Modified Shuttle Test Distance Correlates With Peak Oxygen Uptake in Children and Adolescents With Severe Therapy-Resistant Asthma

Schiwe, Daniele; Heinzmann‐Filho, João Paulo; Cs, Schindel; Mf, Gheller; Ne, Campos; Pitrez, Paulo Márcio; Mvf, Donadio

doi:10.3389/fphys.2019.01245

Cited by 3 publications

(7 citation statements)

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“…However, when we analyzed the combination of EIB and physical deconditioning, we found a prevalence of 55%, comparable to the prevalence of EIB reported in the literature. Schiwe et al (2019) and Villa et al (2011) reported the prevalence of physical deconditioning, as assessed by calculating the VO 2 , to be 31 and 55%, respectively, among individuals with severe asthma, higher than the 25% observed in the present study for physical deconditioning in isolation. However, those authors did not evaluate EIB.…”

Section: Discussioncontrasting

confidence: 83%

“…Physiological indicators of physical conditioning are important biomarkers for monitoring overall cardiorespiratory, muscle, and bone health ( World Health Organization, 2011 ). However, few studies have used CPET effectively to identify physical deconditioning ( Vahlkvist and Pedersen, 2009 ; Villa et al, 2011 ; Schiwe et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, the patients with asthma consumed the same amount of oxygen but completed the test with a 25% lower workload in comparison with the controls, suggesting that individuals with asthma have less aerobic capacity. In addition, the patients reported less dyspnea, according to the Borg scale, than did the controls, possibly due to the lower workload they endured or the poor perception of symptoms that some asthma patients have ( Schiwe et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

“…Although some studies have evaluated the level of physical activity in patients with asthma using objective measures ( Cassim et al, 2016 ; Pike et al, 2019 ; van der Kamp et al, 2019 ) few have evaluated physical deconditioning ( Vahlkvist and Pedersen, 2009 ; Villa et al, 2011 ; Schiwe et al, 2019 ) or have used CPET to investigate the mechanisms responsible for reducing exercise tolerance ( McNicholl et al, 2011 ). To our knowledge, there have been no studies employing CPET to analyze the possible mechanisms involved in exercise limitation in pediatric patients with severe asthma.…”

Section: Introductionmentioning

confidence: 99%

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Exercise Limitation in Children and Adolescents With Severe Refractory Asthma: A Lack of Asthma Control?

et al. 2021

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BackgroundPatients with severe refractory asthma (SRA), even when using high doses of multiple controller medications in a regular and appropriate way, can have persistent complaints of exercise limitation.MethodsThis was a cross-sectional study involving patients with SRA (treated with ≥ 800 μg of budesonide or equivalent, with ≥ 80% adherence, appropriate inhaler technique, and comorbidities treated), who presented no signs of a lack of asthma control other than exercise limitation. We also evaluated healthy controls, matched to the patients for sex, age, and body mass index. All participants underwent cardiopulmonary exercise testing (CPET) on a cycle ergometer, maximum exertion being defined as ≥ 85% of the predicted heart rate, with a respiratory exchange ratio ≥ 1.0 for children and ≥ 1.1 for adolescents. Physical deconditioning was defined as oxygen uptake (VO2) < 80% of predicted at peak exercise, without cardiac impairment or ventilatory limitation. Exercise-induced bronchoconstriction (EIB) was defined as a forced expiratory volume in one second ≥ 10% lower than the baseline value at 5, 10, 20, and 30 minutes after CPET.ResultsWe evaluated 20 patients with SRA and 19 controls. In the sample as a whole, the mean age was 12.9 ± 0.4 years. The CPET was considered maximal in all participants. In terms of the peak VO2 (VO2peak), there was no significant difference between the patients and controls, (P = 0.10). Among the patients, we observed isolated EIB in 30%, isolated physical deconditioning in 25%, physical deconditioning accompanied by EIB in 25%, and exercise-induced symptoms not supported by the CPET data in 15%.Conclusion and Clinical RelevancePhysical deconditioning, alone or accompanied by EIB, was the determining factor in reducing exercise tolerance in patients with SRA and was not therefore found to be associated with a lack of asthma control.

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Section: Discussioncontrasting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exercise Limitation in Children and Adolescents With Severe Refractory Asthma: A Lack of Asthma Control?

et al. 2021

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“…The ISWT was originally designed to determine cardiorespiratory fitness and functional capacity and to predict mortality and morbidity in specific populations with chronic medical conditions (1,3–16) and more recently in apparently healthy, relatively inactive populations (17–22). It is a safe, fairly simple test to learn and administer and should be considered a viable alternative to treadmill or bicycle ergometer testing for apparently healthy, nonathletic clients.…”

Section: Purpose Of the Assessmentmentioning

confidence: 99%

The Incremental Shuttle Walk Test

Ronai

Mendola

2021

ACSM's Health and Fitness Journal

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Reduction of Exercise Capacity, Respiratory and Peripheral Muscle Strength in Severe Asthma

et al. 2022

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Background: Patients with severe asthma need to be studied separately due to differences from less severe asthma. This is the first study to carry out a wide physical evaluation of children and adolescents with severe asthma. The objective was to evaluate maximal and submaximal exercise capacity, respiratory and peripheral muscle strength in children and adolescents with severe asthma. Methods:The study included children and adolescents (6 to 18 years) diagnosed with severe asthma, controlled in the last 4 weeks. The maximal exercise capacity was measured by the modified shuttle test (MST) and submaximal by the 6-min walk test. Respiratory muscle strength was evaluated by measuring maximal respiratory pressures and the peripheral strength through a handgrip.Results: Thirty patients were included, with mean age of 10.3 years, 63% female and 46.7% overweight or obese. Patients underperformed but reached more than 80% of expected in all evaluations. There was a moderate correlation between age and body mass index (BMI) with MST, maximal expiratory pressure and peripheral muscle strength. The correlation between MST and BMI was negative. There was a strong correlation between peripheral muscle strength and age. Peripheral muscle strength also correlated moderately with respiratory muscle strength and lung function. Conclusion:Children and adolescents with severe asthma had lower maximal and submaximal exercise capacity and reduced peripheral and respiratory muscle strength. These results are slightly below normal and very similar to patients with less severe asthma, allowing us to infer that patients with severe asthma have a good functional condition when the disease is controlled.

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Modified Shuttle Test Distance Correlates With Peak Oxygen Uptake in Children and Adolescents With Severe Therapy-Resistant Asthma

Cited by 3 publications

References 33 publications

Exercise Limitation in Children and Adolescents With Severe Refractory Asthma: A Lack of Asthma Control?

Exercise Limitation in Children and Adolescents With Severe Refractory Asthma: A Lack of Asthma Control?

The Incremental Shuttle Walk Test

Reduction of Exercise Capacity, Respiratory and Peripheral Muscle Strength in Severe Asthma

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