Skip to main content
Log in

Fitness and Physical Activity in Children with Asthma

  • Leading Article
  • Published:
Sports Medicine Aims and scope Submit manuscript

Abstract

Asthma remains the most common chronic disease in childhood, reportedly affecting up to 25% of children in Western urban environmental settings. There seems to be a common perception that asthmatic children have a reduced capacity for exercise. Surprisingly, there is conflicting evidence in the literature in relation to this position. In this review, we present an overview of the literature in which habitual physical activity and fitness levels, including aerobic fitness, of asthmatic and non-asthmatic children are compared.

There is contradictory evidence regarding the aerobic fitness levels of asthmatic children and adolescents, and it remains unclear whether significant differences exist between asthmatic children and their non-asthmatic counterparts. There is limited information concerning the relative anaerobic fitness of asthmatic children and adolescents; however, this is also conflicting. During childhood and adolescence, asthmatic individuals seem to have physical activity levels comparable with those of the normal paediatric population. However, differences in physical activity levels may develop during the time of maturation from adolescence into adulthood. Accordingly, it is not possible to establish a definitive conclusion about the issue in either children or adults. Further research with well designed methodologies is needed in order to determine whether asthmatic children and adolescents have different aerobic fitness, anaerobic fitness and physical activity levels when compared with the normal paediatric population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table II

Similar content being viewed by others

Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

References

  1. Kun HY, Oates RK, Mellis CM. Hospital admissions and attendances for asthma: a true increase? Med J Aust 1993; 159: 312–3

    PubMed  CAS  Google Scholar 

  2. Robertson CF, Dalton MF, Peat JK, et al. Asthma and other atopic diseases in Australian children: Australian arm of the International Study of Asthma and Allergy in Childhood. Med J Aust 1998; 168(9): 434–8

    PubMed  CAS  Google Scholar 

  3. Ng K, Toelle BG, Belousova EG, et al. Trends in the prevalence of asthma over 20 years in Belmont, NSW, Australia. Respirology 2003; Suppl. 8: A31

    Google Scholar 

  4. Akinbami LJ, Schoendorf KC. Trends in childhood asthma: prevalence, health care utilization, and mortality. Pediatrics 2002; 110(2): 315–22

    Article  PubMed  Google Scholar 

  5. Johansson H, Foucard T, Petterson LG. Exercise tests in large groups of children are not a suitable screening procedure for undiagnosed asthma. Allergy 1997; 52(11): 1128–32

    Article  PubMed  CAS  Google Scholar 

  6. Wilkerson LA. Exercise-induced asthma. J Am Osteopath Assoc 1998; 11(4): 322–31

    Google Scholar 

  7. Wilber RL, Rundell KW, Szmedra L, et al. Incidence of exercise-induced bronchospasm in Olympic winter sport athletes. Med Sci Sports Exerc 2000; 32(4): 732–7

    Article  PubMed  CAS  Google Scholar 

  8. Rundell KW, Wilber RL, Szmedra L, et al. Exercise-induced asthma screening of elite athletes: field versus laboratory exercise challenge. Med Sci Sports Exerc 2000; 32(2): 309–16

    Article  PubMed  CAS  Google Scholar 

  9. Helenius I, Haahtela T. Allergy and asthma in elite summer sport athletes. J Allergy Clin Immunol 2000; 106(3): 444–52

    Article  PubMed  CAS  Google Scholar 

  10. Mirwald RL, Bailey DA, Cameron N, et al. Longitudinal comparison of aerobic power in active and inactive boys aged 7 to 17 years. Ann Hum Biol 1981; 8(5): 405–14

    Article  PubMed  CAS  Google Scholar 

  11. Åstrand PO, Rodahl, K. Textbook of work physiology. New York: McGraw Hill, 1986

    Google Scholar 

  12. Craig SB, Bandini LG, Lichenstein LH, et al. The impact of physical activity on lipids, lipoproteins, and blood pressure in preadolescent girls. Pediatrics 1996; 98: 389–95

    PubMed  CAS  Google Scholar 

  13. NIH develops consensus statement on the role of physical activity for cardiovascular health. Am Fam Physician 1996; 54(2): 763–4

    Google Scholar 

  14. Yu CW, Sung RY, So R, et al. Energy expenditure and physical activity of obese children: cross-sectional study. Hong Kong Med J 2002; 8(5): 313–7

    PubMed  CAS  Google Scholar 

  15. Oseid S, Haaland K. Exercise studies on asthmatic children before and after regular physical training. In: Eriksson BO, Furberg B, editors. Swimming medicine IV. Baltimore (MD): University Park Press, 1978: 32–41

    Google Scholar 

  16. Fink G, Kaye C, Blau H, et al. Assessment of exercise capacity in asthmatic children with various degrees of activity. Pediatr Pulmonol 1993; 15(1): 41–3

    Article  PubMed  CAS  Google Scholar 

  17. Garfinkel SK, Kesten S, Chapman KR, et al. Physiologic and nonphysiologic determinants of aerobic fitness in mild to moderate asthma. Am Rev Respir Dis 1992; 145: 741–5

    PubMed  CAS  Google Scholar 

  18. Gossard D, Haskell WL, Taylor CB, et al. Effects of low- and high-intensity home-based training on functional capacity in healthy middle-aged men. Am J Cardiol 1986; 57(6): 446–9

    Article  PubMed  CAS  Google Scholar 

  19. Seals DR, Sinacore DR, Hurley BF, et al. Failure of endurance training to alter the cardiovascular response to static contraction. Clin Physiol 1983; 3(3): 219–26

    Article  PubMed  CAS  Google Scholar 

  20. Blumenthal JA, Matthews K, Fredrikson M, et al. Effects of exercise on cardiovascular function and plasma lipid, lipoprotein, and apolipoprotein concentrations in premenopausal women. Arterioscler Thromb 1991; 11(4): 912–7

    Article  PubMed  CAS  Google Scholar 

  21. Mirwald RL, Bailey DA. Maximal aerobic power. London: Sports Dynamics, 1986

    Google Scholar 

  22. Andersen KL, Ilmarinen J, Rutenfranz J, et al. Leisure time sport activities and maximal aerobic power during late adolescence. Eur J Appl Physiol 1984; 52(4): 431–6

    Article  CAS  Google Scholar 

  23. Al-Hazzaa HM, Sulaimen MA. Maximal oxygen uptake and daily physical activity in 7 to 12 year old boys. Pediatr Exerc Sci 1993; 5: 357–66

    Google Scholar 

  24. Wong TW, Yu TS, Wang XR, et al. Predicted maximal oxygen uptake in normal Hong Kong Chinese Schoolchildren and those with respiratory diseases. Pediatr Pulmonol 2001; 31: 126–32

    Article  PubMed  CAS  Google Scholar 

  25. Janz KF, Golden JC, Hansen JR, et al. Heart rate monitoring of physical activity in children and adolescents: the Muscatine Study. Pediatrics 1992; 89: 256–61

    PubMed  CAS  Google Scholar 

  26. Baranowski T. Validity and reliability of self report measures of physical activity: an information-processing perspective. Res Q Exerc Sport 1988; 59: 314–27

    Google Scholar 

  27. Cooper A. Objective measurement of physical activity. In: McKenna J, Riddoch C, editors. Perspectives on health and exercise. New York: Palgrave, 2003: 104

    Google Scholar 

  28. Armstrong N, Welsman J. Young people and physical activity. New York: Oxford University Press, 1997

    Google Scholar 

  29. Lussier L, Buskirk ER. Effects of an endurance training regimen on assessment of work capacity in prepubertal children. Ann N Y Acad Sci 1977; 30: 734–47

    Article  Google Scholar 

  30. Sady SP. Cardiorespiratory exercise training in children. Clin Sports Med 1986; 5: 493–514

    PubMed  CAS  Google Scholar 

  31. Bevegård S, Eriksson BO, Graff-Lonnevig V, et al. Circulatory and respiratory dimensions and functional capacity in boys aged 8–13 years with bronchial asthma. Acta Paediatr Scand 1971; Suppl. 217: 86–9

    Google Scholar 

  32. Boas SR, Danduran MJ, Saini SK. Anaerobic exercise testing in children with asthma. J Asthma 1998; 35(6): 481–7

    Article  PubMed  CAS  Google Scholar 

  33. Buttifant DC, Carlson JS, Naughton GA. Anaerobic characteristics and performance of prepubertal asthmatic and nonasthmatic males. Pediatr Exerc Sci 1996; 8: 268–75

    Google Scholar 

  34. Counil FP, Karila C, Varray A, et al. Anaerobic fitness in children with asthma: adaptation to maximal intermittent short exercise. Pediatr Pulmonol 2001; 31: 198–204

    Article  PubMed  CAS  Google Scholar 

  35. Hedlin G, Graff-Lonnevig V, Freyschuss U. Working capacity and pulmonary gas exchange in children with exercise-induced asthma. Acta Paediatr Scand 1986; 75(6): 947–54

    Article  PubMed  CAS  Google Scholar 

  36. Counil FP, Varray A, Karila C, et al. Wingate test performance in children with asthma: aerobic or anaerobic limitation? Med Sci Sports Exerc 1997; 29: 430–5

    Article  PubMed  CAS  Google Scholar 

  37. Kukafka DS, Lang DM, Porter S, et al. Exercise-induced bronchospasm in high school athletes via a free running test. Chest 1998; 114(6): 1613–22

    Article  PubMed  CAS  Google Scholar 

  38. Riedler J, Reade T, Dalton M, et al. Hypertonie saline challenge in an epidemiological survey of asthma in children. Am J Respir Crit Care Med 1994; 150: 1632–9

    PubMed  CAS  Google Scholar 

  39. Santuz P, Baraldi E, Fillippone M, et al. Exercise performance in children with asthma: is it different from that of healthy controls? Eur Respir J 1997; 10: 1254–60

    Article  PubMed  CAS  Google Scholar 

  40. Strunk RC, Rubin D, Kelly L, et al. Determination of fitness in children with asthma. Am J Dis Child 1988; 142(9): 940–4

    PubMed  CAS  Google Scholar 

  41. Thio B, Nagelkerke AF, Ketel AG, et al. Exercise-induced asthma and cardiovascular fitness in asthmatic children. Thorax 1996; 51: 207–9

    Article  PubMed  CAS  Google Scholar 

  42. Varray A, Mercier J, Ramonatxo M, et al. Maximal exercise in asthmatic children: aerobic limitation or anaerobic compensation [in French]? Sci Sports 1989; 4: 199–207

    Article  Google Scholar 

  43. Welsh L, Roberts RGD, Kemp JG. Aerobic fitness, physical activity and asthma in Australian school children [abstract]. Am J Respir Crit Care Med 2002; 165(8): A740

    Google Scholar 

  44. Santuz P, Baraldi E, Zaramella P, et al. Factors limiting exercise performance in long-term survivors of bronchopulmonary dysplasia. Am J Respir Crit Care Med 1995; 152: 1284–9

    PubMed  CAS  Google Scholar 

  45. van Veldhoven NH, Vermeer A, Bogaard JM, et al. Children with asthma and physical exercise: effects of an exercise program. Clin Rehabil 2001; 15(4): 360–70

    Article  PubMed  Google Scholar 

  46. Brewer J, Ramsbottom R, Williams C. Multistage fitness test. Leeds: National Coaching Foundation, 1988: 5–7

    Google Scholar 

  47. Ferris BG. Epidemiology standardization project. Am Rev Respir Dis 1978; 118: 1–88

    PubMed  CAS  Google Scholar 

  48. Aghemo P, Rovelli E. Measurement of muscular power (anaerobic) in man. J Appl Physiol 1966; 21: 1662–4

    PubMed  Google Scholar 

  49. Ayalon A, Inbar O, Bar-Or O. Relationships among measurements of explosive strength and anaerobic power. In: Nelson RC, Morehouse CA, editors. International series on sport sciences. Vol. 1. Biomechanics IV. Baltimore (MD): University Park Press, 1974: 572–7

    Google Scholar 

  50. Vandewalle H, Pérès G, Heller J, et al. All out anaerobic capacity test on cycle ergometers. Eur J Appl Physiol 1985; 54: 222–9

    Article  CAS  Google Scholar 

  51. Kowalski KC, Crocker PRE, Faulkner RA. Validation of the physical activity questionnaire for older children. Pediatr Exerc Sci 1997; 9: 174–86

    Google Scholar 

  52. Weston AR, MacFarlane DJ, Hopkins WG. Physical activity of asthmatic and non-asthmatic children. J Asthma 1989; 26(5): 279–86

    Article  PubMed  CAS  Google Scholar 

  53. Crocker PR, Bailey DA, Faulkner RA, et al. Measuring general levels of physical activity: preliminary evidence for the Physical Activity Questionnaire for Older Children. Med Sci Sports Exerc 1997; 29(10): 1344–9

    Article  PubMed  CAS  Google Scholar 

  54. Ford ES, Heath GW, Mannino DM, et al. Leisure-time physical activity patterns among US adults with asthma. Chest 2003; 124: 432–7

    Article  PubMed  Google Scholar 

  55. Mälkiä E, Impivaara O. Intensity of physical activity and respiratory function in subjects with and without bronchial asthma. Scand J Med Sci Sports 1998; 8: 27–32

    Article  PubMed  Google Scholar 

  56. Nystad W. The physical activity level in children with asthma based on a survey among 7–16 year old school children. Scand J Med Sci Sports 1997; 7: 331–5

    Article  PubMed  CAS  Google Scholar 

  57. Asher MI, Keil U, Anderson H, et al. International Study of Asthma and Allergies in Childhood (ISAAC): rationale and methods. Eur Respir J 1995; 8: 483–91

    Article  PubMed  CAS  Google Scholar 

  58. Saltin B, Grimby G. Physiological analysis of middle-aged and old former athletes. Circulation 1968; 38: 1104–15

    Article  PubMed  CAS  Google Scholar 

  59. Wilhelmsen L, Tibblin G, Fodor J, et al. A multifactorial primary preventative trial in Gothenberg. In: Larsen OA, Malmorg RO, editors. Coronary heart disease and physical fitness. Copenhagen: Munksgaard, 1971: 266–79

    Google Scholar 

  60. Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995; 273: 402–7

    Article  PubMed  CAS  Google Scholar 

  61. Tantisira KG, Weiss ST. Complex interactions in complex traits: obesity and asthma. Thorax 2001; 56Suppl. II: ii64–74

    PubMed  Google Scholar 

  62. Rossner S. Obesity: the disease of the twenty-first century. Int J Obes Relat Metab Disord 2002; 26Suppl. 4: S2–4

    Article  PubMed  Google Scholar 

  63. Metcalf BS, Voss LD, Wilkin TJ. Accelerometers identify inactive and potentially obese children (EarlyBird 3). Arch Dis Child 2002; 87(2): 166–7

    Article  PubMed  CAS  Google Scholar 

  64. Gilliland FD, Berhane K, Islam T, et al. Obesity and the risk of newly diagnosed asthma in school-age children. Am J Epidemiol 2003; 158: 406–15

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Liam Welsh is funded by the Australian Research Council for an Australian Postgraduate Award with Industry (APAI) grant. The authors have no conflicts of interest that are directly relevant to the content of this review.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Richard G. D. Roberts.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Welsh, L., Roberts, R.G.D. & Kemp, J.G. Fitness and Physical Activity in Children with Asthma. Sports Med 34, 861–870 (2004). https://doi.org/10.2165/00007256-200434130-00001

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-200434130-00001

Keywords

Navigation