Asthmatic Children Sidelined by Exercise-Related Respiratory Symptoms

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.

SAN FRANCISCO – Coughing, shortness of breath, and other exercise-related respiratory symptoms substantially limit the ability of children with asthma to participate in normal physical activities.

In addition, many asthmatic children who experience such symptoms are not using short-acting bronchodilators as recommended in national guidelines.

Those are key findings from a national survey of parents that set out to evaluate the impact of exercise-related respiratory symptoms on physical activities of children with asthma.

"Kids with asthma need to be active to be healthy," Dr. Nancy K. Ostrom said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "A lot of them have exercise-induced bronchospasm that needs to be recognized and treated. This is a critical issue for health in the United States right now. If you can’t be physically active, you are not going to be able to be fit."

The telephone survey included 516 parents of children or adolescents with current asthma contacted between Dec. 8, 2009, and Jan. 3, 2010, said Dr. Ostrom, codirector of the San Diego–based Allergy and Asthma Medical Group and Research Center. The study by Dr. Ostrom and her colleagues, known as the EIB Landmark Survey, consisted of 84 questions structured to provide data on demographics, symptoms experienced, and impact of exercise-induced bronchospasm (EIB) on daily function.

More than three-quarters of parents of children with asthma (79%) reported that their child experienced at least one exercise-related respiratory symptom, and nearly half (46%) reported that their child experienced four or more such symptoms. The three most common symptoms were coughing (62%), shortness of breath (61%), and wheezing (53%).

Adolescents were more likely than younger children to avoid activities because of exercise-related respiratory symptoms (32% vs. 22%, respectively). At the same time, parents of children aged 4-12 years reported that asthma limited their child’s ability to participate either "a lot" or "some" in sports/recreation (30%), normal physical exertion (21%), and other outdoor activities (26%). The corresponding figures for adolescents were 21%, 24%, and 54%, respectively.

"That’s a huge number of kids with potential impact," Dr. Ostrom commented. "You tend to learn exercise habits when you’re a child, not when you’re an adult."

Adolescents were also more likely to be limited "a lot" in sports competition, compared with younger children (13% vs. 7%, respectively).

Use of bronchodilators such as albuterol before exercise was infrequent. Only 23% of children and adolescents with asthma took bronchodilators "always" or "most of the time," 19% took them "sometimes," 15% took them rarely, and 42% never took them (1% was unknown).

In their poster, the researchers stated that adherence to controller therapy and prevention of exercise-related symptoms with short-acting bronchodilators "should be optimized per current treatment guidelines." One way to achieve that goal, Dr. Ostrom said, is to ask parents and asthmatic children during office visits if they ever experience shortness of breath, coughing, or other respiratory symptoms during or shortly after physical activity. "The important question is, ‘Does that keep you from what you want to do or what you should be doing from a health standpoint?’ " she said. "Exercise is critical. These health habits need to begin in childhood."

Dr. Ostrom acknowledged certain limitations of the study, including the fact that it surveyed parents, not the children directly.

The study was sponsored by Teva Respiratory. Dr. Ostrom disclosed that she has served in one or more capacities as a consultant, clinical investigator, or speaker for multiple companies, including Teva, GlaxoSmithKline, and Merck.