This week, we had the sad news of the death of a 14-year-old boy, in the court of his condominium in the interior of São Paulo, due to respiratory failure, acute pulmonary edema, physical exertion in sport, and chronic bronchial asthma.
After all, can an asthmatic child do physical activity?
You can and should. Like all children, asthmatics benefit from physical activities, which enable good musculoskeletal development and the acquisition of motor skills, a healthy lifestyle, and social inclusion, improving self-esteem and quality of life. Having healthy lifestyle habits and good physical conditioning in childhood are decisive for good physical fitness in adult life. However, asthmatic children need to practice physical activities with follow-up and adequate medication.
50% to 90% of asthmatic children and adolescents have this diagnosis: “Exercise-induced bronchospasm”, which obstructs the bronchi associated with physical activity, and usually occurs soon after exercise interruption. Its symptoms are coughing, wheezing, chest tightness, dyspnoea, or increased mucus production. The intensity varies depending on some factors, such as air humidity and asthma severity.
The diagnosis is often clinical, but the idea is to perform a laboratory test for confirmation, called bronchoprovocation, with physical exercise. The patient performs a controlled physical activity, usually running on a treadmill or pedaling an exercise bike.
It is necessary to correctly diagnose who has this diagnosis to limit physical activity in any child with asthma. Children who have exercise-induced bronchospasm need to be properly treated and their exercise controlled. Bronchospasm can be a consequence of poorly controlled disease, requiring a greater intensity of prophylactic treatment, for example, with the use of inhaled corticosteroids.
Those who do not have a diagnosis of exercise-induced bronchospasm can and should freely engage in physical activity. It is common for asthmatic children to stop exercising, even if they do not have this diagnosis, due to lack of information.
Children, parents, and educators likely interpret symptoms produced by physical exertion due to the lack of cardiovascular conditioning arising from asthma, resulting in avoidance of exercise when, in reality, the lack of physical activity is the cause of the problem.
Benefits of Physical Activity for Asthmatics
Children with asthma and other chronic diseases benefit from regular physical activity: there is a reduction in the frequency of wheezing, in the number of hospitalizations and school absenteeism, reduction in unscheduled medical appointments and the need for medication to control asthma, weight loss in obese patients with reduction of symptoms, promotion of psychological well-being, protection against the increased risk of osteoporosis associated with prolonged steroid therapy, and improvement in asthma control.
With so many physical, psychological, social, and therapeutic benefits, children and adolescents with asthma should be encouraged to perform regular physical activity. To ensure safety, they need to be properly medicated and monitored.
With proper control, asthmatic children will participate in sports and games, which are essential activities for their development.
With information from the Brazilian Association of Allergy and Immunopathology (ASBAI)
Asthma appears up to one year, and care must be redoubled, especially in autumn and winter.
On the National Asthma Control Day, celebrated on June 21, the Sabará Hospital Infantil draws attention to the onset of the disease, whose symptoms appear, in 50% of cases, in childhood, up to three years of age.
Asthma is a chronic disease with the highest prevalence in childhood, affecting 10% of the pediatric population and 20% of adolescents, the fourth leading cause of hospitalization by SUS.
The disease is characterized by chronic inflammation that affects the airways or bronchi (the “tubes” that carry air into the lungs), making breathing difficult.
Because of the COVID-19 pandemic, the Brazilian Society of Pulmonology and Phthisiology (SBPT) warns that viral infections are frequent causes of asthma attacks. Therefore, these patients should be in social isolation whenever possible, especially those with more severe forms of the disease.
At Sabará Children’s Hospital, specializing in the care of children and adolescents, the most critical period for crises is between May and August when there is a change of climate, which causes crises. In 2020, the case rate for May was 5.30% in admissions due to the closing of schools, and, in 2021, with children attending schools physically, this number rose to 21%.
Asthma ranks fourth among the rates of all hospital admissions for other respiratory diseases (10%); second only to cases of bronchiolitis (41%), bronchitis (13%), and respiratory failure (11%).
“Although this type of disease can appear at all ages, in most cases, the onset is more common in childhood, 60% of patients manifest the disease in the first year of life, explains the pulmonologist of Sabará Hospital Infantil, Dr. Maria Helena Bussamra.
The most common symptoms are shortness of breath, wheezing or tightness in the chest, and coughing. The child may also have purplish-colored lips, extreme difficulty breathing, mental confusion, drowsiness, rapid pulse, and sweating during an attack.
“Since it is a chronic disease, going to the Hospital should be done when the signs of crisis do not improve with medication guided by the professional. Only then should parents seek care in the emergency room”, explains Dr. Maria Helena.
The factors that can trigger the disease are dust, mites, pollution, cigarette smoke, cold air, viral infections, sudden temperature changes.
To alleviate crises, it is possible to take some preventive measures such as: maintain adherence to the treatment proposed by the specialist, avoid closed, poorly sunny, and stuffy environments, keep the house airy, and exercise regularly and in a controlled manner.
“With the correct treatment, the asthmatic child can have the same quality of life as any other individual. Asthma is a disease that has no cure. However, the symptoms can be controlled by clinical monitoring and with the removal of possible agents causing the crises”, concludes the specialist.
Download the booklet of the Sabará Hospital Infantil: Asthma booklet: Playing and learning.
To access the answers in the booklet, click here.
About Sabará Children’s Hospital
Sabará Children’s Hospital, located in the city of São Paulo, is a reference in the care of children and adolescents up to 18 years of age. It is the first exclusively pediatric Hospital accredited by the Joint Commission International (JCI), a seal that assures its quality of care.
Founded 60 years ago, Sabará Hospital Infantil operates according to the model of American children’s hospitals, Children’s Hospitals, based on highly complex expertise in all pediatric specialties, which has an integrated multidisciplinary team with high resolutive capacity in child care.
With a highly trained medical and care team and a modern and complete technological park, the Institution is prepared to carry out deliveries when there is a need for immediate surgical intervention at birth and kidney transplants.
Its focus on pediatrics allows the Institution to learn about the most diverse childhood illnesses and guarantees expertise in the diagnosis and treatment of simple to rare diseases that are difficult to diagnose.
To transform the experience of hospitalized children, it has the Child Life Program, made up of specialists in child development. Through playful activities, professionals communicate with the child according to their language development and understanding of the world, thus facilitating treatment follow-up.
The Hospital that most understands children. From the Emergency Room to High Complexity – Sabará Children’s Hospital.