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01-08-2010 | General practice | Article

Children with asthma ‘overprotected’


British Journal of General Practice

Children with asthma are not exercising as much as they can, report researchers whose study points to a 'culture of overprotection' that may be unwittingly reinforced by GPs.

Dr Brian Williams, Director of the Social Dimensions of Health Institute at the University of Dundee, and colleagues explain: "Exercise improves general health status, and reduces GP consultations and medication use among children with asthma.

"The findings from the study show that lower levels of activity reported among children with asthma were strongly influenced by parental beliefs about the child's physical capability and fears about the safety of exercising in the presence of perceived 'triggers'. This resulted in limitations being imposed on the intensity and duration of physical activities."

The researchers conducted in-depth interviews and focus groups with asthmatic children and their parents and teachers at six general practices, a paediatric respiratory unit and four schools in Tayside, Scotland.

Of note, although most parents recognised that medical opinion encourages exercise in children with asthma, they also believed that exercise - and overexertion in particular - is a major trigger for an asthma attack.

GPs were seen to sanction this when children and parents cited medical opinion to support non-participation at school. This, combined with lack of knowledge about asthma, undermined efforts of school staff to engage children in physical activity.

The authors say that primary care professionals could have a pivotal role in promoting exercise in children with asthma, by addressing the fears of both children and parents.

Indeed, they conclude: "GPs and asthma management nurses need to provide clear management plans explaining what is appropriate and safe in terms of exercise on a child-by-child basis, to counter the considerable misunderstanding and disagreement among children, parents and teachers."

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By Caroline Price