Capacidade de exercício em crianças e adolescentes com asma: estudo Coorte

Abstract

Children and adolescents with asthma have exercise intolerance, but little is known about the evolution of exercise capacity over time. Objective: to evaluate the exercise capacity in children and adolescents with asthma and quality of life over 12 months, and to verify the factors that influence it. Methods: A prospective cohort study with 59 volunteers between 6 and 18 years old with asthma, in regular clinical follow-up. Exercise capacity was assessed by the Cardiopulmonary Exercise Test (CPET), Modified Shuttle Test (MST). The sedentary behaviour was measured by the accelerometer and quality of life by specific questionnaire (PAQLQ). Volunteers were asked about hospitalizations and crises. These evaluations were performed at the beginning of the protocol (baseline) and after 12 months (follow-up). Outcomes: oxygen consumption (VO2peak) and load in CPET, distance walked in MST, quality of life, sedentary behaviour and number of crises. Results: The mean age at baseline was 10.5 ± 3.1 years old. After 12 months there was an increase in exercise capacity observed by the increase in load in the TECP from 81.1 ± to 37.6 Watts at baseline to 92.2 ± 39.6 Watts in follow-up, p < 0.0001, although there was a reduction in VO2peak baseline 40.1 ± 12.5 ml/kg vs follow-up 34.9 ± 7.3ml/kg, p = 0.023. The distance walked in the MST increased from 797 ± 186 m at baseline to 871 ± 198 m in follow-up, p < 0.001. There was an important increase in sedentary behaviour between baseline (51.9 ± 13.4%) and follow-up (82.9 ± 7.6%), p < 0.001. There were no changes in the number of crises and the number of hospitalizations. There was an improvement in quality of life in the symptoms and activities domains (p < 0.05). In logistic regression, the sedentary time was associated with the load in the CPET and the distance walked in the MST in the follow-up (R2: 0.38, p = 0.004). Conclusions: Over 12 months, children and adolescents with asthma did not present a reduction in functional capacity and exercise capacity, improving quality of life, however, they significantly increased the sedentary lifestyle. The increase in sedentary time, or the reduction in the number of steps, was related to exercise capacity.