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IMHE Rome Dec 2009
‘Predicted Aerobic Capacity of
Asthmatic Children,
derived from Clinical Studies’
PhD. Fellow Lene Lochte
Background
Asthma or asthma symptoms among 20% of youth populations
Rasmussen F et al. Eur Resp J 2000;16:866-70Nystad W et al. Respir Med 2001;95:806-10
Associations cardio respiratory fitness and
physical activity Andersen LB. J Sports Med Phys Fitness 1994;34:390-7Kemper HCG et al. Eur J Appl Physiol 2001;84:395-402
Worldwide 50% of
children/adolescents physically
inactive with low fitnesshttp://www.euro.who.int/Document/e82923.
BMI
Physical
Activity
Lung
function
Symptomsof
asthma
Previous /or current asthma
Maturity
Hypotheses
Asthmatic children would demonstrate different Aerobic Capacity than controls
• at baseline
• over time
Objectives
Compare longitudinally the
Aerobic Capacity of asthmatic children
against that of controls
Provide data for health promotion of
asthmatic youth
Aerobic Capacity (AC)
----------------------------- ---------------------------
-1st 0 2nd 1st 4th 10th week base week month month month
line
⌂ ∆
Time Scale
⌂ Practice
Submaximal exercise
∆ EIA
Methods
•Aerobic Capacity Test
• EIA Test
• Questionnaire
Anova, P<0.05
Method
Photo with kind permission
Constant treadmill running
Submax test
5 - 6 min
Steroids allowedB
HR monitored →
AC predicted by equation
B -2-Agonist withheld
Study Participants
Asthma Control
Sex, n of ♂/♀ 17/11 16/11
Age (years)a 10.1(2.5) 9.8 (2.7)
BMI (kg/m2)a 18.6 (3.7) * 17.3 (2.2)
FEV1 (mL) 2.2 (0.8) 2.3 (1.0)
a Mean (±SD) * P<0.05
Results
T0 T1 T4 T100
10
20
30
40
50
60
70
80Aerobic
Capacity
Asthma Controls
T0: baseline; T1: 1st month; T4: 4th month; T10: 10th month
¶
¶ Mean ±SE
* P<0.01
{-------------------P<0.0001-------------------------}
*
Aerobic Capacity by Physical Activity (hours/week) at 4th month
2 3 4 5 6
Physical Activity
0
20
40
60
80
100Aerobic Capacity
Asthma
Controls
P<0.01 (effect of group and PA)
R2=0.3040
’Ever Asthma’ & ’Current Asthma’
’Ever’
Yes 78 (21) 27 (4)
No 22 (6) 73 (11)
’Current’
Yes 68 (15) 0 (0)
No 32 (7) 100 (22)
Asthma Control
% (n)
Respiratory Symptoms by
Physical Activity
• Reported by 86 % of asthmatics
4 % reported daily symptoms
of which 46 % associated allergic reactions
such as eczema
7 % previous allergy test
14 % family predisposition
FEV1 by EIA Test
* n.s.
* P<0.01
0
50
100
150 FEV1 (%)
*
Pre Post Pre Post
Asthma Control
FEV1 Reduction
3.81 (1.47 to 6.16)
1.33 (-1.11 to 3.77)mean% (CI)
Public Health Problem
• Asthmatic children experience respiratory symptoms
by physical activity
EIA frequently manifest untreated asthma
• Physical fitness reduction
Impaired ‘Quality of life’
Public Health Perspective
Volume of problem?
Can it be prevented?
Public Health Implications
AR% & PAR%
• Quantify relations of determinant - outcome
• Assumption of causal associations
AR % = 46 %
Avoidable proportion of reduced
aerobic capacity
if the asthmatic children increased
physical activity ≥ 2 hours per week
PAR % = 15 %
Influence of
low physical activity level on
aerobic capacity in
asthmatic youth populations aged 7 - 15 years
Message
Paper submitted to Annals of Respiratory Medicine [AoRM]
Oct. 2009
Asthmatic youth be encouraged to
physical activity
Data suggest the monitoring of both
lung function & aerobic capacity
Current / Future Studies
Associations of Asthma Development with
Low Levels of Physical Activity (PA) in Childhood
-
A Longitudinal Paediatric Population Health Study
of Epidemiological (asthma, ALSPAC*) and
Biomonitoring (PA, subgroup of ALSPAC*) data
* The Avon Longitudinal Study of Parents and Children
http://www.bristol.ac.uk/alspac
Research Grants
Danish Lung Association
Danish Health Insurance Foundation
Danish Physical Therapy Organisation
Danish Asthma & Allergy Research Fund
Thanks
ISS & Delegates
for your kind attention
Lene Lochte
L.Lochte@bristol.ac.uk
Courtesy to child & parents, Copenhagen, DK
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