Acta Gymnica, 2017 (vol. 47), issue 4

Acta Gymnica 2017, 47(4):180-186 | DOI: 10.5507/ag.2017.023

Respiratory muscle strength in children with mild bronchial asthma disease

Kateřina Neumannová1, Zuzana Kováčiková1, Jakub Zatloukal2, Milan Elfmark1, Jana Rydlová3, Miroslav Janura1
1 Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic;
2 Department of Pulmonary Rehabilitation, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, United Kingdom;
3 Miramonti Children's Medical Institution, Luhačovice Spa, Luhačovice, Czech Republic

Background: Respiratory muscle strength can be decreased in patients with asthma; however, it is not well-documented whether a mild bronchial asthma disease can affect respiratory muscle strength in children and can be associated with higher presence of breathing difficulties.

Objective: The main aim of the present study was to compare respiratory muscle strength between children with asthma and age-matched healthy children. The next aim of this study was to assess the incidence of decreased respiratory muscle strength in children with asthma and healthy children and assess the effect of decreased respiratory muscle strength on the incidence of breathing difficulties.

Methods: Children with mild bronchial asthma (n = 167) and age-matched, healthy children (n = 100) were recruited into this study. Pulmonary function tests, maximal inspiratory (PImax) and expiratory (PEmax) mouth pressures and the incidence of breathing difficulty were evaluated in children with asthma and healthy controls.

Results: The inspiratory muscle strength was similar between children with asthma and healthy children. Conversely, the expiratory muscle strength was lower in asthmatic children. There was a statistically significant difference between girls with asthma and healthy girls (PEmax = 81.7 ± 29.8% vs. 100.1 ± 23.7% of predicted, p < .001). PEmax was significantly higher in boys with asthma than in girls with asthma (PEmax = 92.9 ± 26.4 % vs. 81.7 ± 29.8% of predicted, p = .03). A higher incidence of breathing difficulties during physical activity (uphill walking, running, swimming) was confirmed in children with asthma with lower respiratory muscle strength.

Conclusions: There was a higher prevalence of decreased expiratory muscle strength in children with asthma; therefore, respiratory muscle strength should be tested in these children, especially in those who are symptomatic.

Keywords: maximal inspiratory mouth pressure, maximal expiratory mouth pressure, ventilatory parameters, breathlessness, physical activities

Received: October 3, 2017; Accepted: December 15, 2017; Prepublished online: December 20, 2017; Published: December 31, 2017

Download citation

References

  1. American Thoracic Society. (1991). Lung function testing: Selection of reference values and interpretative strategies. American Review of Respiratory Disease, 144, 1202-1218. Go to PubMed...
  2. British Thoracic Society Scottish Intercollegiate Guidelines Network. (2014). British guideline on the management of asthma. Thorax, 69(Suppl. 1), i1-i192.
  3. de Oliveira, C. M. G., Lanza, F. C., & Solé, D. (2012). Respiratory muscle strength in children and adolescents with asthma: Similar to that of healthy subjects? Jornal Brasileiro de Pneumologia, 38, 308-314. Go to original source... Go to PubMed...
  4. Fauroux, B. (2003). Respiratory muscle testing in children. Paediatric Respiratory Reviews, 4, 243-249. Go to original source... Go to PubMed...
  5. Global Initiative for Asthma. (2014). Global strategy for asthma management and prevention 2014. Retrieved from http://www.ginasthma.org
  6. Heinzmann-Filho, J. P., Vidal, P. C. V., Jones, M. H., & Donadio, M. V. F. (2012). Normal values for respiratory muscle strength in healthy preschoolers and school children. Respiratory Medicine, 106, 1639-1646. Go to original source... Go to PubMed...
  7. Hronek, M., Kovarik, M., Aimova, P., Koblizek, V., Pavlikova, L., Salajka, F., & Zadak, Z. (2013). Skinfold anthropometry-the accurate method for fat free mass measurement in COPD. COPD: Journal of Chronic Obstructive Pulmonary Disease, 10, 597-603. Go to original source...
  8. Marcelino, A. M. F. C., Da Cunha, D. A., Da Cunha, R. A., & Da Silva, H. J. (2012). Respiratory muscle strength in asthmatic children. International Archives of Otorhinolaryngology, 16, 492-496. Go to original source... Go to PubMed...
  9. McConnel, A. (2013). Respiratory muscle training: Theory and practice. Edinburgh, United Kingdom: Churchill Livingstone.
  10. Neder, J. A., Andreoni, S., Lerario, M. C., & Nery, L. E. (1999). Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. Brazilian Journal of Medical and Biological Research, 32, 719-727. Go to original source... Go to PubMed...
  11. Perez, T., Becquart, L. A., Stach, B., Wallaert, B., & Tonnel, A. B. (1996). Inspiratory muscle strength and endurance in steroid-dependent asthma. American Journal of Respiratory and Critical Care Medicine, 153, 610-615. Go to original source... Go to PubMed...
  12. Sette, L., Ganassini, A., Boner, A. L., & Rossi, A. (1997). Maximal inspiratory pressure and inspiratory muscle endurance time in asthmatic children: Reproducibility and relationship with pulmonary function tests. Pediatric Pulmonology, 24, 385-390. Go to original source... Go to PubMed...
  13. Spruit, M. A., Singh, S. J., Garvey, C., Zu Wallack, R., Nici, L., Rochester, C., … Wouters, E. F. M. (2013). An official American Thoracic Society/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation. American Journal of Respiratory and Critical Care Medicine, 188, e13-e64. Go to original source... Go to PubMed...
  14. Troosters, T., Gosselink, R., & Decramer, M. (2005). Respiratory muscle assessment. In R. Gosselink & H. Stam (Eds.), European respiratory monograph 31: Lung function testing (Vol. 10, pp. 57-71). Wakefield, United Kingdom: European Respiratory Society Journals.
  15. Varekova, R., & Vareka, I. (2013). How to estimate overweight in pubescent asthmatics? Advances in Medical Sciences, 58, 331-337. Go to original source... Go to PubMed...
  16. Weiner, P., Azgad, Y., Ganam, R., & Weiner, M. (1992). Inspiratory muscle training in patients with bronchial asthma. Chest, 102, 1357-1361. Go to original source... Go to PubMed...
  17. Weiner, P., Magadle, R., Massarwa, F., Beckerman, M., & Berar-Yanay, N. (2002). Influence of gender and inspiratory muscle training on the perception of dyspnea in patients with asthma. Chest, 122, 197-201. Go to original source... Go to PubMed...
  18. Wilson, S. H., Cooke, N. T., Edwards, R. H. T., & Spiro, S. G. (1984). Predicted normal values for maximal respiratory pressures in caucasian adults and children. Thorax, 39, 535-538. Go to original source... Go to PubMed...