Abstract
BackgroundIndividuals with chronic lung disease are more susceptible to present reduction in exercise tolerance and muscles strength not only due to pulmonary limitations but also due systemic repercussions of the pulmonary disease.The aim of this study is to assess the physical capacity, peripheral muscle function, physical activity in daily life, and the inflammatory markers in children and adolescents with asthma after pulmonary rehabilitation program.MethodThis is a study protocol of randomized controlled trial in asthmatic patients between 6 to 18 years old. The assessments will be conducted in three different days and will be performed at the beginning and at the end of the protocol. First visit: quality of life questionnaire, asthma control questionnaire, pre- and post-bronchodilator spirometry (400 μcg salbutamol), inflammatory assessment (blood collection), and cardiopulmonary exercise test on a cycle ergometer to determine aerobic capacity. Second visit: assessment of strength and endurance of the quadriceps femoris and biceps brachii muscles with concomitant electromyography to assess peripheral muscle strength. Third visit: incremental shuttle walk test (ISWT) and accelerometer to evaluate functional capacity and physical activity in daily life during 7 days. Then, the volunteers will be randomized to receive pulmonary rehabilitation program (intervention group) or chest physiotherapy + stretching exercises (control group). Both groups will have a supervised session, twice a week, each session will have 60 minutes duration, with minimum interval of 24 hours, for a period of 8 weeks. Intervention group: aerobic training (35 minutes) intensity between 60 to 80 % of the maximum workload of cardiopulmonary exercise testing or of ISWT; strength muscle training will be applied to the quadriceps femoris, biceps brachii and deltoid muscles (intensity: 40 to 70 % of maximal repetition, 3 x 8 repetition); finally the oral high-frequency oscillation device (Flutter®) will be used for 5 minutes. The control group: oral high-frequency oscillation device (Flutter®) for 10 minutes followed by the stretching of upper and lower limbs for 40 minutes. It is expected to observe the improvement in aerobic capacity, physical activity in daily life, muscle strength and quality of life of patients in the intervention group, and reduction in inflammatory markers.Trial registrationClinical Trial Number: NCT02383069. Data of registration: 03/03/2015
Highlights
Individuals with chronic lung disease are more susceptible to present reduction in exercise tolerance and muscles strength due to pulmonary limitations and due systemic repercussions of the pulmonary disease
Individuals with chronic lung disease are more susceptible to present reduction in exercise tolerance, due to ventilatory constraints, and due to systemic manifestations of pulmonary disease [2]
The study will include patients diagnosed with asthma, between 6 and 18 years old, who are under medical treatment and disease control according to the Global Initiative for Asthma (GINA) criteria [1]
Summary
Individuals with chronic lung disease are more susceptible to present reduction in exercise tolerance and muscles strength due to pulmonary limitations and due systemic repercussions of the pulmonary disease. Individuals with chronic lung disease are more susceptible to present reduction in exercise tolerance, due to ventilatory constraints, and due to systemic manifestations of pulmonary disease [2]. The obstruction increases the airways resistance, hindering the physiological ventilatory response during physical exertion and leading to dyspnea [2]. This in turn leads to the patient having a more sedentary lifestyle, predisposing them to early fatigue and exercise intolerance
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