Association and Impact of the Physical Environment on Physical Activity and Sedentary Behaviours in an Asthmatic Pediatric Population

Association and Impact of the Physical Environment on Physical Activity and Sedentary Behaviours in an Asthmatic Pediatric PopulationGiorge Voutsas Doctor of Philosophy Institute of Medical Science University of Toronto 2025 Abstract Background: Asthma prevalence has increased worldwide in recent decades, resulting in extensive use of emergency care services that significantly contribute to burdens on the healthcare system. Lifestyle factors, notably decreased physical activity (PA) and increased sedentary behaviour, are implicated in increased asthma severity and prevalence. However, the amount and intensity of PA in children with severe asthma are not well described, and the factors contributing to decreased PA are not well understood. This study aims to characterize the full movement spectrum over 24 hours and identify risk factors that may modify physical activity (PA) in children with severe asthma. Methods: This prospective cross-sectional study compared two age- and sex-matched groups aged 7 to 10 years: a group with severe asthma and a healthy control group. Anthropometric measurements were collected, and subjects were provided with the GT3X accelerometer and GPS devices to be worn simultaneously for seven consecutive days and nights, following a 24-hour protocol. The GT3X device evaluated wake-sleep cycles across all age groups, providing objective measures of physical activity (PA) intensities and sleep using age-specific, validated cut-off points. GPS devices objectively assessed the impact of the physical environment as the primary moderator influencing PA participation. Furthermore, specific barriers and facilitators to physical activity (PA) in pediatric asthma were assessed through qualitative interviews and structured surveys. Results: Children with uncontrolled severe asthma did not significantly differ in their participation of weekly mean MVPA compared to controls (92.3 minutes [85.3-122.6] vs. 110.2 minutes [86.3-132.7], p=0.38), while increased weekly mean sedentary time (490.3 minutes [452.9-536.8] vs. 441.6 minutes [364.3-518.3], p=0.06) was seen in uncontrolled severe asthma phenotypes. Physical environment was not found to have an impact on PA participation in this population. Additionally, we found that social pressure may act as a significant facilitator of PA for children, while parents often restrict activities due to concerns about exacerbating symptoms. By identifying the factors that impact PA behaviours in children with severe asthma, this research provides the foundation for future studies to develop tailored PA interventions and specific guidelines for safe exercise, with a personalized approach to exercise prescription for this population.

Department dc:contributor.department

Medical Science

Year dc:date.issued

2025

Author dc:creator

• Voutsas, Giorge Thomas

Advisor dc:contributor.advisor

• Narang, Dr. Indra

• Movement Profile
• Pediatric Population
• Physical Activity
• Physical Environment
• Sedentary Behaiviour
• Severe Asthma

Statement dc:rights

• Attribution 4.0 International

Licence dc:rights.uri

• http://creativecommons.org/licenses/by/4.0/

Handle dc:identifier.uri

https://hdl.handle.net/1807/150142

OAI identifier oai:identifier

oai:utoronto.scholaris.ca:1807/150142