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Oliveira MCDP, Costa EC, Leal VS, Dos Santos Machado EK, Sarinho ESC, de Freitas Dias R, de Menezes RCE, de Barros MVG, Almendra R, de Valois Correia Junior MA. Geographic pattern of asthma prevalence in Brazilian adolescents: a systematic review with meta-analysis. J Pediatr (Rio J) 2025; 101:312-323. [PMID: 39923813 PMCID: PMC12039388 DOI: 10.1016/j.jped.2024.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Revised: 12/12/2024] [Accepted: 12/12/2024] [Indexed: 02/11/2025] Open
Abstract
OBJECTIVES This study aimed to verify the prevalence of asthma in Brazilian adolescents and its geographic pattern carried through a systematic review and meta-analysis. SOURCES A survey of databases (Pubmed, Chocrane, LILACS, SCIELO and SCOPUS) was carried out, following the PRISMA statement, between the years 2013 and 2023 (PROSPERO-ID-CRD42023427988). Articles that presented a measure relative to the prevalence of asthma in adolescents were included. The methodological quality regarding risk of bias was assessed according to the approach proposed by the Joanna Brigg Institute. SUMMARY OF THE FINDINGS Ten of a total of 3140 studies were included. Six studies were collected before 2015. The prevalence of active asthma, severe asthma, and diagnosed asthma were 18 %, 6 %, and 14 %, respectively. The studies were presented in large urban centers and capitals, had a high methodological quality, and showed high heterogeneity. Subgroup analysis was carried out, separating the cities according to the different regions of Brazil (north, northeast, center-west, south, and southeast). The northeast was the region with the lowest prevalence of active asthma (14 %, 95 % CI = 12-17 %, p < 0.001). There was no difference between regions in terms of diagnosed asthma and severity. CONCLUSION A high proportion of Brazilian adolescents reported having active asthma, with the northeast region having the lowest prevalence. Most of the studies were collected more than eight years ago and regard capitals and large urban centers. The high heterogeneity found demonstrates uncertainty in asthma prevalence in Brazil and highlights the need for clearer protocols addressing the multifactorial nature of the disease.
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Affiliation(s)
| | - Emília Chagas Costa
- Universidade Federal de Pernambuco (UFPE), Programa de Pós-Graduação em Nutrição, Recife, PE, Brazil
| | - Vanessa Sá Leal
- Universidade Federal de Pernambuco (UFPE), Programa de Pós-Graduação em Nutrição, Recife, PE, Brazil
| | | | | | - Ricardo de Freitas Dias
- Universidade de Pernambuco (UPE), Programa de Pós-Graduação em Hebiatria, Recife, PE, Brazil
| | | | - Mauro Virgílio Gomes de Barros
- Universidade de Pernambuco (UPE), Programa de Pós-Graduação em Hebiatria, Recife, PE, Brazil; University of Pernambuco and Federal University of Paraiba Associate Postgraduate Program in Physical Education, Recife, Pernambuco, Brazil; University of Coimbra, Department of Geography and Tourism and Centre of Studies in Geography and Spatial Planning (CEGOT), Coimbra, Portugal
| | - Ricardo Almendra
- University of Coimbra, Department of Geography and Tourism, Coimbra, Portugal
| | - Marco Aurélio de Valois Correia Junior
- Universidade de Pernambuco (UPE), Programa de Pós-Graduação em Hebiatria, Recife, PE, Brazil; University of Pernambuco and Federal University of Paraiba Associate Postgraduate Program in Physical Education, Recife, Pernambuco, Brazil; University of Coimbra, Department of Geography and Tourism and Centre of Studies in Geography and Spatial Planning (CEGOT), Coimbra, Portugal.
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Grandinetti R, Mussi N, Rossi A, Zambelli G, Masetti M, Giudice A, Pilloni S, Deolmi M, Caffarelli C, Esposito S, Fainardi V. Exercise-Induced Bronchoconstriction in Children: State of the Art from Diagnosis to Treatment. J Clin Med 2024; 13:4558. [PMID: 39124824 PMCID: PMC11312884 DOI: 10.3390/jcm13154558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/17/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
Exercise-induced bronchoconstriction (EIB) is a common clinical entity in people with asthma. EIB is characterized by postexercise airway obstruction that results in symptoms such as coughing, dyspnea, wheezing, chest tightness, and increased fatigue. The underlying mechanism of EIB is not completely understood. "Osmotic theory" and "thermal or vascular theory" have been proposed. Initial assessment must include a specific work-up to exclude alternative diagnoses like exercise-induced laryngeal obstruction (EILO), cardiac disease, or physical deconditioning. Detailed medical history and clinical examination must be followed by basal spirometry and exercise challenge test. The standardized treadmill running (TR) test, a controlled and standardized method to assess bronchial response to exercise, is the most adopted exercise challenge test for children aged at least 8 years. In the TR test, the goal is to reach the target heart rate in a short period and maintain it for at least 6 min. The test is then followed by spirometry at specific time points (5, 10, 15, and 30 min after exercise). In addition, bronchoprovocation tests like dry air hyperpnea (exercise and eucapnic voluntary hyperpnea) or osmotic aerosols (inhaled mannitol) can be considered when the diagnosis is uncertain. Treatment options include both pharmacological and behavioral approaches. Considering medications, the use of short-acting beta-agonists (SABA) just before exercise is the commonest option strategy, but daily inhaled corticosteroids (ICS) can also be considered, especially when EIB is not controlled with SABA only or when the patients practice physical activity very often. Among the behavioral approaches, warm-up before exercise, breathing through the nose or face mask, and avoiding polluted environments are all recommended strategies to reduce EIB risk. This review summarizes the latest evidence published over the last 10 years on the pathogenesis, diagnosis using spirometry and indirect bronchoprovocation tests, and treatment strategies, including SABA and ICS, of EIB. A specific focus has been placed on EIB management in young athletes, since this condition can not only prevent them from practicing regular physical activity but also competitive sports.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Valentina Fainardi
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy; (R.G.); (N.M.); (A.R.); (G.Z.); (M.M.); (A.G.); (S.P.); (M.D.); (C.C.); (S.E.)
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Zhou L, Xu H. Feasibility of exercise therapy for children with asthma: a meta-analysis. Front Cell Dev Biol 2023; 11:1192929. [PMID: 37492220 PMCID: PMC10364120 DOI: 10.3389/fcell.2023.1192929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/24/2023] [Indexed: 07/27/2023] Open
Abstract
Background: Although numerous studies have demonstrated the clear benefits of exercise for people with asthma, controversy remains. This study evaluated the effects of sustained exercise types on lung function and quality of life in patients with asthma. Methods: We searched PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang database since January 2000 to August 2022 .included randomized controlled trials (RCTs) of asthmatic children intervened with exercise. The outcomes were lung function and asthma-related quality of life. Fixed-effects model (I2≤50%) or random-effects model (I2>50%) was applied to calculate the pooled effects. Funnel plots were quantified to present publication bias, and a P value <0.05 was statistically significant. Results: Eventually, 15 trials conformed to the selection criteria. The exercise group significantly improved lung function (FEV1 and FVC) in asthmatic children compared with the control group. Forced Expiratory Volume in 1 Second (MD = 2.12, 95%CI = 0.70, 3.53; p = 0.003; I2 = 15%); Forced Vital Capacity (MD = 2.78, 95%CI = 1.26, 4.31; p = 0.0004; I2 = 56%). The immune system markers IL-6 and TNF-α, were significantly reduced in the exercise group. Interleukin-6 (MD = -0.49, 95%CI = -0.81, -0.17; p = 0.003; I2=0%); tumor necrosis factor-α (MD = -0.54, 95%CI = -0.92, -0.15; p = 0.006; I2 = 0%). That quality of life (PAQLQ) was significantly improved in children with asthma in the exercise group. PAQLQ-Total score (MD = 1.06, 95%CI = 0.46, 1.66; p = 0.006; I2 = 94%); PAQLQ-Emotional (MD = 0.91, 95%CI = 0.76, 1.06; p<0.00001; I2 = 90%); PAQLQ-symptoms (MD = 0.87, 95%CI = 0.71, 1.02; p<0.00001; I2 = 95%); PAQLQ-activities (MD = 1.20, 95%CI = 0.58, 1.82; p = 0.00001; I2 = 93%). Meta-analysis showed significant improvements in body composition in the exercise group. BMI (MD = -2.42, 95%CI = -4.40, 0.44; p = 0.02; I2 = 85%). Conclusions: This meta-analysis demonstrated the effectiveness of exercise in improving pulmonary function index (FEV1, FVC), immune system (IL-6, TNF-α, Feno), exercise ability (6MWT), body composition (BMI), and quality of life (PAQLQ) in asthmatic children. Asthmatic children should regularly participate in physical exercise.
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Brandão JTS, Nelo EMDA, Correia Júnior JL, Santos HFA, Lima Júnior JPD, Freitas-Dias RD, Moraes JFVND. Analysis of the association between exercise induced bronchospasm, cardiorespiratory fitness, and physical activity levels of adolescents. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/21024929012022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT This study aims to verify the association between exercise-induced bronchospasm (EIB), cardiorespiratory fitness, and physical activity levels in adolescents. To do so, we evaluated 202 healthy adolescents aged from 13 to 18 years, out of which 94 (46.5%) were females and 108 (53.5%) males. Participants performed a bronchial challenge test in a treadmill (Master Super ATL, Inbramed®) to evaluate bronchial hyper-responsiveness; a spirometric test (Microquark, Cosmed®) to evaluate lung function; answered the Baecke’s Questionnaire of Habitual Physical Activity; and performed the progressive aerobic cardiovascular endurance run test. Data were analyzed using Spearman’s correlation, chi-square test, and odds ratio. The significance level adopted was p<0.05. No statistically significant correlations were found between the decrease of the forced expiratory volume in the first second (FEV1), cardiorespiratory fitness, and physical activity levels. Likewise, the chi-squared test revealed no significant differences between classifications of cardiorespiratory fitness (low or adequate) and EIB (presence or absence) (χ2=0.155; p=0.694). Finally, odds ratio showed no increased chances of the presence of EIB in participants who presented low cardiorespiratory fitness (OR=1.130; CI: 0.616-2.073). We concluded that cardiorespiratory fitness and physical activity levels are not associated with the decrease of FEV1 and that there is no relation between the presence of EIB and the classification of cardiorespiratory fitness of adolescents.
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Rizzo JÂ, Rodrigues Filho EDA, Gonçalves AV, Albuquerque LCBDB, Albuquerque EMD, Albuquerque CGD, Almeida AHSD, Peixoto DM, Correia Junior MADV. Reproducibility of eucapnic voluntary hyperpnoea for exercise-induced bronchoconstriction diagnosis in asthmatic children and adolescents. Pediatr Allergy Immunol 2021; 32:1700-1708. [PMID: 34324737 DOI: 10.1111/pai.13610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/21/2021] [Accepted: 06/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Respiratory symptoms after exercise are frequently reported by asthmatic patients, and exercise-induced bronchoconstriction (EIB) is a frequent cause, which requires objective testing for diagnosis. Eucapnic voluntary hyperpnea (EVH) is recommended as a surrogate stimulus for this purpose. Its short-term reproducibility is not yet established in children and young adolescents with asthma. OBJECTIVE To evaluate the short-term test-retest agreement and reproducibility of FEV1 changes after EVH in this population. METHODS Asthmatic patients aged between 10 and 20 years underwent EVH for EIB diagnosis on two occasions 2-4 days apart at a specialized university clinic. FEV1 was measured at 5, 15, and 30 min after EVH with a target ventilation rate 21 times the baseline FEV1 . EIB was diagnosed as a decrease ≥10% in FEV1 from baseline. RESULTS A total of 26 of 62 recruited individuals tested positive for EIB on both visits (positive group) and 17 on one visit only (divergent group), while 19 tested negative on both visits (negative group). The overall agreement was 72.5% (95%CI 61.6%, 83.6%), and Cohen's kappa coefficient was 0.452. Low bias (0.87%) and high intra-class correlation coefficient (0.854, 95%CI 0.758,0.912; p < .001) for FEV1 response between test days were found, but with wide limits of agreement (±20.72%). There were no differences in pre-challenge FEV1 or achieved ventilation rate between visits either between groups (p = .097 and p = .461) or within groups (p = .828 and p = .780). There were no safety issues. CONCLUSIONS More than one EVH test should be performed in children and young adolescents with asthma to exclude EIB and minimize misdiagnosis and mistreatment.
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Affiliation(s)
- Jose Ângelo Rizzo
- Center for allergy and clinical immunology research and pulmonology department at Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil.,Infant and adolescent health post-graduation program, Universidade Federal de Pernambuco, Recife, Brazil
| | - Edil de Albuquerque Rodrigues Filho
- Center for allergy and clinical immunology research and pulmonology department at Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil.,Infant and adolescent health post-graduation program, Universidade Federal de Pernambuco, Recife, Brazil
| | - Adriana Velozo Gonçalves
- Center for allergy and clinical immunology research and pulmonology department at Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Laienne Carla Barbosa De Barros Albuquerque
- Center for allergy and clinical immunology research and pulmonology department at Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil.,Hebiatrics post-graduation program, Universidade de Pernambuco, Recife, Pernambuco, Brazil
| | - Eduardo Martins de Albuquerque
- Center for allergy and clinical immunology research and pulmonology department at Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil.,Hebiatrics post-graduation program, Universidade de Pernambuco, Recife, Pernambuco, Brazil
| | - Cláudio Gonçalves de Albuquerque
- Center for allergy and clinical immunology research and pulmonology department at Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil.,Infant and adolescent health post-graduation program, Universidade Federal de Pernambuco, Recife, Brazil
| | - Anderson Henrique Souza de Almeida
- Center for allergy and clinical immunology research and pulmonology department at Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Decio Medeiros Peixoto
- Center for allergy and clinical immunology research and pulmonology department at Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil.,Infant and adolescent health post-graduation program, Universidade Federal de Pernambuco, Recife, Brazil
| | - Marco Aurelio de Valois Correia Junior
- Center for allergy and clinical immunology research and pulmonology department at Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil.,Hebiatrics post-graduation program, Universidade de Pernambuco, Recife, Pernambuco, Brazil.,Physical Education post-graduation program, Universidade de Pernambuco, Recife, Pernambuco, Brazil
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Morales-Castillo M. Las creencias parentales en el proceso de crianza y sus relaciones con el comportamiento adolescente. PSICOLOGIA USP 2020. [DOI: 10.1590/0103-6564e190052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Las creencias parentales están integradas estructuralmente en la relación entre padres e hijos y pueden ser consideradas como contribuciones para comprender el desarrollo adolescente. El presente trabajo busca analizar los vínculos entre las creencias parentales y el comportamiento adolescente, para ello se desarrolló una revisión bibliográfica en seis bases de datos, que incluyó 53 estudios en donde se dimensiona la influencia de las creencias parentales en la crianza con adolescentes. En el análisis de datos, se destacaron como “creencias parentales” los siguientes conceptos: las creencias generales sobre los atributos y las experiencias humanas, las expectativas parentales, las percepciones sobre las capacidades de los hijos, los valores y metas parentales, la autoeficacia parental y las creencias sobre el control de las situaciones. Se concluye que las creencias parentales son afectadas por los atributos y las experiencias de los padres, lo que influye en un efecto de cascada sobre el comportamiento adolescente.
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Correia Junior MADV, Costa EC, Barros LCBD, Soares AA, Sarinho ESC, Rizzo JA, Sarinho SW. PHYSICAL ACTIVITY LEVEL IN ASTHMATIC ADOLESCENTS: CROSS-SECTIONAL POPULATION-BASED STUDY. ACTA ACUST UNITED AC 2019; 37:188-193. [PMID: 30624537 PMCID: PMC6651305 DOI: 10.1590/1984-0462/;2019;37;2;00002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 01/09/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess the level of physical activity in asthmatics in comparison with non-asthmatics in a population study. METHODS Cross-sectional study with 13 to 14-year-old adolescents who participated in the International Study of Asthma and Allergies in Childhood (ISAAC). The subjects were classified into three groups: individuals with active asthma, individuals diagnosed with asthma, and respiratory asymptomatic individuals. To evaluate the level of physical activity, the International Physical Activity Questionnaire (IPAQ-short version) was used. The analysis consisted of comparing individuals with active asthma, diagnosed as asthmatic and asymptomatic, with a significance level of 5%. RESULTS The participants were 1,591 adolescents, of which 791 (49.7%) were male. There were 222 (14.0%) individuals with active asthma and 284 (17.8%) asthma diagnoses; 55% of the population were physically active. Adolescents diagnosed with asthma were more active than their non-asthmatic peers (64.4 versus 53.3%; p=0.001). CONCLUSIONS Adolescents diagnosed with asthma were more physically active than their non-asthmatic peers.
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Correia Junior MADV, Costa EC, Sarinho SW, Rizzo JÂ, Sarinho ESC. Exercise-induced bronchospasm in a hot and dry region: study of asthmatic, rhinitistic and asymptomatic adolescents. Expert Rev Respir Med 2017; 11:1013-1019. [PMID: 28984485 DOI: 10.1080/17476348.2017.1389278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Exercise-induced bronchospasm (EIB) is the bronchial narrowing that occurs after intense exercise in a significant number of asthmatics and in some non-asthmatics. This study aims to evaluate the occurrence of EIB in adolescents with asthma, rhinitis and respiratory asymptomatics in a hot and dry climate. RESEARCH DESIGN AND METHODS This is a cross-sectional study based on an epidemiological study that evaluated the prevalence of asthma in schoolchildren in a semi-arid zone of Brazil. The EIB was defined as a reduction in forced expiratory volume in first second (FEV1) greater than 10%. RESULTS A total of 114 individuals participated in the study (36.8% male), of whom 54 were asymptomatic, 30 asthmatic and 30 with rhinitis. Asthmatics presented a higher proportion of EIB in comparison to rhinitis and asymptomatics (46.7% vs. 13.3% and 7.4%, p = 0.001) and none of the individuals had severe EIB (ΔFEV1 ≥ 50%). CONCLUSIONS A large proportion of the asthmatics selected from the community for the clinical study had EIB. Among participants with rhinitis, EIB was found in slightly more than 10%, while in the asymptomatics the frequency was slightly more than 5%. This study presents an important aspect in individuals living in hot and dry climates.
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Affiliation(s)
- Marco Aurélio de Valois Correia Junior
- a Postgraduate program in hebiatrics , Universidade de Pernambuco , Recife , Brazil.,b Postgraduate Program in Child and Adolescent Health , Universidade Federal de Pernambuco , Recife , Brazil.,c Postgraduate Program in Health Sciences , Universidade Federal de Pernambuco , Recife , Brazil.,d Center for Research in Allergy and Clinical Immunology, Clinics Department , Universidade Federal de Pernambuco , Recife , Brazil
| | - Emília Chagas Costa
- c Postgraduate Program in Health Sciences , Universidade Federal de Pernambuco , Recife , Brazil
| | - Silvia Wanick Sarinho
- b Postgraduate Program in Child and Adolescent Health , Universidade Federal de Pernambuco , Recife , Brazil
| | - José Ângelo Rizzo
- b Postgraduate Program in Child and Adolescent Health , Universidade Federal de Pernambuco , Recife , Brazil.,c Postgraduate Program in Health Sciences , Universidade Federal de Pernambuco , Recife , Brazil.,d Center for Research in Allergy and Clinical Immunology, Clinics Department , Universidade Federal de Pernambuco , Recife , Brazil
| | - Emanuel Sávio Cavalcanti Sarinho
- b Postgraduate Program in Child and Adolescent Health , Universidade Federal de Pernambuco , Recife , Brazil.,c Postgraduate Program in Health Sciences , Universidade Federal de Pernambuco , Recife , Brazil
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Westergren T, Berntsen S, Ludvigsen MS, Aagaard H, Hall EOC, Ommundsen Y, Uhrenfeldt L, Fegran L. Relationship between physical activity level and psychosocial and socioeconomic factors and issues in children and adolescents with asthma: a scoping review. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2017; 15:2182-2222. [PMID: 28800060 DOI: 10.11124/jbisrir-2016-003308] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Asthma is a heterogeneous chronic airway disease which may reduce capability for physical activity. In healthy peers, physical activity is influenced by psychosocial and socioeconomic factors. Knowledge about the role of these factors has not been mapped in children and adolescents with asthma. OBJECTIVE The main objective of this scoping review was to identify psychosocial and socioeconomic factors associated with physical activity level in children and adolescents with asthma in the literature. The specific objectives were to map the instruments used to measure these factors, report on the construction and validation of these instruments, map psychosocial and socioeconomic issues related to physical activity level reported in qualitative studies, and identify gaps in knowledge about the relationship between psychosocial and socioeconomic factors and physical activity level in children and adolescents with asthma. INCLUSION CRITERIA TYPES OF PARTICIPANTS Children and adolescents with asthma aged six to 18 years. CONCEPT Psychosocial and socioeconomic factors related to physical activity level and participation. CONTEXT All physical activity contexts. TYPES OF SOURCES Quantitative and qualitative primary studies in English, with no date limit. SEARCH STRATEGY The databases searched included nine major databases for health and sports science, and five databases for unpublished studies. After screening and identification of studies, the reference lists of all identified reports were searched, and forward citation searches were conducted using four databases. EXTRACTION OF THE RESULTS The following data were extracted: (a) relevant study characteristics and assessment of physical activity level, (b) instruments used to assess psychosocial and socioeconomic factors, (c) association between physical activity level and these factors, (d) construction and validation of instruments, and (e) psychosocial and socioeconomic issues related to physical activity participation. PRESENTATION OF THE RESULTS Twenty-one quantitative and 13 qualitative studies were included. In cross-sectional studies, enjoyment, physical self-concept, self-efficacy, attitudes and beliefs about physical activity and health, psychological distress, health-related quality of life, and social support were more often reported as being correlated with physical activity level. In three studies, the construct validity was assessed by factor analysis and construct reliability tests for the study population. Qualitative studies reported 10 issues related to physical activity participation, and capability and being like peers were most commonly reported. There was no direct evidence that qualitative research informed the development or adjustment of instruments in quantitative studies. CONCLUSIONS Seven psychosocial factors correlated with physical activity level; capability and being like peers were the most commonly reported issues. Reports of the construction and validation of instruments were sparse.
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Affiliation(s)
- Thomas Westergren
- 1Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway 2Clinical Research Unit, Randers Regional Hospital, Randers, Denmark 3Department of Clinical Medicine, Aarhus University, Aarhus, Denmark 4Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark 5Section of Nursing, Department of Public Health, Health, Aarhus University, Aarhus, Denmark 6Department of Coaching and Psychology, Norwegian School of Sports Science, Oslo, Norway 7Danish Centre of Systematic Reviews: a Joanna Briggs Institute Center of Excellence, The Center of Clinical Guidelines - Clearing house, Aalborg University, Aalborg, Denmark 8Faculty of Nursing and Health Sciences, Nord University, Bodo, Norway 9Department of Pediatrics, Sørlandet Hospital, Kristiansand, Norway
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Chateaubriand do Nascimento Silva Filho MJ, Gonçalves AV, Tavares Viana M, Peixoto DM, Cavalcanti Sarinho ES, Rizzo JÂ. Exercise-induced bronchoconstriction diagnosis in asthmatic children: comparison of treadmill running and eucapnic voluntary hyperventilation challenges. Ann Allergy Asthma Immunol 2015; 115:277-81. [PMID: 26238422 DOI: 10.1016/j.anai.2015.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 07/02/2015] [Accepted: 07/12/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Exercise-induced bronchoconstriction (EIB) occurs in up to 90% of young people with asthma and can be diagnosed using serial measurements of forced expiratory volume in 1 second (FEV1) after standardized exercise, usually treadmill running (TR). Eucapnic voluntary hyperventilation (EVH) is a guideline-recommended alternative challenge for EIB diagnosis. The 2 methods have not been compared for EIB diagnosis in this population. OBJECTIVE To compare 2 methods of EIB diagnosis in children and adolescents with asthma. METHODS Thirty-four children 8 to 18 years of age attending the allergy clinic of the Hospital das Clínicas (Recife, Brazil) from September through December 2013 were examined. All underwent a basal FEV1 determination followed by TR for 8 minutes or EVH for 6 minutes on consecutive days. The first challenge was chosen at random. Serial FEV1 determinations were obtained at 3, 5, 7, 10, 15, and 30 minutes after the challenge and the test result was considered positive if at least 2 consecutive FEV1 measurements decreased at least 10% below the basal value. RESULTS Thirteen patients responded to the 2 challenges, 6 only after TR and 4 exclusively after EVH (agreement 71%, κ = 0.41). The 95% limits of agreement of FEV1 decreasing after the challenges were widely spread (mean 0.1%, limits 19.8% to -19.6%). CONCLUSION The 2 tests cannot be used interchangeably and the reproducibility of the FEV1 response to the EVH challenge has to be properly evaluated to better understand its role in EIB diagnosis.
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Affiliation(s)
| | - Adriana Velozo Gonçalves
- Health Sciences Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Marcelo Tavares Viana
- Health Sciences Postgraduate Course, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Décio Medeiros Peixoto
- Departments of Pediatrics and Allergy, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | | | - José Ângelo Rizzo
- Departments of Pneumology and Allergy, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
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Dantas FMNA, Correia MAV, Silva AR, Peixoto DM, Sarinho ESC, Rizzo JA. Mothers impose physical activity restrictions on their asthmatic children and adolescents: an analytical cross-sectional study. BMC Public Health 2014; 14:287. [PMID: 24673939 PMCID: PMC4230244 DOI: 10.1186/1471-2458-14-287] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 03/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Physical activities are important for children and adolescents, especially asthmatics. A significant proportion is considered less active than their non-asthmatic peers and mother's beliefs about asthma are thought to be a determinant factor.The research objectives were to investigate whether mothers try to impose limitations on the physical activity (PA) of their asthmatic children/adolescents; identify associated factors; and explore if this attitude has any impact on children's PA levels. METHODS In this cross sectional investigation, we studied 115 asthmatics aged between 9 and 19 years and their mothers. Asthma severity, PA level and exercise induced bronchospasm (EIB) were evaluated. Mothers were questioned on their beliefs about physical activity in non-asthmatic and asthmatic children, if they imposed restrictions on their children's physical activity, on EIB perception and personal levels of anxiety and depression. RESULTS Ninety six percent of the mothers answered that PA are important for children and adolescents. Despite this, 37% of them admitted imposing restrictions to their children's PA. This attitude was associated with mother's negative opinions about asthmatics doing PA, perception of children's dyspnea after running on a treadmill, mother's anxiety level and children's asthma severity. The mother's restrictive attitudes were not associated with children's lower PA levels. CONCLUSION A high proportion of the mothers said that they restrained their asthmatic children from engaging in physical activity. This fact should be recognized by health professionals and discussed with parents and caregivers as these negative beliefs may lead to conflicts and prejudiced attitudes that could discourage children's involvement in physical activities and sports.
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Affiliation(s)
| | | | | | | | | | - José A Rizzo
- Center for Research in Allergy and Clinical Immunology, Clinical Medicine Department - Pneumology, Universidade Federal de Pernambuco, Recife, Brazil.
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