Association between regular exercise and asthma control among adults: The population-based Northern Finnish Asthma Study

Jaakkola, Maritta S.; Aalto, Sirpa; Hyrkäs-Palmu, Henna; Jaakkola, Jouni J. K.

doi:10.1371/journal.pone.0227983

Cited by 13 publications

(7 citation statements)

References 15 publications

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“…The cardiopulmonary fitness level is correlated with the ACQ 6 score, indicating that those with uncontrolled asthma had the lowest level of fitness score and probably also the lowest level of activity. These findings confirm that exercise training is associated with better asthma control, which is supported by former research in the field [ 4 , 5 , 15 , 17 , 35 , 36 ].…”

Section: Discussionsupporting

confidence: 89%

“…Another more recent review including 11 studies and 543 adult participants with asthma found a significant improvement in FEV1 induced by exercise training [ 4 ]. Exercise-induced bronchospasm (EIB) has long been thought to be part of the explanation of the lower level of PA among patients with asthma [ 16 ], but two systemic reviews suggest that exercise training in patients with stable asthma would not cause EIB limitations [ 15 , 17 ]⁠.…”

Section: Introductionmentioning

confidence: 99%

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Physical activity, physical capacity and sedentary behavior among asthma patients

Hansen

Henriksen

Dall

et al. 2022

European Clinical Respiratory Journal

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BACKGROUND : Although exercise and daily physical activity (PA) have long been known to benefit patients with chronic disorders, knowledge is limited regarding asthma. OBJECTIVE : In a Danish setting, our aim was to measure physical activity, sedentary behavior, and physical capacity among patients with asthma. We hypothesized that people with severe asthma would be less active and more sedentary than their mild-moderate counterparts. METHODS : Adults with asthma were recruited through respiratory outpatient clinics and subsequently examined twice, 4 weeks apart. At each visit, participants underwent a series of lung function tests, questionnaires, and maximum oxygen uptake testing (VO 2 max). Between the visits, participants wore an accelerometer continuously for 4 weeks, measuring sedentary time and daily steps. Sixty patients, 27 with mild-moderate asthma (GINA 1–3) and 33 with severe asthma (GINA 4–5), completed both visits and had valid accelerometer measurements. RESULTS : No significant differences between the two groups were found in sedentary time, number of steps or VO 2 max. VO 2 max was significantly correlated with FeNO (r = −0.30, p < 0.05), Short Form-12 Mental Health (r = 0.37, p < 0.05), Asthma Control Questionnaire (r = −0.35, p < 0.05), and Mini Asthma Quality of Life Questionnaire (r = 0.36, p < 0.05). CONCLUSION : No differences were observed between patients with mild-moderate and severe asthma regarding sedentary behavior, daily steps or level of cardiopulmonary fitness. Furthermore, patients with the highest VO 2 max had the higher quality of life scores. Abbreviations : VO 2 max: Maximal Oxygen Uptake; CPET: Cardiopulmonary Exercise Testing; BMI: Body Mass Index; FEV1: Forced Expired Volume in the First Second; FVC: Forced Vital Capacity; PEF: Peak Expiratory Flow; EIB: Exercise-Induced Bronchoconstriction; COPD: Chronic Obstructive Pulmonary Disease; ACQ: Asthma Control Questionnaire; Mini-AQLQ: Mini Asthma Quality of Life Questionnaire; SF-12: Short Form 12 Health Survey; SNOT-22: Sino-Nasal Outcome Test 22; GINA: The Global Initiative for Asthma; CRP: C-reactive Protein; Hgb:Hemoglobin count; EOS: Eosinophil count; EVH: Eucapnic Voluntary Hyperventilation; FeNO: Fractional Exhaled Nitric Oxide; PA: Physical Activity ERS: European Respiratory Society; ATS: American Thoracic Society; CRS: Chronic Rhinosinusitis; AHR: Airway Hyperresponsiveness

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Physical activity, physical capacity and sedentary behavior among asthma patients

Hansen

Henriksen

Dall

et al. 2022

European Clinical Respiratory Journal

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“…Although benefits of exercise training for asthma control have already been described for children (34), we were not able to find studies comparing exercise capacity between children with controlled or uncontrolled STRA. An association of exercise and control of asthma has already been demonstrated in a large population-based study in adults (35). In addition, in children, a recent study has shown that asthmatic patients with uncontrolled asthma achieved a decreased distance in the 6-min walk test when compared to controlled subjects, although no information on disease severity of patients was provided (36).…”

Section: Discussionmentioning

confidence: 98%

“…It seems possible that shorter temporal exposure to the disease, impaired airway remodeling, and use of modern pharmacotherapy may help explain these findings in pediatric samples (37)(38)(39)(40)(41). In asthmatic patients, pulmonary function impairment appears to become more relevant in early adulthood, which may be associated with an excessively labile bronchomotor tone in children with STRA, thereby explaining the few spirometric changes even in the presence of frequent symptoms (35).…”

Section: Discussionmentioning

confidence: 99%

Determinants of exercise capacity in children and adolescents with severe therapy-resistant asthma

et al. 2020

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Objective: To evaluate the exercise capacity of children and adolescents with severe therapy resistant asthma (STRA) aiming to identify its main determinants. Methods: Cross-sectional study including individuals aged 6-18 years with a diagnosis of STRA. Clinical (age and gender), anthropometric (weight, height and body mass index) and disease control data were collected. Lung function (spirometry), cardiopulmonary exercise testing (CPET) and exercise-induced bronchoconstriction (EIB) test were performed. Results: Twenty-four patients aged 11.5 ± 2.6 years were included. The mean forced expiratory volume in one second (FEV 1 ) was 91.3 ± 9.2%. EIB occurred in 54.2% of patients. In CPET, the peak oxygen uptake (VO 2peak ) was 34.1 ± 7.8 mL kg À1 min À1 . A significant correlation between ventilatory reserve and FEV 1 (r ¼ 0.57; p ¼ 0.003) was found. Similarly, there was a significant correlation between CPET and percent of FEV 1 fall in the EIB test for both V E /VO 2 (r ¼ 0.47; p ¼ 0.02) and V E /VCO 2 (r ¼ 0.46; p ¼ 0.02). Patients with FEV 1 <80% had lower ventilatory reserve (p ¼ 0.009). In addition, resting heart rate correlated with VO 2peak (r¼-0.40; p ¼ 0.04), V E /VO 2 (r ¼ 0.46; p ¼ 0.02) and V E /VCO 2 (r ¼ 0.48; p ¼ 0.01). Conclusions: Exercise capacity is impaired in approximately 30% of children and adolescents with STRA. The results indicate that different aspects of aerobic fitness are influenced by distinct determinants, including lung function and EIB.

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“…This article compared methods for the imputation of a semi-continuous variable in a context where it is analyzed as a categorical exposure variable as is commonly done in epidemiological analyses. [43][44][45][46] We examined three methods that imputed ordinal categories directly, and six methods that imputed the semi-continuous variable followed by categorization. Across the simulation scenarios, we found that the ordinal logistic regression and ZINB imputation approaches performed well across most scenarios.…”

Section: Discussionmentioning

confidence: 99%

Multiple imputation of semi‐continuous exposure variables that are categorized for analysis

Nguyen

Moreno‐Betancur

Rodwell

et al. 2021

Statistics in Medicine

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Semi-continuous variables are characterized by a point mass at one value and a continuous range of values for remaining observations. An example is alcohol consumption quantity, with a spike of zeros representing non-drinkers and positive values for drinkers. If multiple imputation is used to handle missing values for semi-continuous variables, it is unclear how this should be implemented within the standard approaches of fully conditional specification (FCS) and multivariate normal imputation (MVNI). This question is brought into focus by the use of categorized versions of semi-continuous exposure variables in analyses (eg, no drinking, drinking below binge level, binge drinking, heavy binge drinking), raising the question of how best to achieve congeniality between imputation and analysis models. We performed a simulation study comparing nine approaches for imputing semi-continuous exposures requiring categorization for analysis. Three methods imputed the categories directly: ordinal logistic regression, and imputation of binary indicator variables representing the categories using MVNI (with two variants). Six methods (predictive mean matching, zero-inflated binomial imputation, and two-part imputation methods with variants in FCS and MVNI) imputed the semi-continuous variable, with categories derived after imputation. The ordinal and zero-inflated binomial methods had good performance across most scenarios, while MVNI methods requiring rounding after imputation did not perform well. There were mixed results for predictive mean matching and the two-part methods, depending on whether the estimands were proportions or regression coefficients. The results highlight the need to consider the parameter of interest when selecting an imputation procedure. K E Y W O R D Smissing data, multiple imputation, ordinal categorical variable, semi-continuous, zero inflated data BACKGROUNDEpidemiological variables often exhibit semi-continuous distributions, which are characterized by a point mass at one value and a continuous range of values for the remaining observations. An example of this is alcohol consumption

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Association between regular exercise and asthma control among adults: The population-based Northern Finnish Asthma Study

Cited by 13 publications

References 15 publications

Physical activity, physical capacity and sedentary behavior among asthma patients

Physical activity, physical capacity and sedentary behavior among asthma patients

Determinants of exercise capacity in children and adolescents with severe therapy-resistant asthma

Multiple imputation of semi‐continuous exposure variables that are categorized for analysis

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