Exercise conditioning in children with asthma

doi:10.1016/S0022-3476(85)80071-8

The Journal of Pediatrics

Volume 106, Issue 4, April 1985, Pages 556-560

https://doi.org/10.1016/S0022-3476(85)80071-8 Get rights and content

A controlled study of 20 children with asthma who participated in a 4-month running program (30 min/day, 3 days/wk), using inhalation of a beta-2 stimulant prior to each running session to prevent exercise-induced asthma, showed significant increases in work tolerance (120.5±45.0 W before, 131.5±43.5 W after, P=0.002) and cardiopulmonary fitness (peak oxygen consumption 37.6±8.6 ml/kg/min before, 43.1±10.5 ml/kg/min after, P<0.001). Asthma severity judged by daily asthma diary scores and twice daily peak flows did not change. Thirteen control patients with asthma did not exercise and demonstrated no change in work tolerance, fitness, or severity of asthma. Thus, children with asthma can safely engage in a running program and can increase work tolerance and fitness without worsening their asthma.

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Cited by (49)

PULMONARY REHABILITATION IN CHILDREN
2017, Revista Medica Clinica Las Condes
La rehabilitación respiratoria consiste en una estrategia de manejo de las enfermedades respiratorias crónicas que tiene como objetivo central obtener el mayor potencial en funcionalidad física, emocional y social del niño. Un programa de rehabilitación respiratoria tiene como objetivo obtener un alto grado de independencia y participación del niño en su comunidad, fomentando el autocuidado y un estilo de vida saludable, lo que impactará en los factores que estén deteriorando la calidad de vida relacionada a la salud. Existe evidencia sobre los efectos beneficiosos del ejercicio como estrategia terapéutica, por ende, su inclusión debe siempre estar considerada como un aspecto relevante de los programas de rehabilitación de los pacientes respiratorios crónicos.
Pulmonary rehabilitation is a strategy of management of chronic respiratory diseases that has the objective to obtain the highest potential in physical, emotional and social functioning. A pulmonary rehabilitation program aims to achieve a high degree of independence and community involvement in the child, promoting self-care and healthy lifestyle which will impact on factors that are deteriorating the quality of life related to health. There is strong evidence on the beneficial effects of exercise as a therapeutic strategy, hence their inclusion should always be considered as an important aspect of rehabilitation programs for chronic respiratory patients.
Effects of physical exercise on lung injury and oxidant stress in children with asthma
2012, Allergologia et Immunopathologia
Citation Excerpt :
Children and adults with asthma may avoid exercise because of their respiratory symptoms and they may have reduced exercise tolerance due to the increased sensation of dyspnoea.9,10,20
The aim of this study was to investigate the influence of exercise training on oxidative stress and markers of lung inflammation in children with asthma.
Thirty children aged 8-13 years diagnosed with asthma were enrolled in the study as well as 13 healthy children. One group received only pharmacological treatment and the other group was also enrolled in an exercise programme. Venous blood and 24-hour urine samples were obtained from the children enrolled in the study at the beginning and end of the study. Leukotriene E4 and creatinine levels were measured in the urine and matrix metallopeptidase (MMP-9), endothelin-1(ET-1), malnodialdehyde (MDA), IgE and specific IgE levels were measured in blood samples.
Leukotriene E4, MDA and MMP9 levels decreased significantly with treatment in both groups (p<0.001). However, ET-1 levels decreased significant only in the exercise group (26.5 ± 3.6 vs 21.3 ± 2.4pg/ml respectively, p=0.001). Moreover, ET-1 levels were found to be significantly lower in the exercise group compared to the only pharmacotherapy group (24.2 ± 3.1 vs 21.3 ± 2.4pg/ml, p=0.007).
Positive influences of exercise training in children with asthma may be mediated by decrease in ET-1 levels.
The beneficial effects of physical exercise on antioxidant status in asthmatic children
2011, Allergologia et Immunopathologia
Citation Excerpt :
Oxidative stress leads to changes such as modification of receptor activity and signalling as well as the release of endogenous mediators of inflammation. Children and adults with asthma may avoid exercise because of their respiratory symptoms and they may have reduced exercise tolerance due to the increased sensation of dyspnoea.11,12 The results of previous studies on the influence of exercise on spirometry are contradictory, some reporting improvement.13
The pathogenesis of asthma involves both airway inflammation and an oxidant/antioxidant imbalance. It is demonstrated in asthmatic adults that exercise programmes improve lung function, a mechanism yet to be elucidated. The purpose of this study was to investigate the possible beneficial effects of physical exercise on antioxidant status in asthmatic children which may lead to ameliorated lung function.
The study enrolled thirteen control and thirty asthmatic children. The asthmatic group was subdivided into two: the first group receiving only pharmacological treatment (n = 15) and the second receiving pharmacological treatment with exercise programme (n = 15) for 8 weeks. Blood samples were drawn from the subjects before and after treatment periods. As oxidant stress markers blood levels of malondialdehyde (MDA) and total nitric oxide (NO), and as antioxidant status, glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) enzyme activities were assessed.
Before any treatment was initiated, MDA and NO levels in the asthmatic group were significantly higher than the controls (3.40 ± 0.96 nmol/ml vs 2.46 ± 0.58 nmol/ml, and 12.53 ± 2.10 vs 9.40 ± 1.39 micromol/L, respectively). Both SOD (p = 0.0001) and GSH-Px (p = 0.023) activities were significantly lower in the asthmatic group. Pharmacological treatment and exercise programme together significantly improved lung performance and decreased the levels of oxidant stress markers, in concordance with a significantly increase in antioxidant enzyme activity measures when compared to the pharmacological treatment.
Structured exercise programme in asthmatic children resulted in better lung function, which may be attributed to its effect on antioxidant status.
Dyspnea in overweight children: Is it asthma?
2009, Journal of Allergy and Clinical Immunology
Paediatric asthma and obesity
2006, Paediatric Respiratory Reviews
None of the explanations proposed for the increase in paediatric asthma have been adequate. It is becoming apparent that the cause of the increase in asthma must be multi-factorial. Increasing attention has been focused on the role of lifestyle in the development of asthma. Lifestyle changes that have occurred in children are those in diet and decreased physical activity, with obesity being the product of these changes. The increase in asthma, obesity and a sedentary lifestyle have occurred together. However, a temporal relationship between asthma, obesity and decreased physical activity has not been determined in the paediatric literature. Limited data suggest that decreased physical activity could be playing a role in the aetiology of asthma independent of obesity. Furthermore, there has been substantial research on the benefits of exercise programmes for paediatric patients with asthma. Longitudinal trials monitoring physical activity, obesity and the development of asthma are needed.
Physical fitness in children with asthma
2006, Archives de Pediatrie
L'intolérance à l'effort physique d'un enfant souffrant d'asthme est la résultante de plusieurs facteurs : limitation ventilatoire, limitation musculaire par déconditionnement, limitation cardiovasculaire. La détérioration de son aptitude physique est déterminée par la sévérité de son obstruction bronchique. Les performances musculaires faisant appel aux métabolismes aérobie et anaérobie sont également affectées. Un réentraînement à l'effort individualisé permet d'améliorer ces 2 types de performance.
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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^*

Supported in part by a grant from the American Lung Association of Tennessee.

Presented in part at the Annual Meeting of the American Thoracic Society, Miami Beach, May 22, 1984.

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Original articleExercise conditioning in children with asthma*

J Asthma Res

The extant works of Arateus the Capodocian

Limitation of activity due to chronic conditions: United States, 1969 and 1970

Vital Health Stat

Physical education programs and exercise-induced asthma

Clin Pediatr

Exercise-induced asthma. Observations on the initiating stimulus

N Engl J Med

Inhibition of exercise-induced asthma by different pharmacologic pathways

Thorax

Exercise testing in children

Exercise conditioning and cardiopulmonary fitness in cystic fibrosis: The effects of a three-month, supervised running program

Chest

Textbook of work physiology

Endurance fitness

Response to exercise after bed rest and after training

Circulation

Intensive physical training in children with bronchial asthma

Acta Paediatr Scand [Suppl]

Original article
Exercise conditioning in children with asthma*