Departamento de Fisioterapia, Universidade de São Paulo, Av. Dr. Arnaldo 455, São Paulo, SP, Brazil.
Arch Dis Child. 2011 Jun;96(6):554-9. doi: 10.1136/adc.2011.212431. Epub 2011 Mar 23.
Peripheral muscle strength and endurance are decreased in patients with chronic pulmonary diseases and seem to contribute to patients' exercise intolerance. However, the authors are not aware of any studies evaluating peripheral muscle function in children with asthma. It seems to be implied that children with asthma have lower aerobic fitness, but there are limited studies comparing the aerobic capacity of children with and without asthma. The present study aimed to evaluate muscle strength and endurance in children with persistent asthma and their association with aerobic capacity and inhaled corticosteroid consumption.
Forty children with mild persistent asthma (MPA) or severe persistent asthma (SPA) (N=20 each) and 20 children without asthma (control group) were evaluated. Upper (pectoralis and latissimus dorsi) and lower (quadriceps) muscle strength and endurance were assessed, and cardiopulmonary exercise testing was performed. Inhaled corticosteroid consumption during the last 6 and 24 months was also quantified.
Children with SPA presented a reduction in peak oxygen consumption (VO(2)) (28.2±8.1 vs 34.7±6.9 ml/kg/min; p<0.01) and quadriceps endurance (43.1±6.7 vs 80.9±11.9 repetitions; p<0.05) compared with the control group, but not the MPA group (31.5±6.1 ml/kg/min and 56.7±47.7 repetitions respectively; p>0.05). Maximal upper and lower muscle strength was preserved in children with both mild and severe asthma (p>0.05). Finally, the authors observed that lower muscle endurance weakness was not associated with reductions in either peak VO(2) (r=0.22, p>0.05) or corticosteroid consumption (r=-0.31, p>0.05) in children with asthma.
The findings suggest that cardiopulmonary exercise and lower limb muscle endurance should be a priority during physical training programs for children with severe asthma.
慢性肺部疾病患者的外周肌肉力量和耐力下降，似乎导致患者运动不耐受。然而，作者不知道有任何研究评估过哮喘儿童的外周肌肉功能。似乎暗示哮喘儿童的有氧运动能力较低，但比较哮喘儿童和非哮喘儿童有氧能力的研究有限。本研究旨在评估持续性哮喘儿童的肌肉力量和耐力及其与有氧运动能力和吸入皮质类固醇消耗的关系。
评估 40 名轻度持续性哮喘（MPA）或重度持续性哮喘（SPA）患儿（每组 20 名）和 20 名无哮喘儿童（对照组）。评估上肢（胸大肌和背阔肌）和下肢（股四头肌）的力量和耐力，并进行心肺运动试验。还量化了过去 6 个月和 24 个月内吸入皮质类固醇的消耗。
与对照组相比，SPA 患儿的峰值摄氧量（VO2）（28.2±8.1 比 34.7±6.9 ml/kg/min；p<0.01）和股四头肌耐力（43.1±6.7 比 80.9±11.9 次；p<0.05）降低，但 MPA 患儿无此差异（分别为 31.5±6.1 ml/kg/min 和 56.7±47.7 次；p>0.05）。轻度和重度哮喘患儿的最大上肢和下肢肌肉力量均保持不变（p>0.05）。最后，作者观察到，哮喘儿童的下肢肌肉耐力较弱与峰值 VO2 降低（r=0.22，p>0.05）或皮质类固醇消耗（r=-0.31，p>0.05）无关。
研究结果表明，心肺运动和下肢肌肉耐力应成为重度哮喘儿童体育训练计划的重点。
