Research On The Role Of Exercise In Child Asthma's Combat And Management

PART 1 A CROSS-SECTIONAL SURVEY OF PARTICIPATION OF ASTHMATIC CHILDREN IN PHYSICAL ACTIVITYObjective:In a long time, as restricted by the worry of exercise may be induce asthma, there are different opinion on physical activity in children with asthma. But asthmatic children can exercising as normal child is not only an indicator of asthma control but also an important part of asthma's non-drug treatment in GINA. The aims of our study were to ascertain the current status of children with asthma taking part in exercise in China and providing a basis for prescribe appropriate exercise prescription for children with asthma.Methods:A cross-sectional investigation was performed as send a questionnaire to asthmatic children over 7 years who visited our asthma control center during Sep. 2008 to Dec. 2008. The questionnaire has mainly the following aspects: (1) General demographic information; (2)The current position of physical activity and the idea about the relation between asthma and exercise i n asthmatic children.; (3)Parents and teachers'attitude toward asthmatic children take part in sports and whether they had restricted children go in for exercise; (4) Doctors'attitude toward asthmatic children attending exercise and whether they had directed the children about how to exercise; (5)The possible clinical manifestations which should appear when children with asthma take part in sports.Results:355 asthmatic children completed the questionnaire. After statistic all data, we found that 54.6%( 19 4/355) children thought that sports could make their asthma worse ; 57.5%( 204/355 )parents worried about their children join in sports ; For all of the 355 cases , 222 children's teachers had a knowledge of t heir asthma , and 61.7%( 137/222) teachers worried about the children with asthma take part in sports; there were 45.4% ( 161/355) doctors never give advice to patients about exercise in addition. The workout of 65.6%( 223/355) children never reached the criterion of exercise prescription for patients with asthma advised by American. The percent of children who ever had cough, chest distress, dyspnea or gasp during exercise was 77.7 % (276/355, but 56.0% (199/ 355 ) appear these symptoms occasionally. Conclusion:1. Most of asthmatic children in Chongqing did not reach the activity level that The American College of Sports Medicine recommends for patients with asthma.2. The perception of asthmatic children, parents, teachers and doctors about children with asthma participating in physical activity appears cautious.3. It is relatively safe for asthmatic children to take part in physical activity.PART 2 RESEARCH ON THE ROLE OF EXERCISE IN CHILD ASTHMA'S COMBAT AND MANAGEMENTObjective:Physical activity is advantageous to young children for their growth and development. For asthmatic children, they can exercising as normal child is an indicator of asthma control in GINA. In our suvey, children with asthma in china generally did not exercise enough. We need to prescribe appropriate exercise for children with asthma. The goal of this study was to ascertain the influence of exercise on asthmatic children and providing a Preparatory exercise prescription for children with asthma.Methods:All the 99 subjects had been made a definite diagnosis as childhood asthma. They were randomly divided into control group (50 subjects, treated only with medications). And exercise group (49 subjects, treated only with medications and gave them exercise Prescription simultaneously). Basic principles of exercise Prescription for asthmatic children: mode: selected according to children interest and condition; intensity: at limits as tolerated by symptoms such as coughing and chest distress; frequency: no less than 3 days a week; duration: no less than 20 minutes of continuous activity; opportunity: when their PEF≥80% of their best value. Observation items: pulmonary function,PEF variation,The pediatric asthma quality-of-life, symptoms score in day and night, and medications score. Observation methods: before and after our experiment , we use the pediatric asthma quality of life questionnaire to assess the quality-of-life and MasterScope children's spirometry was used for the pulmonary function assessment (index: the percentage of FVC, FEVl, PEF, FEF25, FEF 50, FEF 75 account for predicted value). During our experiment, asthma diary was used for the medications and symptoms scores and PEFam and PEFpm of everyday. PEF variation=∣(PEFam—PEFpm)/(PEFam+ PEFpm)∣×2×100%。Results:Before experiment, there were no significant differences between the two groups in all the outcome measures. After 4 months of experiment, percent of predicted PEF in exercise group was significantly higher than that in control group (P<0.05), but there were no obvious differences in percent of predicted FVC, FEVl, FEF25, FEF50, FEF 75 between the two groups. From 13th week, PEF variation in exercise group significantly lower that that in control group (P<0.05). After experiment, the scores both in total and for every single aspect of quality of life in exercise group are significantly higher than that in control group (P<0.05). After 4 months of experiment,symptoms score in day and night, and medications score are all significantly lower in exercise group than that in control group(all P<0.05). In the experiment, children in exercise group had took part in physical activity for 3406 person-trips, 19 children had 152 person-trips of the appearance of exercise-induced asthma symptoms (129 only slight cough appeared; 19 had heavier cough and had chest distress; 4 had cough, chest distress and slight gasping), the incidence rate was 4.46%。All the symptoms improved after stop exercising immediately, inhaled salbutamol and had a rest. No child needed to go to the emergency room when symptoms appeared during physical activity.Conclusion:4 months of exercise that no less than 3 days a week and no less than 20 minutes of continuous is benefit for asthmatic children'asthma management and is safe:1. Help significantly improve asthmatic children'PEF.2. Help significantly improve asthmatic children'PEF variation.3. Help significantly improve asthmatic children's quality of life.4. Help significantly reduce asthmatic children's symptoms.5. Help significantly reduce asthmatic children's medication use.6. It is safe for asthmatic children who were managed appropriately to take part in physical activity.