Exercise and Asthma in Children

Exercise is for both for adults and children. Regular daily exercises is part of a healthy lifestyle. However, exercise is a common trigger for asthma. When asthma is well controlled, you should not be limited in your regular exercise activities.

Exercise induced asthma occurs with exercise and symptoms include coughing, wheezing, shortness of breath, chest pain or tightness, tiredness and difficulty in keeping up everyday. These symptoms can occur during strenuous activity, but usually 5-10 minutes after stopping the activity. Recurrence of symptoms may develop hours after. Intense sports activities such as swimming, soccer, and long distance running are most likely to cause asthma symptoms but do not always need to be avoided since the symptoms can be controlled. Whether exercise brings on asthma symptoms it may depend on how long you are active, how intense the activity is and the environment you exercise.

Asthma symptoms may occur with environmental trigger exposure. For example, a child may breathe comfortably indoors on a basketball court, but will develop asthma symptoms when running in a grassy field. Several asthma triggers will include air pollution, pollens and molds in the air, outside temperature, humidity and tobacco smoking.

How can I prevent asthma symptoms with exercise?

1. Identify your exercise induced asthma trigger.
2. Take your pre-treatment asthma medicine at least 15-30 minutes before exercise
3. Warm up before exercise
4. End with a cool down exercise

The two main types are: bronchodilator and anti-inflammatory medicines.

Short acting beta agonist (SABA) bronchodilators include salbutamol. Ipratropium bromide is a short acting muscarinic receptor antagonist that is also used at times for exercise pre treatment. You should take your SABA 15-30 minutes before starting exercise. It will not last longer than 4-6 hours.

Anti-inflammatory medications include corticosteroids such as budesonide, fluticasone and non-steroidal medications like montelukast. Anti-inflammatory medications are usually taken on regular schedule to control asthma. These are regular controller medications.

Warming up begin with walking slowly and slowly increase activity or speed over 3-5 minutes. Cooling down slowly for 5-10 minutes after each exercise can prevent exercise induced asthma. Cool down activities include stretching exercises and walking.

Despite the use of SABA before each exercise, asthma symptoms may occur. If they do occur, advise to slow down exercise activity. However, if symptoms continue to get worse, use SABA as a reliever medication. Even with SABA was taken before exercising, it is OK to take it again to relieve his/her symptoms. However, if symptoms persisted and makes limit your physical activity, re evaluate your patient.

Conditioning is very important at all times. Overweight, sedentary lifestyle and unhealthy eating habits make as at high risk for many diseases. Poor conditioning can make your patient feel out of breath and can be confused for asthma symptoms. It takes effort and time to build physical fitness and be in good shape. Make a plan to be active and exercise regularly.

Reference:

American Thoracic Society; www.thoracic.org/patients

National Heart, Lung and Blood Institute; http://nhlbi.nih.gov/health/resources/lung/asthma-physical activity

Asthma UK; http://www.asthma.org.uk/knowledge-bank-exercise

Exercise-induced asthma http://myhealth.alberta.ca/health/Pages/conditions.aspx?hwid=hw161742hw161742-sec