Physical activity among children with asthma: Cross‐sectional analysis in the UK millennium cohort

Abstract

Background Although beneficial for health and well‐being, most children do not achieve recommended levels of physical activity. Evidence for children with asthma is mixed, with symptom severity rarely considered. This paper aimed to address this gap. Methods We analyzed cross‐sectional associations between physical activity and parent‐reported asthma symptoms and severity for 6497 UK Millennium Cohort Study 7−year‐old participants (3321, [49%] girls). Primary outcomes were daily moderate‐to‐vigorous physical activity (MVPA, minutes) and proportion of children achieving recommended minimum daily levels of 60 minutes of MVPA. Daily steps, sedentary time, and total activity counts per minute (cpm) were recorded, as were parent‐reported asthma symptoms, medications, and recent hospital admissions. Associations were investigated using quantile (continuous outcomes) and Poisson (binary outcomes) regression, adjusting for demographic, socioeconomic, health, and environmental factors. Results Neither asthma status nor severity was associated with MVPA; children recently hospitalized for asthma were less likely to achieve recommended daily MVPA (risk ratio [95% confidence interval [CI]]: 0.67 [0.44, 1.03]). Recent wheeze, current asthma, and severe asthma symptoms were associated with fewer sedentary hours (difference in medians [95% CI]: −0.18 [−0.27, −0.08]; −0.14 [−0.24, −0.05]; −0.15, [−0.28, −0.02], respectively) and hospital admission with lower total activity (−48 cpm [−68, −28]). Conclusion Children with asthma are as physically active as their asthma‐free counterparts, while those recently hospitalized for asthma are less active. Qualitative studies are needed to understand the perceptions of children and families about physical activity following hospital admission and to inform support and advice needed to maintain active lifestyles for children with asthma.

Patient perceived barriers to exercise and their clinical associations in difficult asthma

“…However, in this present research, objective asthma specific markers of severity such as lung function and markers of Type 2 high disease did not correlate with perceived barriers to exercise. Similarly, a cross-sectional analysis of physical activity in the UK millennium cohort demonstrated that activity levels in children with asthma were not affected by the severity of their disease [36]. This is a clinically relevant finding which suggests that severity of disease is not necessarily a barrier to exercise.…”

“…This appears to be a key stage for engagement in sport in later life, with a report from The Women in Sport Research group showing that if children start to drop out of sporting activities at this age then they tend not to reengage as adults [35]. Comparatively, exercise levels in children at age 7 are not reduced in those with a diagnosis of asthma [36]. It may be that diagnosis at this age compounds the effects of this transition point.…”

Is asthma associated with physical inactivity in children?

“…Previous studies have relied upon self‐reported data on physical activity and only a few smaller studies measured physical activity objectively. We read with great interest the study by Pike et al 1 that focuses on the association between parent‐reported asthma diagnosis and physical activity measured by the accelerometer in 6497 children aged 7 years from the UK Millennium Cohort Study. Only half of the children met the recommendation of at least 60 minutes of MVPA per day.…”

“…The study by Pike et al 1 adds valuable and good‐quality evidence on the association between asthma and physical activity in children, but the authors did not provide information on asthma symptoms triggered by exercise or results of exercise challenge testing. We believe this information would be important when studying the association between asthma and physical inactivity in children.…”

“…Pike et al 1 conclude that reported asthma does not limit physical activity in children. However, it is important to clarify if exercise‐induced respiratory symptoms cause physical activity limitations in children, independently of the underlying diagnosis.…”