ABSTRACT
Abstract Objective: To develop, validate, and test the reproducibility of a new test capable of assessing functional performance in children and adolescents (PAY test: Performance Activity in Youth). Methods: participants without and with asthma were included in the development and validation phases, respectively. The PAY test includes five activities: transition from sitting to standing, walking 10 m, step climbing, shoulder extension and flexion, and star jumps. Participants underwent the Pediatric Glittre test (TGlittre-P test time), modified shuttle test (MST), and cardiopulmonary exercise test (CPET). Outcomes: PAY test and TGlittre-P test times, oxygen uptake (VO2peak), and distance walked in the MST. Results: 8 healthy volunteers, aged 12 (7 -15) years old were included in the development phase and 34 participants with asthma, aged 11 (7-14) years old, in the validation phase. The PAY test elicited greater physiological responses (VO2peak 33.5 ± 6.9 mL/kg) than the TGlittre-P (VO2peak: 27.4 ± 9.0 mL/kg), but lower than the MST (VO2peak: 48.9 ± 14.2 mL/kg) and CPET (VO2peak: 42.0 ± 8.8 mL/kg), p < .05. Moderate correlation between the PAY test time and the TGlittre-P time (r = 0.70, p < .001) and distance walked in the MST (r = -0.72, p < .001). The PAY test time was longer in participants with asthma than in healthy participants (3.1 [3.0 - 3.3] min vs. 2.3 [2.1 - 2.4 min]), p < .001.; and the test was reproducible (ICC 0.78, CI 95% 0.55-0.90, p < .001). Conclusions: The PAY test is a valid and reproducible tool for assessing functional performance in children and adolescents with asthma.
ABSTRACT
Asma grave é a asma que requer tratamento com altas doses de corticosteroide inalado associado a um segundo medicamento de controle (e/ou corticosteroide sistêmico) para impedir que se torne "descontrolada" ou permaneça "descontrolada" apesar do tratamento. Asma grave é considerada um subtipo de asma de difícil tratamento. A prevalência em crianças evidenciada pelo International Study of Asthma and Allergies in Childhood variou entre 3,8% e 6,9%. Existem diversos instrumentos para avaliação subjetiva, como diários de sintomas e questionários, bem como para avaliação objetiva com função pulmonar e avaliação da inflamação por escarro induzido, ou óxido nítrico exalado. A abordagem terapêutica varia desde doses altas de corticosteroide inalado e/ou oral, broncodilatadores de longa duração, antaganonistas de receptores muscarínicos, até os mais recentes imunobiológicos que bloqueiam a IgE ou IL-5.
Severe asthma is asthma that requires treatment with high doses of inhaled corticosteroids in combination with a second control drug (and/or a systemic corticosteroid) to prevent it from becoming "uncontrolled" or remaining "uncontrolled" despite treatment. Severe asthma is considered a difficult-to-treat asthma subtype. The prevalence in children found by the International Study of Asthma and Allergies in Childhood ranged from 3.8% to 6.9%. There are several instruments for subjective assessment, such as symptom diaries and questionnaires, as well as for objective assessment, including pulmonary function testing and evaluation of inflammation by induced sputum or exhaled nitric oxide. The therapeutic approach includes high doses of inhaled and/or oral corticosteroids, long-acting bronchodilators, muscarinic receptor antagonists, and the latest biologics that block IgE or IL-5.
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Pediatrics , Asthma , Societies, Medical , Bronchodilator Agents , Immunoglobulin E , Interleukin-5 , Adrenal Cortex Hormones , Respiratory Therapy , Signs and Symptoms , Sinusitis , Sputum , Therapeutics , Vocal Cords , Nebulizers and Vaporizers , Influenza Vaccines , Prevalence , Sleep Apnea, Obstructive , Pneumococcal Vaccines , Diagnosis, Differential , Allergy and Immunology , Rhinitis, Allergic , Omalizumab , Nitric Oxide , ObesityABSTRACT
BACKGROUND: The step test has been used to assess exercise capacity in patients with chronic respiratory disease; however, its use has not been described with regard to patients with bronchiectasis (BCT). OBJECTIVE: This study assessed the reliability of the Chester step test (CST) and the modified incremental step test (MIST) and also correlated these tests with pulmonary function, heart rate (HR), and distance walked during the 6-min walk test (6-MWT). METHOD: On separate days, 17 patients randomly underwent two CSTs, two MISTs, and two 6-MWTs. Number of steps (NOSs), HR, and perceived exertion were recorded immediately before and after these tests. RESULTS: NOSs were similar across CSTs (124±65 and 125±67) and MISTs (158±83 and 156±76). Differences were not found across the CSTs and MISTs with regard to HR (138±25 bpm and 136±27 bpm), SpO2 (91±5% and 91±3%), perceived exertion (dyspnea=4 [3-5] and 4 [2-4.5]) and fatigue (4 [2-6] and 4 [3-5]). The CST was significantly briefer than the MIST (6.0±2.2 min and 8.6±3.0 min) and had fewer associated NOS (125±67 and 158±83). NOSs were correlated with FEV1, the 6-MWD, and HR for both tests. CONCLUSIONS: The CST and MIST are reliable in patients with BCT. Patients tolerated the MIST more than the CST. Better lung function and 6-MWT scores predicted the greater NOSs and greater peak HR. .