PEDIATRICS Vol. 84 No. 3 September 1989, pp. 460-464
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Cardiovascular Fitness in Children With Asthma Correlates With Psychologic Functioning of the Child

Robert C. Strunk MD1, David A. Mrazek MD1, Jolene T. Fukuhara BA1, Jim Masterson MSW1, Susan K. Ludwick RPT1, and John F. LaBrecque PhD1

1 The Department of Pediatrics and Rehabilitation Services, National Jewish Center for Immunology and Respiratory Medicine, and the Departments of Pediatrics and Psychiatry, the University of Colorado School of Medicine, Denver, Colorado

Abnormalities in fitness in asthmatic children are assumed to derive from illness severity. We studied 90 children with moderately severe to severe but stable asthma for (1) fitness levels using bicycle ergometry, (2) measures of asthma severity, (3) clinician's impression of child (Child Global Assessment Scale), and (4) mother's rating of child's behavior (Child Behavior Checklist). Fitness values ranged from 15% to 120% of normal values for age, sex, and body surface area: 48% were abnormal (<2 SD below mean) and 5% were borderline (1 to 2 SD below mean). Associations between levels of fitness and medical and psychologic criteria were tested using regression analyses. Of the 11 medical variables used to define the severity of asthma, recent exacerbation of disease, forced expiratory volume in 1 second, and specific airway conductance together accounted for 8.1% of the variability in the workload ratios (ie, R2 = 0.081). The importance of the psychologic factors in determining the variability in the workload ratios was tested after the importance of the medical variables had been considered: Child Global Assessment Scale accounted for a significant amount of variability, improving the R2 to 0.180 (an increase to 0.100, P = .003). These data suggest that, within the spectrum of disease presented by the patients in this study, adjustment to the disease is at least as important as severity of disease in determining fitness.

Key Words: asthma • cardiovascular fitness • psychologic function

Submitted on May 31, 1988
Accepted on September 29, 1988




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