Asma induzida pelo exercício: aspectos atuais e recomendações

Abstract

OBJETIVO: Descrever os mecanismos da asma induzida pelo exercício (AIE), bem como os efeitos de diferentes tipos de treinamento físico na função pulmonar e nas capacidades aeróbia e anaeróbia. Destaca-se a importância de um diagnóstico correto mediante o teste de exercício e, no manejo, o uso de drogas beta-adrenérgicas e anticolinérgicas. FONTE DOS DADOS: Os artigos foram criteriosamente escolhidos utilizando as bases de dados PubMed e Scielo pelo ano de publicação e dando preferência a ensaios clínicos randomizados, com critérios de seleção da amostra bem definidos. SÍNTESE DOS DADOS: Os mecanismos para explicar a AIE permanecem sem conclusão, mas parece haver uma interação fisiológica entre as hipóteses aqui apresentadas. O uso de medicamentos e as freqüentes crises durante o exercício aparecem como fatores limitantes para a prática de exercícios físicos, conduzindo para um estilo de vida sedentário. CONCLUSÃO: Deve-se incentivar a prática de exercícios devidamente prescritos e minimizar as restrições aos sujeitos com AIE.

Effect of Physical Training on Exercise-Induced Bronchospasm in Young Asthmatics

“…Although swimming is one of the most recommended erercise modalities for asthmatic individuals, the benefits of swimming for this population seem to be more associated with the environment in which this modality is performed than with the modality itself. [5][6] In the present review, two studies used swimming as a modality for asthmatic children and adolescents, and the results were contradictory. Matsumoto et al 21 found a small reduction in FEV 1 after exercise, yet with no significant statistical difference when compared to the control group.…”

“…Asthma is a disease with high prevalence in childhood and adolescence, and regular physical activity has been recommended as an integral part of a healthy lifestyle. 1,4 Regular physical activity reduces the frequency of asthma attack, 5 besides bringing numerous benefits to health and quality of life. 16 In addition, PA has the role of improving physical fitness in childhood, which is essencial for the maintenance of physical fitness in adulthood, as well as improving psychological, social and therapeutic aspects, and reducing wheezing, hospitalization, and even the use of medication for asthma.…”

“…What has been speculated is that the improvement of aerobic fitness allows asthmatic individuals to better tolerate asthma attacks, as well as submaximal exercise, which lowers the chances of EIB triggering. 5 However, it occurs without any changes in the pulmonary variables which characterize the presence of EIB, such as the reduction in FEV 1 or PEF. 19 Another possible effect could be the anti-inflammatory role of exercise in the reduction of the pulmonary inflammation present in asthmatic individuals.…”

“…Walking and running are two types of physical exercise considered more asthmogenic than others, such as swimming and cycling. 5 Although the mechanisms for this are unclear, it is believed that the intensity achieved through these modalities, especially because they carry body weight, induce greater ventilation and, consequently, greater susceptibility to the triggering of bronchospasm. 7 In addition, the environments in which these activities are normally performed have a number of potential allergens that could induce an asthma attacks during or shortly after exercise.…”

“…Although physical activity (PA) is an indispensable component for the health and integral development of children and adolescents, 4 this activity can trigger a bronchospasm crisis, which is known as exercise--induced bronchospasm (EIB). 5,6 This condition is highly common in asthmatics (40 to 90%), but can also occur in 5 to 20% of the general population. 7 The world prevalence of EIB in children and adolescents is 9%, being 8% in countries of Europe, and 12% in America and Asia.…”