{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T17:18:27Z","timestamp":1778087907135,"version":"3.51.4"},"reference-count":14,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"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":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Asthma is one of the most prevalent chronic diseases in childhood and a major cause of respiratory morbidity, school absenteeism, and restrictions in physical activity. Although asthma control is commonly assessed using clinical and inflammatory markers, its functional impact on daily activities and participation is less frequently addressed. Fractional exhaled nitric oxide (FeNO) is a well\u2010established biomarker of eosinophilic airway inflammation; however, its integration with quality\u2010of\u2010life measures within a biopsychosocial framework, such as the International Classification of Functioning, Disability and Health (ICF), remains limited. This study aimed to examine the associations between quality of life, airway inflammation, and functional status in children and adolescents with asthma using the ICF as a conceptual integrative framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross\u2010sectional study included 112 children and adolescents with clinically diagnosed asthma receiving care at a pediatric respiratory physiotherapy clinic. Data collection comprised demographic and anthropometric variables, FeNO levels, and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) scores. Clinical and patient\u2010reported outcomes were conceptually linked to ICF categories related to body functions and activities and participation and expressed as functional impairment levels (0\u20134) for descriptive and comparative purposes. Descriptive analyses were performed, and participants were stratified according to FeNO levels (&lt;\u00a035 vs.\u00a0\u2265\u00a035 ppb). Group comparisons were conducted using Welch's\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test, with effect sizes estimated using Cohen's d (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The sample had a mean age of 8.9\u00a0\u00b1\u00a02.7\u00a0years and a mean FeNO level of 47.1\u00a0\u00b1\u00a038.6 ppb. Overall PAQLQ scores indicated relatively preserved perceived quality of life across domains. ICF\u2010based descriptive analysis indicated predominantly mild\u2010to\u2010moderate limitations in activity\u2010 and symptom\u2010related domains and minimal emotional impairment, with a mean global ICF score of 1.5\u00a0\u00b1\u00a00.6. Participants with FeNO \u2265\u00a035 ppb presented lower PAQLQ scores in symptoms, emotions, and activities, as well as higher global ICF scores, compared with those with FeNO &lt;\u00a035 ppb (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0\u2264\u00a00.05). Effect sizes were large (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u00a0\u2265\u00a00.8).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Higher FeNO levels were associated with poorer quality\u2010of\u2010life scores and greater functional impairment. The conceptual integration of FeNO and PAQLQ findings within the ICF framework facilitated the interpretation of inflammatory status in relation to functional domains relevant to physiotherapy without implying causality. This approach supports a more comprehensive understanding of asthma\u2010related functioning in children and adolescents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pri.70184","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T09:14:03Z","timestamp":1773998043000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quality of Life and Airway Inflammation in Children With Asthma: Integrating Clinical and Functional Measures Through the International Classification of Functioning (ICF)"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9950-6396","authenticated-orcid":false,"given":"Julia dos Santos","family":"Lima","sequence":"first","affiliation":[{"name":"Department of Physical Therapy School of Medicine University of S\u00e3o Paulo Communication Sciences &amp; Disorders, and Occupational Therapy  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1275-8300","authenticated-orcid":false,"given":"Ang\u00e9lica Goden\u00e7o","family":"Leite","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy School of Medicine University of S\u00e3o Paulo Communication Sciences &amp; Disorders, and Occupational Therapy  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0334-3899","authenticated-orcid":false,"given":"Dirceu","family":"Costa","sequence":"additional","affiliation":[{"name":"Independent Researcher  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0636-6041","authenticated-orcid":false,"given":"Evelim","family":"Leal de Freitas Dantas Gomes","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy School of Medicine University of S\u00e3o Paulo Communication Sciences &amp; Disorders, and Occupational Therapy  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200406\u2010710ST"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/165019702760279189"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/16501970510040263"},{"key":"e_1_2_13_5_1","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J.","year":"1988"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.9120\u201011st"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjpt.2018.08.010"},{"key":"e_1_2_13_8_1","unstructured":"Global Initiative for Asthma (GINA). n.d.Global Strategy for Asthma Management and Prevention 2025 update.https:\/\/ginasthma.org."},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00435967"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pai.12457"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.2223\/jped.1283"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/00099228251348266"},{"issue":"3","key":"e_1_2_13_13_1","first-page":"329","article-title":"How to Apply the International Classification of Functioning, Disability and Health (ICF) for Rehabilitation Management in Clinical Practice","volume":"44","author":"Rauch A.","year":"2008","journal-title":"European Journal of Physical and Rehabilitation Medicine"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977\u20100041"},{"key":"e_1_2_13_15_1","volume-title":"International Classification of Functioning, Disability and Health (ICF)","author":"World Health Organization","year":"2001"}],"container-title":["Physiotherapy Research International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pri.70184","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pri.70184","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pri.70184","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T17:02:52Z","timestamp":1778086972000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pri.70184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,20]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/pri.70184"],"URL":"https:\/\/doi.org\/10.1002\/pri.70184","archive":["Portico"],"relation":{},"ISSN":["1358-2267","1471-2865"],"issn-type":[{"value":"1358-2267","type":"print"},{"value":"1471-2865","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,20]]},"assertion":[{"value":"2025-12-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70184"}}