Abstract
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.
Highlights
Bronchial asthma, defined as a heterogeneous disease that is usually characterised by chronic airway inflammation, is one of the most common chronic diseases in children (Global Initiative for Asthma, 2014)
Few studies have investigated respiratory muscle strength according to the predicted values, for that reason the objective of the present study was to compare the values of the PImax and PEmax as a percentage of the predicted values between children with asthma and age-matched healthy children
Baseline characteristics There were no significant differences in the age, vital capacity, and forced expiratory volume in one second or maximal inspiratory mouth pressure between children with asthma and healthy children (Table 1)
Summary
Bronchial asthma, defined as a heterogeneous disease that is usually characterised by chronic airway inflammation, is one of the most common chronic diseases in children (Global Initiative for Asthma, 2014). Marcelino, Da Cunha, Da Cunha, and Da Silva (2012) documented a lack of significant differences between the maximal inspiratory and expiratory (PEmax) mouth pressures in children with and without asthma. They observed just slightly decreased values of PImax and PEmax in children with asthma compared with children without asthma. Objective: The main aim of the present study was to compare respiratory muscle strength between children with asthma and age-matched healthy children. Maximal inspiratory (PImax) and expiratory (PEmax) mouth pressures and the incidence of breathing difficulty were evaluated in children with asthma and healthy controls. Conclusions: There was a higher prevalence of decreased expiratory muscle strength in children with asthma; respiratory muscle strength should be tested in these children, especially in those who are symptomatic
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