Assessment of asthma control among different measures and evaluation of functional exercise capacity in children and adolescents with asthma

Author(s)

Natasha Yumi Matsunaga ; Caio de Oliveira ^[2] ; Livea Gianfrancesco ; Marina Simões Oliveira ; Maria Cristina Ribeiro dos Santos Simões ^[5] ; André Moreno Morcillo ^[6] ; José Dirceu Ribeiro ; Maria Angela Gonçalves de Oliveira Ribeiro ; Adyléia Aparecida Dalbo Contrera Toro

• Document type: Journal article
• Source: Jornal Brasileiro de Pneumologia; v. 46, n. 3 2020-03-13.

Abstract

ABSTRACT Objective To assess the agreement among asthma control measures and functional exercise capacity in children and adolescents with uncontrolled and controlled asthma. Methods Children and adolescents with asthma from 7-17 years old were selected, and they were attended in the “Pediatric Pulmonology Outpatient Clinic of State University of Campinas”, in Brazil. All patients had asthma control level assessed by Global Initiative for Asthma questionnaire (GINAq), Asthma Control Test (ACT), spirometry and six-minute-walk-test (6MWT). Patients were classified as uncontrolled or controlled asthma in each test and agreement among measures was assessed by kappa statistics. The ROC curve was calculated for the 6MWT. The spirometric index obtained from spirometry was composed by FEV1, FEV1/FVC and FEF25-75%. Spirometry and 6MWT results were compared between uncontrolled and controlled asthma group by GINAq. Results Of the 138 subjects included, 78 (56.5%) were male with median age of 11 (7-17) years old. GINAq detected 68.8% of patients with uncontrolled asthma. Moderate agreement (p < 0.001; k = 0.56) and high specificity (100%) was observed between GINAq and ACT. In 6MWT, the cut-off point of 82.03% of predicted distance was able to distinguish patients with controlled and uncontrolled asthma. Spirometric index presented 73.4% of sensitivity according to GINAq. The results for 6MWT in patients with uncontrolled asthma were the worst of all. Conclusion This study highlights the importance of assessing more than one measure to differentiate asthma control level. GINAq identified more patients with uncontrolled asthma and presented moderate agreement with ACT. Spirometric index was associated with uncontrolled asthma according to GINAq. 6MWT was a suitable measure to distinguish patients with controlled and uncontrolled asthma. (AU)

• FAPESP's process: 16/22102-8 - Assessment of inflammatory and functional features along with risk factors associated to chronic obstructive pulmonary disease of pediatric patients
• Grantee: Adyléia Aparecida Dalbo Contrera Toro
• Support Opportunities: Regular Research Grants