Patients with asthma have reduced functional capacity and sedentary behavior

Reimberg, Mariana Mazzuca; Pachi, Jessyca Rodrigues Selman; Scalco, Rebeca Souza; Serra, Andrey Jorge; Fernandes, Leandro; Politti, Fabiano; Wandalsen, Gustavo Falbo; Solé, Dirceu; Dal Corso, Simone; Lanza, Fernanda Cordoba

doi:10.1016/j.jped.2018.07.011

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Sumário

Original articles • J. Pediatr. (Rio J.) 96 (1) • Jan-Feb 2020 • https://doi.org/10.1016/j.jped.2018.07.011 copy

Patients with asthma have reduced functional capacity and sedentary behavior^☆ ☆ Please cite this article as: Reimberg MM, Pachi JP, Scalco RS, Serra AJ, Fernandes L, Politti F, et al. Patients with asthma have reduced functional capacity and sedentary behavior. J Pediatr (Rio J). 2020;96:53-9.

Authorship SCIMAGO INSTITUTIONS RANKINGS

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 (790 m [222 m]) when compared with the control group (950 m [240 m]; 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.

Keywords
Asthma; Functional capacity; Number of steps; Muscle strength; Inflammatory profile

	Control group (n = 24)	Asthma group (n = 43)	p
Age, years old	11 (3)	10 (3)	0.49
Weight, kg	41.3 (15.5)	41.9 (12.9)	0.84
Height, cm	145.0 (17.3)	144.8 (15.5)	0.95
FVC, L [%pred]	2.6 (0.8) [106.6 (13.1)]	2.6 ± 0.8 [107.0 (11.0)]	0.97
FEV₁, L [%pred]	2.2 ± 0.7 [99.3 (13.3)]	2.2 ± 0.7 [102.1 (14.6)]	0.88
FEV₁/FVC	87.1 (6.6)	87.5 (7.6)	0.90
FEF_25-75%, L [%pred]	2.4 ± 0.8 [108.1 (29.8)]	2.7 ± 1.1 [121.3 (36.9)]	0.42
GINA step^a a Median (25-75%). FVC, forced vital capacity; L, liters; FEV1, forced expiratory volume in the first second of FVC; FEF25-75%, forced expiratory flow at 25-75% of FVC; C-ACT, asthma control test under 11 years old; ACT, asthma control test over 12 years old.	-	3 (2-4)
C-ACT (n = 23)^a a Median (25-75%). FVC, forced vital capacity; L, liters; FEV1, forced expiratory volume in the first second of FVC; FEF25-75%, forced expiratory flow at 25-75% of FVC; C-ACT, asthma control test under 11 years old; ACT, asthma control test over 12 years old.	-	20 (17-22)
ACT (n = 20)^a a Median (25-75%). FVC, forced vital capacity; L, liters; FEV1, forced expiratory volume in the first second of FVC; FEF25-75%, forced expiratory flow at 25-75% of FVC; C-ACT, asthma control test under 11 years old; ACT, asthma control test over 12 years old.	-	20 (16-22)

	Control group (n = 24)	Asthma group (n = 43)	p
Walk distance, m [% predicted]	950 (240) [100 (16)]	790 (222) [82 (14)]	0.007
HR, bpm [% predicted]	192 (8) [96 (4)]	187 (12) [93 (6)]	0.10
SpO₂, %	93 (5)	90 (6)	0.03
Desaturation, %	-3.6 (5)	-7.2 (5)	0.01
Borg dyspnea^a a Median (25-75%). HR, heart rate; bpm, beats per minute; SpO2, oxygen pulse saturation; PAS, systolic blood pressure; PAD, diastolic blood pressure; VO2, oxygen uptake; VCO2, carbon dioxide production; R, respiratory coefficient, VE, minute ventilation, MVV, maximal voluntary ventilation.	4 (2-7.5)	4 (2-7)	0.92
Borg lower limbs^a a Median (25-75%). HR, heart rate; bpm, beats per minute; SpO2, oxygen pulse saturation; PAS, systolic blood pressure; PAD, diastolic blood pressure; VO2, oxygen uptake; VCO2, carbon dioxide production; R, respiratory coefficient, VE, minute ventilation, MVV, maximal voluntary ventilation.	4 (2-7.5)	4 (2-7)	0.81
PAS, mmHg	135 (18)	134 (11)	0.66
PAD, mmHg	76 (7)	80 (8)	0.02
VO₂, mL/kg	46 (13)	47 (11)	0.65
VCO₂, mL/kg	52 (14)	49 (14)	0.55
R	1.1 (0.1)	1.0 (0.1)	0.01
VE, L	43 (15)	46 (15)	0.56
VE/MVV, %	51 (13)	51 (11)	0.87

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[1] * Corresponding author. lanzafe@gmail.com

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Patients with asthma have reduced functional capacity and sedentary behavior☆ ☆ Please cite this article as: Reimberg MM, Pachi JP, Scalco RS, Serra AJ, Fernandes L, Politti F, et al. Patients with asthma have reduced functional capacity and sedentary behavior. J Pediatr (Rio J). 2020;96:53-9.

Abstract

Objective

Method

Results

Conclusion

Patients with asthma have reduced functional capacity and sedentary behavior^☆ ☆ Please cite this article as: Reimberg MM, Pachi JP, Scalco RS, Serra AJ, Fernandes L, Politti F, et al. Patients with asthma have reduced functional capacity and sedentary behavior. J Pediatr (Rio J). 2020;96:53-9.