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Bright Futures in Practice: Physical Activity

ASTHMA

BFPAIC_ILP34

Asthma is a chronic lung condition in which airway inflammation results in recurrent breathing problems. Approximately 5 million children and adolescents in the United States have been diagnosed with asthma.1 However, it is likely that asthma goes undiagnosed in many children and adolescents.2 Minorities, particularly African Americans, experience a higher incidence of asthma than whites. Children and adolescents living in the inner city also suffer from a disproportionately high incidence of asthma.1 In addition, children and adolescents from families with low incomes and from single parent households are more likely to have an asthma-related disability.3 Asthma in children and adolescents is a leading cause of school absenteeism and ranks first among chronic conditions that limit children's and adolescents' participation in physical activity. And children with asthma and obesity have more frequent and longer-lasting asthma attacks.4

Vigorous physical activity may cause asthma symptoms in children and adolescents whose asthma is poorly controlled. As a result, many children and adolescents with asthma limit their physical activity, which can lead to poor physical fitness status. Children and adolescents with asthma who limit their physical activity usually do so because of misinformation, fear, or mismanagement of their condition, not because the condition demands these limitations. Improved understanding of and treatments for asthma will help children and adolescents with asthma participate fully in physical activity.

Exercise-induced asthma (EIA), which occurs in almost 90 percent of children and adolescents who have asthma and in approximately 40 percent of children and adolescents who have allergic rhinitis, can occur without other forms of asthma.5 People who do not suffer from chronic asthma can still have EIA, an intermittent physical-activity-triggered narrowing of the airways. It is believed to be caused by a loss of heat, water, or both from the lungs during physical activity, triggered by rapid, deep breathing of air that is cooler and drier than the interior of the respiratory tree. EIA usually occurs during vigorous physical activity or several minutes after, reaches its peak 5 to 10 minutes after cessation of activity, and resolves in another 20 to 30 minutes.6,7

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