Determinants of Physical Fitness in Children With Asthma

Abstract

ABSTRACT. Rationale. This study was designed to examine the relationships among weight, asthma severity, physical activity, and aerobic fitness in children with asthma.Subjects and Methods. Sixty-four asthmatic children 8 to 12 years old (53% female) were assessed while attending a summer asthma camp. Measures included height and weight, spirometry, histamine bronchial provocation challenge, maximal aerobic power, and questionnaires to quantify habitual activity, perceived activity limitations due to asthma, perceived competence in physical activity, and attitudes toward physical activity. Asthma severity was determined from spirometric indices (forced expiratory volume during the first second), degree of airway hyperresponsiveness, and amount of medication prescribed.Results. There was no correlation between asthma severity and aerobic fitness. Only perceived competence at physical activity was found to have a significant correlation with aerobic fitness. Appropriate-weight, overweight, or obese (defined by body mass index) children all had similar results for maximum aerobic power and level of habitual activity. However, overweight or obese children reported greater limitation of physical activity. Their asthma-impairment scores were higher than the scores of appropriate-weight peers, although standard measures of pulmonary function were no different among groups. The higher asthma-severity scores were related to greater medication needs in the overweight or obese children with asthma.Conclusions. Lower maximum aerobic power in asthmatic children is related more to how capable they perceive themselves than to asthma severity. Overweight asthmatic children experience greater limitation of physical activity and thus are prescribed more medication, although by standard measures of asthma severity, they are very similar to normal-weight peers with asthma. Efforts should be directed at understanding the reasons responsible for reduced exercise tolerance before escalating pharmacologic treatment. Pediatrics 2004;113:e225-e229. URL: http://www.pediatrics.org/cgi/content/full/113/3/e225; asthma, exercise, physical activity, obesity.ABBREVIATIONS. FVC, forced vital capacity; FEV 1 , forced expiratory volume during the first second; ATS, American Thoracic Society; PC 20 , provocative concentration causing a 20% fall in FEV 1 ; BMI, body mass index. E xercise-induced bronchoconstriction affects a majority of children with asthma, 1 and the resulting unpleasant symptoms may incline the child to refrain from such activity. According to current treatment guidelines, a diagnosis of asthma should not deter a child from physical activity, inasmuch as normal physical activity is a recognized goal of optimal asthma control. 2 There are conflicting studies regarding fitness levels in children with asthma. [3][4][5][6][7][8] If children with asthma indeed are less fit than their nonasthmatic peers, then elucidation of the reason(s) responsible would enable clinicians to direct educational and therapeutic effects to enable their pa...

Asthma and body weight change: a 20-year prospective community study of young adults

“…36 Additionally, studies in children with asthma have found them to be less physically fit than non-asthmatics, which could not be accounted for by their lung disease. 37 Over the long term, a lack of physical fitness could pre-dispose one to weight gain. Unfortunately, detailed information on asthma treatment was not available, and the level of physical activity was based on data from interviews in 1981 and 1986, making it impossible to test the relationship between asthma and physical activity over time.…”

A nested case–control study: personal, social and environmental correlates of vigorous physical activity in adolescents with asthma

“…Furthermore, van Gent et al (10) did not found lower level of VPA based on both self-reports and objective recordings, and neither did Nystad (11) at any level of exercise frequency or exercise hours a week in asthma based on self-reports. Even though asthma control and severity are associated with level of PA (1,6,7), and that increased intensity and exercise load is associated with bronchoconstriction (12), there is also evidence that psychosocial and socio-demographical factors and knowledge/competence are important for level of physical activity in children and adolescents with asthma (1,(13)(14)(15)(16)(17)(18). Parents observing shortness of breath in their child may lead them to restrain their children from exertion (14), with subsequent increasing fear of breathlessness followed by personal or parental restrictions (15,16).…”

Treinamento muscular inspiratório e exercícios respiratórios em crianças asmáticas

“…(1) Asthma patients, due to the characteristics of the disease, suffer from increased airway resistance, as well as air trapping and lung hyperinflation, which lead to changes in the thoraco-abdominal mechanics and inspiratory muscle impairment. (2)(3)(4) Various respiratory therapy programs for patients with asthma, using inspiratory muscle training (IMT) or breathing exercises, have been studied as a complement to pharmacological treatment.…”