Physical activity, lung function, and sleep outcomes in urban children with asthma
Corresponding Author
Kate E. Powers DO
Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, USA
Bradley/Hasbro Children's Research Center, Providence, Rhode Island, USA
The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Correspondence Kate E. Powers, DO, Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, 593 Eddy St., Providence, RI 02903, USA.
Email: [email protected]
Search for more papers by this authorElissa Jelalian PhD
Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, USA
Bradley/Hasbro Children's Research Center, Providence, Rhode Island, USA
The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Search for more papers by this authorShira Dunsiger PhD
Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island, USA
Search for more papers by this authorMichael Farrow MA
Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, USA
Search for more papers by this authorLuis G. Miranda BS
Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, USA
Search for more papers by this authorPatricia Mitchell MS
Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, USA
Bradley/Hasbro Children's Research Center, Providence, Rhode Island, USA
Search for more papers by this authorSheryl Kopel MSc
Bradley/Hasbro Children's Research Center, Providence, Rhode Island, USA
The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Search for more papers by this authorDaphne Koinis-Mitchell PhD
Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, USA
Bradley/Hasbro Children's Research Center, Providence, Rhode Island, USA
The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Search for more papers by this authorCorresponding Author
Kate E. Powers DO
Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, USA
Bradley/Hasbro Children's Research Center, Providence, Rhode Island, USA
The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Correspondence Kate E. Powers, DO, Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, 593 Eddy St., Providence, RI 02903, USA.
Email: [email protected]
Search for more papers by this authorElissa Jelalian PhD
Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, USA
Bradley/Hasbro Children's Research Center, Providence, Rhode Island, USA
The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Search for more papers by this authorShira Dunsiger PhD
Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island, USA
Search for more papers by this authorMichael Farrow MA
Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, USA
Search for more papers by this authorLuis G. Miranda BS
Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, USA
Search for more papers by this authorPatricia Mitchell MS
Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, USA
Bradley/Hasbro Children's Research Center, Providence, Rhode Island, USA
Search for more papers by this authorSheryl Kopel MSc
Bradley/Hasbro Children's Research Center, Providence, Rhode Island, USA
The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Search for more papers by this authorDaphne Koinis-Mitchell PhD
Division of Pediatric Pulmonology, Hasbro Children's Hospital/Rhode Island Hospital, Providence, Rhode Island, USA
Bradley/Hasbro Children's Research Center, Providence, Rhode Island, USA
The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
Search for more papers by this authorAbstract
Objectives
To examine (1) whether daily declines in physical activity (PA) level and/or in lung function (FEV1) predict an asthma exacerbation in a sample of urban children with asthma, and (2) the association between number of sleep awakenings and decline in daytime PA in this group.
Methods
In this sample of urban children aged 7–9 years with persistent asthma (N = 147), objective methods assessing lung function via a handheld spirometer and moderate-to-vigorous physical activity (MVPA) via accelerometry were measured over a 4-week period during the fall and early winter of each year as part of a larger 5-year study.
Results
In the entire sample, a significant association between PA and lung function was noted such that a greater decline in daily MVPA was associated with lower odds of exacerbation. Ethnic group differences showed that this association was also significant only among Latino children (odds ratio [OR] = 0.98; 95% confidence interval [CI]:0.97–0.99). A greater number of sleep awakenings were associated with greater declines in daily MVPA among Latinos only (p = .05).
Conclusions
Results suggest that declining MVPA may contribute to lower risk for an exacerbation. Reasons for declining MVPA need to be further explored in this group. Children with asthma may avoid or be fearful of engaging in PA or may face early symptoms which influence patterns of PA, and this may minimize risk for an exacerbation. Results also suggest reasons for night-time disruptions may need to be targeted in further research or interventions as they can contribute to PA avoidance in this high-risk group.
CONFLICT OF INTERESTS
The authors declare that there are no conflict of interests.
REFERENCES
- 1 Akinbami L, Moorman J, Liu X. Asthma prevalence, health care use, and mortality: United States, 2005-2009. Natl Health Stat Report. 2011; 32: 1-15.
- 2
Kattan M, Mitchell H, Eggleston P, et al. Characteristics of inner-city children with asthma: The National Cooperative Inner-City Asthma Study. Pediatr Pulmonol. 1997; 24(4): 253-262.
10.1002/(SICI)1099-0496(199710)24:4<253::AID-PPUL4>3.0.CO;2-L CAS PubMed Web of Science® Google Scholar
- 3 Koinis-Mitchell D, McQuaid EL, Seifer R, et al. Multiple urban and asthma-related risks and their association with asthma morbidity in children. J Pediatr Psychol. 2007; 32(5): 582-595.
- 4 Canino G, Koinis-Mitchell D, Ortega AN, McQuaid EL, Fritz GK, Alegria M. Asthma disparities in the prevalence, morbidity, and treatment of Latino children. Soc Sci Med. 2006; 63(11): 2926-2937.
- 5 Glazebrook C, McPherson AC, Macdonald IA, et al. Asthma as a barrier to children's physical activity: implications for body mass index and mental health. Pediatrics. 2006; 118(6): 2443-2449.
- 6 Lang DM, Butz AM, Duggan AK, Serwint JR. Physical activity in urban school-aged children with asthma. Pediatrics. 2004; 113(4): e341-e346.
- 7 Lu KD, Manoukian K, Radom-Aizik S, Cooper DM, Galant SP. Obesity, asthma, and exercise in child and adolescent Health. Pediatr Exerc Sci. 2016; 28(2): 264-274.
- 8 Akinbami LJ, Simon AE, Rossen LM. Changing trends in asthma prevalence among children. Pediatrics. 2016; 137(1):e20152354.
- 9 Apovian CM. Obesity: definition, comorbidities, caues, and burden. Am J Manag Care. 2016; 22(7 Suppl): s176-s185.
- 10 Anderson SE, Economos CD, Must A. Active play and screen time in US children aged 4 to 11 years in relation to sociodemographic and weight status characteristics: a nationally representative cross-sectional analysis. BMC Public Health. 2008; 8: 366.
- 11 National Heart Lung and Blood Institute. Guidelines for the Diagnosis and Management of Asthma (EPR-3). Bethesda, MD: National Institutes of Health; 2007.
- 12 Eisenberg SR, Jelalian E, Farrow M, et al. Perceptions of asthma and exercise, and associations with weight status and asthma morbidity in urban children. Acad Pediatr. 2020; 20(1): 55-62.
- 13 Piercy KL, Troiano RP, Ballard RM, et al. The physical activity guidelines for Americans. JAMA. 2018; 320(19): 2020-2028.
- 14 Centers for Disease Control and Prevention (US). Fact Sheet for Health Professionals on Physical Activity Guidelines for Children and Adolescents. Washington, DC: U.S. Department of Health and Human Services; 2008.
- 15 American Academy of Pediatrics. Committee on Public Education. American Academy of Pediatrics: children, adolescents, and television. Pediatrics. 2001; 107(2): 423-426.
- 16 Holderness H, Chin N, Ossip DJ, Fagnano M, Reznik M, Halterman JS. Physical activity, restrictions in activity, and body mass index among urban children with persistent asthma. Ann Allergy Asthma Immunol. 2017; 118(4): 433-438.
- 17 Nnodum BN, McCormack MC, Putcha N, et al. Impact of physical activity on reporting of childhood asthma symptoms. Lung. 2017; 195(6): 693-698.
- 18 Randolph C. Pediatric exercise-induced bronchoconstriction: contemporary developments in epidemiology, pathogenesis, presentation, diagnosis, and therapy. Curr Allergy Asthma Rep. 2013; 13(6): 662-671.
- 19 Mitchell EA, Beasley R, Bjorksten B, et al. The association between BMI, vigorous physical activity and television viewing and the risk of symptoms of asthma, rhinoconjunctivitis and eczema in children and adolescents: ISAAC Phase Three. Clin Exp Allergy. 2013; 43(1): 73-84.
- 20 Nystad W, Nafstad P, Harris JR. Physical activity affects the prevalence of reported wheeze. Eur J Epidemiol. 2001; 17(3): 209-212.
- 21 Kosti RI, Priftis KN, Anthracopoulos MB, et al. The association between leisure-time physical activities and asthma symptoms among 10- to 12-year-old children: the effect of living environment in the PANACEA study. J Asthma. 2012; 49(4): 342-348.
- 22 Lochte L, Nielsen KG, Petersen PE, Platts-Mills TA. Childhood asthma and physical activity: a systematic review with meta-analysis and Graphic Appraisal Tool for Epidemiology assessment. BMC Pediatr. 2016; 16: 50.
- 23 Matsumoto I, Araki H, Tsuda K, et al. Effects of swimming training on aerobic capacity and exercise induced bronchoconstriction in children with bronchial asthma. Thorax. 1999; 54(3): 196-201.
- 24 Santuz P, Baraldi E, Filippone M, Zacchello F. Exercise performance in children with asthma: is it different from that of healthy controls? Eur Respir J. 1997; 10(6): 1254-1260.
- 25 Counil FP, Varray A, Matecki S, et al. Training of aerobic and anaerobic fitness in children with asthma. J Pediatr. 2003; 142(2): 179-184.
- 26 Boergers J, Koinis-Mitchell D. Sleep and culture in children with medical conditions. J Pediatr Psychol. 2010; 35(9): 915-926.
- 27 Koinis-Mitchell D, Boergers J, Kopel SJ, McQuaid EL, Farrow ML, LeBourgeois M. Racial and ethnic disparities in sleep outcomes among urban children with and without asthma. Sleep Health. 2019; 5(6): 532-538.
- 28 Koinis-Mitchell D, Kopel SJ, Seifer R, et al. Asthma-related lung function, sleep quality, and sleep duration in urban children. Sleep Health. 2017; 3(3): 148-156.
- 29 Koinis-Mitchell D, Kopel SJ, Boergers J, et al. Good sleep health in urban children with asthma: a risk and resilience approach. J Pediatr Psychol. 2015; 40(9): 888-903.
- 30 Horner CC, Mauger D, Strunk RC, et al. Most nocturnal asthma symptoms occur outside of exacerbations and associate with morbidity. J Allergy Clin Immunol. 2011; 128(5): 977-82.
- 31 Beebe DW. Cognitive, behavioral, and functional consequences of inadequate sleep in children and adolescents. Pediatr Clin North Am. 2011; 58(3): 649-665.
- 32 Saunders TJ, Gray CE, Poitras VJ, et al. Combinations of physical activity, sedentary behaviour and sleep: relationships with health indicators in school-aged children and youth. Appl Physiol Nutr Metab. 2016; 41(6 Suppl 3): S283-S293.
- 33 Fritz GK, McQuaid EL, Kopel SJ, et al. Ethnic differences in perception of lung function: a factor in pediatric asthma disparities? Am J Respir Crit Care Med. 2010; 182(1): 12-18.
- 34 Evenson KR, Catellier DJ, Gill K, Ondrak KS, McMurray RG. Calibration of two objective measures of physical activity for children. J Sports Sci. 2008; 26(14): 1557-1565.
- 35 Ward DS, Evenson KR, Vaughn A, Rodgers AB, Troiano RP. Accelerometer use in physical activity: best practices and research recommendations. Med Sci Sports Exerc. 2005; 37(11 Suppl): S582-S588.
- 36 Trost SG, Loprinzi PD, Moore R, Pfeiffer KA. Comparison of accelerometer cut points for predicting activity intensity in youth. Med Sci Sports Exerc. 2011; 43(7): 1360-1368.
- 37 Meltzer LJ, Walsh CM, Traylor J, Westin AM. Direct comparison of two new actigraphs and polysomnography in children and adolescents. Sleep. 2012; 35(1): 159-166.
- 38 Acebo C, Sadeh A, Seifer R, Tzischinsky O, Hafer A, Carskadon MA. Sleep/wake patterns derived from activity monitoring and maternal report for healthy 1- to 5-year-old children. Sleep. 2005; 28(12): 1568-1577.
- 39 Hughes D. Childhood asthma and exercise. Paediatr Child Health. 2014; 19(9): 467-468.
- 40 Sanz-Santiago V, Diez-Vega I, Santana-Sosa E, et al. Effect of a combined exercise program on physical fitness, lung function, and quality of life in patients with controlled asthma and exercise symptoms: a randomized controlled trial. Pediatr Pulmonol. 2020; 55(7): 1608-1616.
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