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World J Clin Cases. Mar 16, 2015; 3(3): 301-309
Published online Mar 16, 2015. doi: 10.12998/wjcc.v3.i3.301
Evaluation of functional, autonomic and inflammatory outcomes in children with asthma
Evelim Leal de Freitas Dantas Gomes, Dirceu Costa
Evelim Leal de Freitas Dantas Gomes, Rehabilitation Sciences, Physical Therapy Course, University Nove de Julho, São Paulo 01504-001, Brazil
Dirceu Costa, Postgraduate Program in Rehabilitation Sciences, University Nove de Julho, São Paulo 01504-001, Brazil
Author contributions: Both authors have made substantial contributions to the conception, design, analysis and interpretation of data, drafting of the manuscript, revising the manuscript critically for important intellectual content and final approval of the version to be published.
Conflict-of-interest: The authors state that there is no conflict of interest in this study.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dirceu Costa, PhD, Professor, LARESP, Postgraduate Program in Rehabilitation Sciences, University Nove de Julho, Mestrado e doutorado em Ciências da Reabilitação, Rua Vergueiro, 235/249, 2SS, São Paulo 01504-001, Brazil. dcosta@uninove.br
Telephone: +55-11-33859241 Fax: +55-11-33859241
Received: July 12, 2014
Peer-review started: July 13, 2014
First decision: September 30, 2014
Revised: December 6, 2014
Accepted: December 18, 2014
Article in press: December 19, 2014
Published online: March 16, 2015
Abstract

Asthma is common in childhood. This respiratory disease is characterized by persistent inflammation of the airways even when the child is not in the throes of an attack. Chronic inflammation is caused by an imbalance between pro-inflammatory and anti-inflammatory mechanisms as well as autonomic dysfunction, which plays an important role in the pathogenesis and control of this condition. The impact of these physiopathological aspects leads to inactivity and a sedentary lifestyle, which exerts an influence on functional capacity and control of the disease. The main objective of non-pharmacological therapy is the clinical control of asthma and the minimization of airway obstruction and hyperinflation during an attack. These factors can be controlled with noninvasive ventilation. The aim or the present review was to describe important neural, inflammatory and functional mechanisms that affect children with asthma.

Keywords: Asthma, Child, Continuous positive airway pressure, Noninvasive ventilation, Autonomic nervous system, Functional capacity, Inflammatory mechanisms, Evaluation

Core tip: The recurring nature of asthma is related to the clinical control of the disease. Neural and inflammatory mechanisms interfere with this clinical control and affect functional capacity. While the magnitude of an asthma attack cannot be controlled, its clinical impact can be minimized with the use of noninvasive ventilation. Moreover, functional capacity and inflammation can be improved with physical exercise.