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Published online December 1, 2006
PEDIATRICS Vol. 118 No. 6 December 2006, pp. 2443-2449 (doi:10.1542/peds.2006-1846)
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ARTICLE

Asthma as a Barrier to Children's Physical Activity: Implications for Body Mass Index and Mental Health

Cristine Glazebrook, RGN, PhD, CPsychola, Amy C. McPherson, PhD, CPsycholb, Ian A. Macdonald, PhDc, Judy A. Swift, PhDd, Christopher Ramsay, BMedSci, BM, BSa, Rachel Newbould, BMedScia, Alan Smyth, MA, MB, BS, MRCP, MD, FRCPCHe

Schools of a Community Health Sciences
b Nursing
c Biomedical Sciences
d Biosciences
e Division of Child Health, University of Nottingham, Nottingham, United Kingdom

OBJECTIVES. The purpose of this work was to identify barriers to physical activity in children with asthma and to compare their customary activity levels, BMI and emotional well-being with that of children with other medical conditions. It was hypothesized that children with asthma would have higher BMI and lower levels of customary activity.

PATIENTS AND METHODS. We studied children aged 7 to 14 years attending hospital outpatient clinics for either asthma (asthma group: n = 56) or for otorhinolaryngology or dermatological conditions (nonasthma group: n = 61). In this cross-sectional survey, children's weight and height were recorded and their BMI classified according to International Obesity Task Force classification of obesity. Child mental health was assessed by the parent-rated Strengths and Difficulties Questionnaire. The child-rated Physical Activity Questionnaire assessed total sedentary and physical activities during the previous 24 hours.

RESULTS. The asthma group had a higher mean BMI (20.78 vs 18.82) and higher rates of obesity (21.4% vs 6.6%). Children with asthma reported fewer physical activities than the nonasthma group (median 4 per day vs 6 per day) but comparable levels of sedentary activities. Asthma was the strongest predictor of lower activity scores, followed by younger age. The asthma group had higher levels of emotional difficulties and, within this group, more active children had better mental health. More parents in the asthma group identified the child's health as a barrier to exercise (60.7% vs 11%). The same was true of children (66.1% vs 11.5%).

CONCLUSIONS. We found that children attending a hospital clinic for asthma were more likely to be obese and were significantly less active than a comparison group with other medical conditions. Asthma was identified as a barrier to exercise by parents and children. Strategies to promote exercise within pediatric asthma care are needed to protect both mental and physical health.

Key Words: asthma • obesity • exercise • psychological impact • child

Abbreviations: PAQ—Physical Activity Questionnaire • SDQ—Strengths and Difficulties Questionnaire • df—degrees of freedom • OR—odds ratio • CI—confidence interval

Accepted Aug 24, 2006.


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