title: Perceived exercise limitation in asthma: The role of disease severity, overweight, and physical activity in children.
abstract: Children with asthma may be less physically active than their healthy peers. We aimed to investigate whether perceived exercise limitation (EL) was associated with lung function or bronchial hyper-responsiveness (BHR), socioeconomic factors, prenatal smoking, overweight, allergic disease, asthma severity, or physical activity (PA).
  
  
  
  The 302 children with asthma from the 10-year examination of the Environment and Childhood Asthma birth cohort study underwent a clinical examination including perceived EL (structured interview of child and parent(s)), measure of overweight (body mass index by sex and age passing through 25 kg/m2or above at 18 years), exercise-induced bronchoconstriction (forced expiratory volume in one-second (FEV1) pre- and post-exercise), methacholine bronchial challenge (severe BHR; provocative dose causing ≥20% decrease in FEV1≤ 1 μmol), and asthma severity score (dose of controller medication and exacerbations last 12 months). Multivariate logistic regression analyses were conducted to assess associations with perceived EL.
  
  
  
  In the final model explaining 30.1%, asthma severity score (OR: 1.49, (1.32, 1.67)) and overweight (OR: 2.35 (1.14, 4.82)) only were significantly associated with perceived EL. Excluding asthma severity and allergic disease, severe BHR (OR: 2.82 (1.38, 5.76)) or maximal reduction in FEV1post-exercise (OR: 1.48 (1.10, 1.98)) and overweight (OR: 2.15 (1.13, 4.08) and 2.53 (1.27, 5.03)) explained 9.7% and 8.4% of perceived EL, respectively.
  
  
  
  Perceived EL in children with asthma was independently associated with asthma severity and overweight, the latter doubling the probability of perceived EL irrespectively of asthma severity, allergy status, socioeconomic factors, prenatal smoking, or PA.
authors.affiliation: Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.
authors.forename: Thomas
authors.initials: T
authors.lastname: Westergren
authors.affiliation: Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.
authors.forename: Sveinung
authors.initials: S
authors.lastname: Berntsen
authors.affiliation: Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Karin C
authors.initials: KC
authors.lastname: Lødrup Carlsen
authors.affiliation: Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Petter
authors.initials: P
authors.lastname: Mowinckel
authors.affiliation: Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: Geir
authors.initials: G
authors.lastname: Håland
authors.affiliation: Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.
authors.forename: Liv
authors.initials: L
authors.lastname: Fegran
authors.affiliation: Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Kai-Håkon
authors.initials: KH
authors.lastname: Carlsen
mesh_terms: D001249:Asthma / Q000453:epidemiology*; D016535:Bronchial Hyperreactivity / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D000073865:Cigarette Smoking; D015331:Cohort Studies; D015444:Exercise; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects; D009664:Norway / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology*; D011247:Pregnancy; D012129:Respiratory Function Tests; D012959:Socioeconomic Factors
keywords: bronchial hyper-reactivity; bronchial provocation tests; cohort studies; exercise-induced asthma; overweight; pulmonary function tests; self-report; socioeconomic status