyperreactivity (BHR or EIB), lung function (FEV₁ or PEF) and training hours on QoL and exercise performance. RESULTS In a total of 17 studies including 599 subjects, meta-analyses showed a significant improvement in days without asthma symptoms, FEV1 and exercise capacity while BHR only tended to improve. The analysis of relative within-group changes after EXT showed, however, significant improvements in QoL (17 %), BHR (53 %), EIB (9 %), and FEV1 (3 %) compared with control conditions. Multiple linear regression models revealed that changes in airway hyperreactivity and lung function significantly contributed to the change in QoL, while mainly the changes in airway hyperreactivity contributed to the change in exercise capacity. CONCLUSION EXT was shown to improve asthma symptoms, QoL, exercise capacity, BHR, EIB, and FEV1 in asthmatics and improvements in BHR explained part of the improvement in QoL and exercise capacity. Thus, physical activity should be recommended as a supplementary therapy to medication. However, more well controlled studies should be performed assessing the relationship of physical activity, QoL, airway hyperreactivity, lung function and especially airway inflammation as well as medication intake.
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Walker TJ, Reznik M. In-school asthma management and physical activity: children's perspectives. J Asthma 2014; 51:808-13. [PMID: 24796650 DOI: 10.3109/02770903.2014.920875] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Regular physical activity (PA) is an important component of pediatric asthma management. No studies have examined how in-school asthma management influences PA from children's perspectives. The aim of this study was to explore children's perceptions of the impact of in-school asthma management on PA. METHODS Qualitative interviews with 23 inner-city minority children with asthma (aged 8-10 yrs; 12 girls, 11 boys) were conducted in 10 Bronx, New York elementary schools. Sampling continued until saturation was reached. Interviews were recorded, transcribed and independently coded for common themes. RESULTS Interviews produced five themes representing students' perceptions about (1) asthma symptoms during in-school PA; (2) methods to control asthma episodes during school PA; (3) methods to prevent asthma episodes during school; (4) limited accessibility of asthma medications; and (5) negative feelings about asthma and medication use. The majority of students experienced asthma symptoms while performing PA during school. Primary methods of managing asthma symptoms were sitting out during activity, drinking water, and visiting the nurse. Students lacked awareness or adherence to action plans to prevent or control asthma. Students reported limited access to medication during school and feelings of embarrassment and/or concerns of teasing when medicating in front of others. CONCLUSIONS Our results indicate inappropriate in-school management of asthma symptoms, poor asthma control, lack of accessible medication, and stigma around publicly using asthma medication. Thus, students often missed or were withheld from PA. Interventions to improve in-school asthma care must consider ways to address these issues.
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Affiliation(s)
- Timothy J Walker
- Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine , Bronx, New York , USA
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Latorre Román PÁ, García Pinillos F, Navarro Martínez AV, Izquierdo Rus T. Validity and reliability of Physical Activity Enjoyment Scale questionnaire (PACES) in children with asthma. J Asthma 2014; 51:633-8. [PMID: 24580370 DOI: 10.3109/02770903.2014.898773] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study is to test the psychometric properties of the Physical Activity Enjoyment Scale (PACES) in children with asthma. METHOD Participants included 185 children (age = 11.38 ± 1.12 years; body mass index = 20.66 ± 4.13 kg/m(2)): 107 children with asthma and 78 healthy children. To test the enjoyment of physical activity, PACES of Motl et al. was used in its Spanish version. In addition, the Physical Activity Questionnaire for Children (PAQ-C), Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and Physical Self-Concept Questionnaire (CAF) have been used. RESULTS The results have shown a two-factor structure corresponding to the model whose settings have been good. PACES internal consistency was very high (Cronbach's alpha = 0.906). The PACES test-retest reliability indicates a good temporal concordance (Spearman rho = 0.868, p < 0.001). This presents an adequate concurrent validity with the total PAQLQ, the PAQ-C as well as with ability, fitness, attractiveness, strength and general physical self-concept. CONCLUSIONS The findings confirm that PACES is a valid and reliable measure of physical activity enjoyment in children with asthma.
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Fedele DA, Janicke DM, Lim CS, Abu-Hasan M. An examination of comorbid asthma and obesity: assessing differences in physical activity, sleep duration, health-related quality of life and parental distress. J Asthma 2014; 51:275-81. [PMID: 24320738 DOI: 10.3109/02770903.2013.873807] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Compare youth with comorbid asthma and obesity to youth with obesity only to determine if differences exist in body mass index, dietary intake, levels of physical activity, sleep duration and health-related quality of life. Levels of parent distress were also compared. METHODS Participants included 248 children (n = 175 in Obesity group; n = 73 in Asthma + Obesity group) with a BMI ≥ 85th percentile for age and gender, and their participating parent(s) or legal guardian(s). Measures of child height and weight were obtained by study personnel and Z-scores for child body mass index were calculated using age- and gender-specific norms. Child physical activity and sleep duration were measured via accelerometers. Dietary intake, health-related quality of life and parent distress were assessed via self-report. RESULTS The Asthma + Obesity group evidenced significantly higher body mass index scores, and had lower sleep duration. There was a non-statistically significant trend for lower levels of physical activity among children in the Asthma + Obesity group. Dietary intake, health-related quality of life and parent distress did not differ between groups. CONCLUSIONS Youth with comorbid asthma and obesity are at increased risk for negative health and psychosocial difficulties compared to youth who are overweight or obese only. Professionals providing treatment for youth with asthma are encouraged to assess the implications of weight status on health behaviors and family psychosocial adjustment.
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Affiliation(s)
- David A Fedele
- Department of Clinical and Health Psychology, University of Florida , Gainesville, FL , USA and
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Moraes EZCD, Trevisan ME, Baldisserotto SDV, Portela LOC. Children and adolescents with mild intermittent or mild persistent asthma: aerobic capacity between attacks. J Bras Pneumol 2013; 38:438-44. [PMID: 22964927 DOI: 10.1590/s1806-37132012000400005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 05/14/2012] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess children and adolescents diagnosed with mild intermittent or mild persistent asthma, in terms of their aerobic capacity between attacks. METHODS We included 33 children and adolescents recently diagnosed with asthma (mild intermittent or mild persistent) and 36 healthy children and adolescents. Those with asthma were evaluated between attacks. All participants underwent clinical evaluation; assessment of baseline physical activity level; pre- and post-bronchodilator spirometry; and a maximal exercise test, including determination of maximal voluntary ventilation, maximal oxygen uptake, respiratory quotient, maximal minute ventilation, ventilatory equivalent, ventilatory reserve, maximal HR, SpO2, and serum lactate. RESULTS No significant differences were found among the groups (intermittent asthma, persistent asthma, and control) regarding anthropometric or spirometric variables. There were no significant differences among the groups regarding the variables studied during the maximal exercise test. CONCLUSIONS A diagnosis of mild intermittent/persistent asthma has no effect on the aerobic capacity of children and adolescents between asthma attacks.
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Wanrooij VHM, Willeboordse M, Dompeling E, van de Kant KDG. Exercise training in children with asthma: a systematic review. Br J Sports Med 2013; 48:1024-31. [PMID: 23525551 DOI: 10.1136/bjsports-2012-091347] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Exercise can provoke asthma symptoms, such as dyspnoea, in children with asthma. Exercise-induced bronchoconstriction (EIB) is prevalent in 40-90% of children with asthma. Conversely, exercise can improve physical fitness. The purpose of this paper is to provide a systematic review of the literature regarding the effects of exercise training in children with asthma, particularly in relation to: EIB, asthma control, pulmonary function, cardiorespiratory parameters and parameters of underlying pathophysiology. A systematic search in several databases was performed. Controlled trials that undertook a physical training programme in children with asthma (aged 6-18 years) were selected. Twenty-nine studies were included. Training had positive effects on several cardiorespiratory fitness parameters. A few studies demonstrated that training could improve EIB, especially in cases where there was sufficient room for improvement. Peak expiratory flow was the only lung function parameter that could be improved substantially by training. The effects of training on asthma control, airway inflammation and bronchial hyper-responsiveness were barely studied. Owing to the overall beneficial effects of training and the lack of negative effects, it can be concluded that physical exercise is safe and can be recommended in children with asthma. A training programme should have a minimum duration of 3 months, with at least two 60 min training sessions per week, and a training intensity set at the (personalised) ventilatory threshold. Further research is recommended regarding the effects of exercise on underlying pathophysiological mechanisms and asthma control in children with asthma.
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Affiliation(s)
- Vera H M Wanrooij
- Department of Paediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Maartje Willeboordse
- Department of Paediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Edward Dompeling
- Department of Paediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Kim D G van de Kant
- Department of Paediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
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Dimitrakaki V, Porpodis K, Bebetsos E, Zarogoulidis P, Papaiwannou A, Tsiouda T, Tsioulis H, Zarogoulidis K. Attitudes of asthmatic and nonasthmatic children to physical exercise. Patient Prefer Adherence 2013; 7:81-8. [PMID: 23378744 PMCID: PMC3554104 DOI: 10.2147/ppa.s40577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study was to examine the physical activity of children with and without asthma in Greece, the factors affecting their intention to exercise, and the influence of gender. METHOD The study involved 50 children with asthma and 50 children without asthma, aged 9-14-years old. We used the leisure time exercise questionnaire to assess the frequency and intensity of exercise. The planned behavior scale examined seven factors affecting physical activity: attitude, intention, self-identity, attitude strength, social role model, information, and knowledge. RESULTS Asthmatic children did not differ significantly in mild, moderate, and overall level of physical activity from children without asthma but they participated less in intense and systematic exercise. The two asthmatic groups did not differ in any of the planned behavior factors. Significant differences between genders occurred with respect to self-identity and social role model. Boys appeared to exercise more regularly and intensely compared to girls. CONCLUSION Asthmatic children did not systematically participate in physical activity, preferring mostly mild and moderate intensity activities. Children with and without asthma had comparable positive attitudes and intentions toward exercise.
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Affiliation(s)
- Vithleem Dimitrakaki
- Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece
| | - Konstantinos Porpodis
- Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelos Bebetsos
- Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece
| | - Paul Zarogoulidis
- Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Correspondence: Paul Zarogoulidis G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Exohi 57010, Greece Tel +30 697 727 1974 Fax +30 231 099 2433 Email
| | - Antonis Papaiwannou
- Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodora Tsiouda
- Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Hlias Tsioulis
- Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Zarogoulidis
- Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Predicted aerobic capacity of asthmatic children: a research study from clinical origin. Pulm Med 2012; 2012:854652. [PMID: 22900171 PMCID: PMC3412093 DOI: 10.1155/2012/854652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 03/20/2012] [Accepted: 04/18/2012] [Indexed: 01/12/2023] Open
Abstract
Objective. To compare longitudinally PAC of asthmatic children against that of healthy controls during ten months. Methods. Twenty-eight asthmatic children aged 7-15 years and 27 matched controls each performed six submaximal exercise tests on treadmill, which included a test of EIA (exercise-induced asthma). Predicted aerobic capacity (mLO(2)/min/kg) was calculated. Spirometry and development were measured. Physical activity, medication, and "ever asthma/current asthma" were reported by questionnaire. Results. Predicted aerobic capacity of asthmatics was lower than that of controls (P = 0.0015) across observation times and for both groups an important increase in predicted aerobic capacity according to time was observed (P < 0.001). FEV(1) of the asthmatic children was within normal range. The majority (86%) of the asthmatics reported pulmonary symptoms to accompany their physical activity. Physical activity (hours per week) showed important effects for the variation in predicted aerobic capacity at baseline (F = 2.28, P = 0.061) and at the T4 observation (F = 3.03, P = 0.027) and the analyses showed important asthma/control group effects at baseline, month four, and month ten. Physical activity of the asthmatics correlated positively with predicted aerobic capacity. Conclusion. The asthmatic children had consistently low PAC when observed across time. Physical activity was positively associated with PAC in the asthmatics.
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Correia MADV, Rizzo JA, Sarinho SW, Sarinho ESC, Medeiros D, Assis F. Effect of exercise-induced bronchospasm and parental beliefs on physical activity of asthmatic adolescents from a tropical region. Ann Allergy Asthma Immunol 2012; 108:249-53. [DOI: 10.1016/j.anai.2012.01.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 01/19/2012] [Accepted: 01/20/2012] [Indexed: 10/28/2022]
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Kim JW, So WY, Kim YS. Association between asthma and physical activity in Korean adolescents: the 3rd Korea Youth Risk Behavior Web-based Survey (KYRBWS-III). Eur J Public Health 2011; 22:864-8. [PMID: 22158994 DOI: 10.1093/eurpub/ckr175] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Asthma is the leading chronic illness among children and adolescents in several nations. This study investigated the association between asthma and physical activity (PA). METHODS The findings in this study are based on the data obtained from the 2007 3rd Korea Youth Risk Behavior Web-Based Survey (KYRBWS-III), a cross-sectional survey of health-risk behaviours among a representative sample of Korean middle- and high-school students aged 13-18 years. This survey is conducted annually by the Korea Centers for Disease Control and Prevention. The 72 943 study subjects were selected using the complex sampling design of the survey. The association between asthma and PA was assessed by conducting multiple logistic regression analyses of the data by using the statistical software SPSS 17.0 Complex Sample. RESULTS Compared with the adolescents without current asthma, significantly fewer adolescents with current asthma had a sedentary time of 3 h or less per day (odds ratio, 0.86; 95% confidence interval, 0.75-0.97). Sedentary time was defined as time spent watching television, surfing the Internet, or playing computer games and excluded the time spent doing homework or study during leisure time. The analysis was adjusted for age, gender, family affluence level (FAL), obesity, allergic rhinitis, atopy and smoking. With regard to participation in adequate vigorous or moderate PA, strengthening exercise or physical education class, no significant differences were found between the adolescent students with current asthma and those without current asthma. In addition, it was found that all PA had no significant differences in their effects on asthma severity (medication, inability to work and absence from school). CONCLUSION Our results show that the amount of sedentary time influenced asthma prevalence; however, PA did not influence asthma prevalence in Korean adolescents.
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Affiliation(s)
- Jae-Woo Kim
- Department of Physical Education, Korea Military Academy, Seoul, Korea
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Shephard RJ. Lifestyle and the Respiratory Health of Children. Am J Lifestyle Med 2011. [DOI: 10.1177/1559827610378337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This article offers a review of the potential influences of personal lifestyle on respiratory health in children, looking at both healthy individuals and those with respiratory disorders. As with many aspects of health, regular physical activity, an appropriate diet, and avoidance of obesity and cigarette smoke all contribute to optimal development of the healthy child. An active lifestyle is associated with greater static and dynamic lung volumes, greater efficiency of the ventilatory process, and an optimization of breathing patterns. The risk of upper respiratory infections is also reduced in those maintaining a moderate level of physical activity. Maternal smoking during pregnancy, as well as active and passive smoking, all have an adverse influence on lung function in the child, the largest effects being on dynamic lung volumes. The risk of developing asthma seems reduced in children who maintain a normal body mass and are physically active. A program of graded physical activity is of therapeutic value in a number of established respiratory conditions, including asthma, cystic fibrosis, and ventilatory impairment from neuromuscular disorders. Exercise carries a slight risk of fatalities from asthma and anaphylactic reactions. In designing an optimal physical activity program, it is also important to guard against the hazards of deep oronasal breathing, including the precipitation of bronchospasm by the inhalation of cold, dry air and pollens; an increased exposure to atmospheric pollutants (reducing and oxidant smog, fine and ultra-fine particulates, and carbon monoxide); and possible long-term dangers from chlorine derivatives in the atmosphere of indoor swimming pools.
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Affiliation(s)
- Roy J. Shephard
- Faculty of Physical Education and Health, University of Toronto, Toronto, ON, Canada,
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Zhu W, Welk GJ, Meredith MD, Boiarskaia EA. A survey of physical education programs and policies in Texas schools. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2010; 81:S42-S52. [PMID: 21049837 DOI: 10.1080/02701367.2010.10599693] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
To better understand key physical education program factors and policies that may affect Texas students' physical fitness, a 39-question survey, administered as part of the Texas Youth Fitness Study (TYFS), was sent to 5651 Texas schools via e-mail. The survey consisted of five sections: (a) demographics, (b) physical education/recess frequency and duration, (c) resources/environment, (d) school physical education polices, and (e) experience/perception of fitness testing. A total of 2576 responses were received, of which 1505 responses (elementary = 58.1%, middle school = 21.2%, high school = 19.4%, and "mixed" school = 1.3%) were used for the report. Most of the findings are consistent with those reported in recent national studies. In addition, there were four distinct aspects: (a) broad support among teachers for the Senate Bill 530 mandate, (b) strong evidence of adherence to the mandated testing protocols, (c) teachers' negative experiences related to the testing, and (d) lack of recess in some Texas elementary schools. The survey provided rich updated information on physical education programs and policies in Texas schools.
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Affiliation(s)
- Weimo Zhu
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana 61801, USA.
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Jones SE, Wheeler LS, Smith AM, McManus T. Adherence to National Asthma Education and Prevention Program's "How Asthma-Friendly Is Your School?" recommendations. J Sch Nurs 2010; 25:382-94. [PMID: 19770490 DOI: 10.1177/1059840509343292] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
School health policies and programs provide the framework for a safe and supportive environment for students with asthma. School Health Policies and Programs Study 2006 data were examined to assess whether schools nationwide have policies and programs consistent with the "How Asthma-Friendly Is Your School?" checklist from the National Asthma Education and Prevention Program. Adherence to some of the recommendations on the checklist was high. For example, 80% or more of schools allowed students to carry and self-administer asthma medications, and obtained and kept asthma action plans. For other recommendations, however, far fewer schools had the recommended polices or programs; most notably, less than one third of schools had a full-time Registered Nurse. Improvements in many school policies and programs are needed so that students have a safe and supportive school environment to help them control their asthma while away from home.
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Rudolph H, Blüher S, Falkenberg C, Neef M, Körner A, Würz J, Kiess W, Brähler E. Perception of body weight status: a case control study of obese and lean children and adolescents and their parents. Obes Facts 2010; 3:83-91. [PMID: 20484940 PMCID: PMC6452133 DOI: 10.1159/000295495] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The objective of this study was to investigate differences in weight perception and self-concept of obese and lean children, and to examine parents' awareness of overweight in themselves and their children. A total of 59 obese patients aged 7-17 years and 49 of their parents from a pediatric obesity out-patient clinic participated and were compared with 96 normal-weight patients and 81 of their parents from a pediatric pulmonary disease out-patient clinic. METHODS Children's and parents' self-perception of weight, desire for weight change and weight concerns, children's belief that their desired weight can be achieved, and parents' perception of their child's weight status were assessed using single questionnaire items. Children's self-concept was measured by the Self-Perception Profile for Children. In addition, children drew pictures about themselves and their favorite activity. RESULTS Obese patients wished to change their weight more frequently (p < 0.001) and had more weight concerns (p < 0.001). Their self-concept was significantly more negative. Physical activities were more common in their drawings than in those of normal-weight peers. Parents of obese children were more frequently overweight or obese themselves (p < 0.001). 35 of them and 73 parents of normal-weight children perceived their own weight realistically. Of the parents with overweight or obese children, 69.4% perceived their own child as overweight and 28.6% as very overweight, whereas 83% of them were obese. CONCLUSION Children and adolescents as well as their parents recognize overweight as a health problem. In the majority, weight perception matches real body weight. Most parents at least recognize overweight in their children.
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Affiliation(s)
- Hagen Rudolph
- University Hospital for Children and Adolescents, University of Leipzig, Germany
- Department of Medical Psychology and Medical Sociology, University Hospital Leipzig, Germany
| | - Susann Blüher
- University Hospital for Children and Adolescents, University of Leipzig, Germany
| | - Christian Falkenberg
- University Hospital for Children and Adolescents, University of Leipzig, Germany
| | - Madlen Neef
- University Hospital for Children and Adolescents, University of Leipzig, Germany
| | - Antje Körner
- University Hospital for Children and Adolescents, University of Leipzig, Germany
| | - Julia Würz
- Department of Medical Psychology and Medical Sociology, University Hospital Leipzig, Germany
| | - Wieland Kiess
- University Hospital for Children and Adolescents, University of Leipzig, Germany
- *Professor Dr. med. Wieland Kiess University Hospital for Children and Adolescents University of Leipzig Liebigstraße 20a, 04103 Leipzig, Germany Tel. +49 341 97 260–00, Fax -09
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, University Hospital Leipzig, Germany
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Walders-Abramson N, Wamboldt FS, Curran-Everett D, Zhang L. Encouraging physical activity in pediatric asthma: a case-control study of the wonders of walking (WOW) program. Pediatr Pulmonol 2009; 44:909-16. [PMID: 19658109 PMCID: PMC3971919 DOI: 10.1002/ppul.21077] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The complex overlap between asthma and obesity may be explained in part by activity avoidance in asthma. We compared responses to a walking intervention between matched groups of children with and without asthma. We expected youth with asthma to have lower baseline and post-intervention activity levels. Psychosocial, demographic, and physiologic correlates of activity were also examined. DESIGN/PARTICIPANTS We compared baseline and post-intervention activity levels among 59 children aged 10-16 with well-controlled asthma and 59 healthy matched controls. Participants completed spirometry, physical examination, anthropometric measurement, and psychosocial questionnaires. INTERVENTION/OUTCOME MEASURE: Participants wore blinded calibrated pedometers for a baseline typical activity week, returning to complete the Wonders of Walking (WOW) intervention, followed by a week of post-intervention pedometer monitoring. RESULTS Contrary to expectation, no differences between cases (median steps = 6,348/day) and controls (median steps = 6,825/day) in baseline activity were found. Response to the WOW intervention was comparable, with both groups demonstrating an increase of approximately 1,485 steps per day (equivalent to more than 5 additional miles walked during the post-intervention week). Health beliefs did not correlate to activity at baseline or intervention response. No significant associations between activity and asthma control, FEV1, or duration of diagnosis were found. Intervention response was comparable across racial/ethnic groups, children versus adolescents, and between normal weight and overweight youth. CONCLUSIONS Contrary to expectation, we found similar rates of objectively measured physical activity among youth with well-controlled asthma and controls. Importantly, we documented statistically significant increases in physical activity across both groups following a brief, pedometer-based intervention. The intervention was successful even among typically sedentary groups, and represents an effective, safe, and inexpensive walking program.
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Oreskovic NM, Sawicki GS, Kinane TB, Winickoff JP, Perrin JM. Travel patterns to school among children with asthma. Clin Pediatr (Phila) 2009; 48:632-40. [PMID: 19420183 DOI: 10.1177/0009922809335323] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Active commuting to school provides regular exercise, which can improve asthma symptoms. Little is known about how children with asthma travel to school. OBJECTIVE To identify travel patterns and parental perceptions surrounding mode of travel to school among children with asthma. METHODS Cross-sectional study of 176 children with asthma aged 5 to 15 years. Parents completed questionnaires assessing mode of travel to school, physical activity, asthma control, physician counseling, and factors influencing parental decisions. Data analysis included descriptive and bivariate statistics. RESULTS Few (16%) children with asthma actively commute to school. Active travelers lived closer to school, and "distance" was the most frequently reported factor influencing a parent's decision regarding travel mode to school. Parents reported few concerns about pollution and little physician counseling on active travel. CONCLUSION Few children with asthma actively travel to school. Asthma-specific concerns do not appear to guide parental decisions on travel mode to school.
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Affiliation(s)
- Nicolas M Oreskovic
- Department of Pediatrics, Center for Child and Adolescent Health Policy, Massachusetts General Hospital, Department of Pediatrics, Children's Hospital Boston, Massachusets, USA.
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Ngai SPC, Jones AYM, Hui-Chan CWY, Ko FWS, Hui DSC. Effect of Acu-TENS on post-exercise expiratory lung volume in subjects with asthma-A randomized controlled trial. Respir Physiol Neurobiol 2009; 167:348-53. [PMID: 19540365 DOI: 10.1016/j.resp.2009.06.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Revised: 06/06/2009] [Accepted: 06/10/2009] [Indexed: 11/28/2022]
Abstract
This study examined the effect of transcutaneous electrical nerve stimulation applied over acupoints (Acu-TENS) on forced expiratory volume, in patients with asthma, after exercise. Thirty subjects were randomly assigned to three groups. Group 1 received Acu-TENS over acupuncture points Lieque and Dingchuan for 45 min prior to a symptom-limited treadmill exercise test. Group 2 had Acu-TENS similarly applied prior to and throughout the exercise test. Group 3 mimicked Group 1 but without any electrical output from the device. Forced expiratory volume in one second (FEV(1)) and forced vital capacity (FVC) were recorded before, immediately after and at 20-min intervals post-exercise for 1h. Immediately after exercise, FEV(1) and FVC rose in Group 2 (p=0.015), but decreased in Group 1 and more so in Group 3. The differences became even more marked at 20, 40 and 60 min. Adjunctive Acu-TENS therapy appears to reduce decline of FEV(1) following exercise training in patients with asthma.
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Affiliation(s)
- Shirley P C Ngai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Abstract
OBJECTIVES The objective of this study was to evaluate the association between socioeconomic factors and asthma control in children, as defined by the Canadian Pediatric Asthma Consensus Guidelines. PATIENTS AND METHODS Cross-sectional data from a completed study of 879 asthmatic children between the ages of 1 and 18 residing in the Greater Toronto Area were used. The database included data on demographics, health status, asthma control, and health-related quality of life. Stepwise forward modeling multiple regression was used to investigate the impact of socioeconomic status on asthma control, based on six control parameters from the 2003 Canadian Pediatric Asthma Consensus Guidelines. RESULTS Only 11% of patients met the requirements for acceptable control, while 20% had intermediate control, and 69% had unacceptable asthma control. Children from families in lower income adequacy levels had poorer control. CONCLUSIONS Disparities in asthma control between children from families of different socio-economic strata persist, even with adjustment for utilization of primary care services and use of controller medications.
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Affiliation(s)
- Shannon F Cope
- Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Williams B, Powell A, Hoskins G, Neville R. Exploring and explaining low participation in physical activity among children and young people with asthma: a review. BMC FAMILY PRACTICE 2008; 9:40. [PMID: 18590558 PMCID: PMC2447841 DOI: 10.1186/1471-2296-9-40] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2007] [Accepted: 06/30/2008] [Indexed: 11/10/2022]
Abstract
Background Asthma is the most common chronic illness among children and accounts for 1 in 5 of all child GP consultations. This paper reviews and discusses recent literature outlining the growing problem of physical inactivity among young people with asthma and explores the psychosocial dimensions that may explain inactivity levels and potentially relevant interventions and strategies, and the principles that should underpin them. Methods A narrative review based on an extensive and documented search of search of CinAHL, Embase, Medline, PsycINFO and the Cochrane Library. Results & Discussion Children and young people with asthma are generally less active than their non-asthmatic peers. Reduced participation may be influenced by organisational policies, family illness beliefs and behaviours, health care advice, and inaccurate symptom perception and attribution. Schools can be reluctant to encourage children to take part in physical education or normal play activity due to misunderstanding and a lack of clear corporate guidance. Families may accept a child's low level of activity if it is perceived that breathlessness or the need to take extra inhalers is harmful. Many young people themselves appear to accept sub-optimal control of symptoms and frequently misinterpret healthy shortness of breath on exercising with the symptoms of an impending asthma attack. Conclusion A multi-faceted approach is needed to translate the rhetoric of increasing activity levels in young people to the reality of improved fitness. Physical activity leading to improved fitness should become part of a goal orientated management strategy by schools, families, health care professionals and individuals. Exercise induced asthma should be regarded as a marker of poor control and a need to increase fitness rather as an excuse for inactivity. Individuals' perceptual accuracy deserves further research attention.
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Affiliation(s)
- Brian Williams
- Social Dimensions of Health Institute, University of Dundee, Dundee, UK.
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Jones SE, Merkle SL, Fulton JE, Wheeler LS, Mannino DM. Relationship between asthma, overweight, and physical activity among U.S. high school students. J Community Health 2007; 31:469-78. [PMID: 17186641 DOI: 10.1007/s10900-006-9026-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Asthma is a leading chronic illness among children and adolescents in the United States. This study examined the relationship between asthma and both overweight and physical activity levels. Results are based on data from the Centers for Disease Control and Prevention's 2003 national Youth Risk Behavior Survey, a cross-sectional survey of health risk behaviors among a representative sample of high school students in the United States. The overall survey response rate was 67% and the results are based on weighted data. SUDAAN was used for all data analysis (prevalence estimates and logistic regression) because it accounts for the complex sampling design of the survey. Significantly more students with current asthma than without were overweight (odds ratio [OR] = 1.4; 95% confidence interval [CI] = 1.1, 1.6) and described themselves as overweight (OR = 1.2; 95% CI = 1.0, 1.4). Significantly more students with current asthma than without used a computer for non-schoolwork 3 or more hours/day (OR = 1.3; 95% CI = 1.1, 1.5). No significant differences were found for participation in sufficient vigorous or moderate physical activity or strengthening exercises among students with and without current asthma. Unlike some other risk factors for developing or exacerbating asthma, overweight and physical activity are generally modifiable. School and community policies and programs can play an important role in asthma management, including promoting the maintenance of an appropriate weight and encouraging continued physical activity.
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Affiliation(s)
- Sherry Everett Jones
- Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS K33, Atlanta, GA 30341, USA.
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Joyner BL, Fiorino EK, Matta-Arroyo E, Needleman JP. Cardiopulmonary exercise testing in children and adolescents with asthma who report symptoms of exercise-induced bronchoconstriction. J Asthma 2007; 43:675-8. [PMID: 17092848 DOI: 10.1080/02770900600925460] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Patients with asthma often report symptoms of exercise-induced bronchoconstriction. We performed cardiopulmonary exercise testing to establish the cause of exercise limitation in patients with asthma, under treatment, who reported symptoms of exercise-induced bronchoconstriction. Ten of the 42 patients meeting criteria for inclusion in our study (24%) developed exercise-induced bronchoconstriction. Exercise limitation without exercise-induced bronchoconstriction was found in both obese and non-obese patients, suggesting that poor fitness is a problem independent of body habitus. Including cardiopulmonary exercise testing in the management of children with suspected exercise-induced bronchoconstriction would provide a better understanding of the etiology of their symptoms and facilitate more appropriate treatment.
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Affiliation(s)
- Benny L Joyner
- Division of Pediatric Respiratory and Sleep Medicine, Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York, USA.
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Counil FP, Voisin M. [Physical fitness in children with asthma]. Arch Pediatr 2006; 13:1136-41. [PMID: 16698247 DOI: 10.1016/j.arcped.2006.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2005] [Accepted: 04/04/2006] [Indexed: 11/26/2022]
Abstract
The exercise limitation in a child with asthma is the result of several factors: the lack of ventilatory reserve, muscle deconditioning, and cardiac limitation. The severity of the airway obstruction is a major determinant of physical fitness. Aerobic and anaerobic fitness are equally affected. Both types of fitness can be improved by specific training programs.
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Affiliation(s)
- F-P Counil
- Service de pédiatrie 1, unité de cardiopneumologie pédiatrique, CHU de Montpellier, hôpital Arnaud-de-Villeneuve, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 05, France.
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