{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:19:43Z","timestamp":1788239983234,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Children with asthma may experience functional exercise limitations that are not fully reflected by resting lung function or conventional clinical assessments. Field\u2010based exercise tests provide complementary information regarding functional capacity, and the International Classification of Functioning, Disability and Health (ICF) offers a biopsychosocial framework to contextualize activity limitations. However, the integration of objective exercise performance with ICF\u2010aligned interpretation in pediatric asthma remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To interpret functional exercise capacity in children with asthma using Incremental Shuttle Walk Test (ISWT) performance through an exploratory operational framework conceptually aligned with ICF activity qualifiers and to examine its association with lung function, asthma control, quality of life, and demographic characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross\u2010sectional study, 39 children with asthma (mean age 8.6\u2009\u00b1\u20092.3 years) underwent spirometry, completed the Asthma Control Questionnaire (ACQ\u20106) and the Pediatric Asthma Quality of Life Questionnaire (PAQLQ), and performed the ISWT. Functional exercise capacity was expressed as a percentage of predicted ISWT distance and interpreted using an exploratory operational framework conceptually aligned with generic ICF activity qualifiers, generating two categories of activity limitation (mild\/moderate and severe).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Resting lung function was relatively preserved (mean FEV\n                      <jats:sub>1<\/jats:sub>\n                      82.0\u2009\u00b1\u200916.4% predicted), whereas functional exercise capacity was markedly reduced (mean ISWT 41.4\u2009\u00b1\u200918.7% predicted). Based on the exploratory ICF\u2010aligned framework, 72% of participants were categorized as having severe activity limitation. Children with severe limitations walked significantly shorter distances than those with mild\/moderate limitations (32.0\u2009\u00b1\u200911.5% vs. 65.3\u2009\u00b1\u200910.1% predicted;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with a very large effect size. Spirometric indices, asthma control, and quality of life scores did not differ between functional categories. ISWT performance was not correlated with lung function, asthma control, or quality of life and demonstrated a negative association with age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Children with asthma may present substantial functional exercise limitations despite relatively preserved lung function and similar levels of asthma control and quality of life. The exploratory operational alignment of ISWT performance with generic ICF activity qualifiers may provide a clinically useful framework to support interpretation of activity limitations not captured by conventional assessments. However, this approach should be interpreted cautiously and requires future validation before broader clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71734","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T07:38:48Z","timestamp":1785137928000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional Exercise Capacity and Exploratory ICF\u2010Aligned Interpretation of the Incremental Shuttle Walk Test in Children With Asthma"],"prefix":"10.1002","volume":"61","author":[{"given":"Danilo Rufino","family":"Cavalcante de Souza","sequence":"first","affiliation":[{"name":"Universidade de S\u00e3o Paulo \u2013 FMUSP S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan Peres","family":"Costa","sequence":"additional","affiliation":[{"name":"Universidade Nove de Julho\u2010 UNINOVE S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5765-7228","authenticated-orcid":false,"given":"Etiene Farah","family":"Teixeira de Carvalho","sequence":"additional","affiliation":[{"name":"Universidade Nove de Julho\u2010 UNINOVE S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirceu","family":"Costa","sequence":"additional","affiliation":[{"name":"Universidade Nove de Julho\u2010 UNINOVE S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelim Leal","family":"de Freitas Dantas Gomes","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo \u2013 FMUSP S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Global Initiative for Asthma (GINA) \u201cGlobal Strategy for Asthma Management and Prevention \u201d 2025(Global Initiative for Asthma 2025).www.ginasthma.org."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21609"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2013.09.010"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedhc.2015.11.012"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2018.08.010"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.04173-2020"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jped.2013.08.006"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jped.2020.04.004"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.36416\/1806-3756\/e20190102"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2020.105953"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.47.12.1019"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00150314"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.07.068"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200434130-00001"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2012-091347"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/00099228251348266"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.29271\/jcpsp.2022.04.473"},{"key":"e_1_2_10_19_1","volume-title":"International Classification of Functioning, Disability and Health: ICF","author":"World Health Organization","year":"2001"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/165019702760279189"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24857"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.36416\/1806-3756\/e20240051"},{"key":"e_1_2_10_24_1","volume-title":"WHO Child Growth Standards","author":"World Health Organization","year":"2006"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.07.043497"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00034805"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00080312"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3003.1999.14d29.x"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00435967"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.2223\/1283"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.2307\/2333709"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7441.702"},{"key":"e_1_2_10_33_1","volume-title":"Statistical Methods for Meta\u2010analysis","author":"Hedges L. V.","year":"1985"},{"issue":"3","key":"e_1_2_10_34_1","first-page":"69","article-title":"Statistics Corner: A Guide to Appropriate Use of Correlation Coefficient in Medical Research","volume":"24","author":"Mukaka M. M.","year":"2012","journal-title":"Malawi Medical Journal"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4614-1353-0"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.3389\/fresc.2026.1792865"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71734","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.71734","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71734","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:04:22Z","timestamp":1788239062000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.71734"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,27]]},"references-count":35,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/ppul.71734"],"URL":"https:\/\/doi.org\/10.1002\/ppul.71734","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,27]]},"assertion":[{"value":"2026-01-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71734"}}