Aerobic training decreases bronchial hyperresponsiveness and systemic inflammation in patients with moderate or severe asthma: a randomised controlled trial

França-Pinto, Andrezza; Mendes, Felipe; Carvalho-Pinto, Regina Maria; Agondi, Rosana Câmara; Cukier, Alberto; Stelmach, Rafaël; Saraiva-Romanholo, Beatriz Mangueira; Kalil, Jorge; Martins, Mílton A.; Giavina‐Bianchi, Pedro; Carvalho, Celso Ricardo Fernandes

doi:10.1136/thoraxjnl-2014-206070

Cited by 179 publications

(196 citation statements)

References 34 publications

(43 reference statements)

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“…In the study by França-Pinto et al [19], patients exercised for 30 min two times/w for 3 months on a treadmill at intensities between 60 and 80% of HRmax. The average improvement in VO 2 max was ~3.5%.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of high-intensity training in asthma

Toennesen

Soerensen

Hostrup

et al. 2018

European Clinical Respiratory Journal

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Background: High-intensity interval training is an effective and popular training regime but its feasibility in untrained adults with asthma is insufficiently described. Objective: The randomized controlled trial ‘EFFORT Asthma’ explored the effects of behavioural interventions including high-intensity interval training on clinical outcomes in nonobese sedentary adults with asthma. In this article we present a sub analysis of data aiming to evaluate if patients’ pre-intervention levels of asthma control, FEV1, airway inflammation and airway hyperresponsiveness (AHR) predicted their training response to the high-intensity interval training program, measured as increase in maximal oxygen consumption (VO2max). Design: We used data from the EFFORT Asthma Study. Of the 36 patients randomized to the 8-week exercise intervention consisting of high-intensity training three times per week, 29 patients (45% females) completed the study and were included in this data analysis. Pre-intervention assessment included the asthma control questionnaire (ACQ), spirometry, fractional exhaled nitric oxide (FeNO) and AHR to mannitol. VO2 max was measured during an incremental cycle test. Results: The majority of included patients had partly or uncontrolled asthma reflected by a mean (SD) ACQ at 1.7 (0.6). Median (IQR) FeNO was 28.5 (23.8) ppb and 75% had a positive mannitol test indicating AHR.The association between patients’ training response measured as increase in VO2max and pre-intervention ACQ scores was not statistically significant (p = 0.49). Likewise, the association between patients’ increase in VO2max and FeNO as well as AHR was not statistically significant (p = 0.80 and p = 0.58). Conclusions: Included asthma patients could adhere to the high-intensity interval protocol and improve their VO2max regardless of pre-intervention levels of asthma control, airway inflammation and AHR.

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Section: Discussionmentioning

confidence: 99%

Feasibility of high-intensity training in asthma

Toennesen

Soerensen

Hostrup

et al. 2018

European Clinical Respiratory Journal

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“…Physical exercise has been shown to be a beneficial factor in the control of asthma [11]. Physical exercise reduces systemic and bronchial inflammation, and increases maximal oxygen uptake [12,13].…”

Section: Introductionmentioning

confidence: 99%

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Loponen

Ilmarinen

Tuomisto

et al. 2018

European Clinical Respiratory Journal

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Background: There is a lack of knowledge on the association between daily physical activity and lung function in patients with asthma. Objective: This study aims to examine the association between daily physical activity and asthma control, lung function, and lung function decline in patients with adult-onset asthma. Design: This study is part of Seinäjoki Adult Asthma Study (SAAS), where 201 patients were followed for 12 years after asthma diagnosis. Daily physical activity was assessed at follow-up by a structured questionnaire and used to classify the population into subgroups of low (≤240 min) or high (>240 min) physical activity. Three spirometry evaluation points were used: 1. diagnosis, 2. the maximum lung function during the first 2.5 years after diagnosis (Max0-2.5), 3. follow-up at 12 years. Results: High physical activity group had slower annual FEV1 (p<0.001) and FVC (p<0.018) decline. Additionally, the high physical activity group had higher FEV1 values at follow-up, and higher FEV1/FVC ratios at follow-up and diagnosis. There was no difference in BMI, smoking, medication, or frequency of physical exercise between high and low physical activity groups. Differences remained significant after adjustments for possible confounding factors. Conclusion: This is the first demonstration of an association between long-term FEV1 decline and daily physical activity in clinical asthma. Low physical activity is independently associated with faster decline in lung function. Daily physical activity should be recommended in treatment guidelines in asthma.

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“…The mechanisms through which exercise training improves exertional symptoms could relate to improving peripheral muscle conditioning, improved emotional wellbeing, modification of dyspnoea perception, or a disease-modifying effect of exercise on asthma. For example, a more recent trial found that 12 weeks of aerobic training improved bronchial hyperresponsiveness, inflammatory markers and patient-reported asthma control and quality of life, with particular improvement in the Activity Limitation domain on the AQLQ [109].…”

Section: Inhaled Corticosteroids and Dyspnoeamentioning

confidence: 99%

Mechanisms, measurement and management of exertional dyspnoea in asthma

et al. 2017

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Asthma is a heterogeneous condition, with dyspnoea during exercise affecting individuals to a variable degree. This narrative review explores the mechanisms and measurement of exertional dyspnoea in asthma and summarises the available evidence for the efficacy of various interventions on exertional dyspnoea. Studies on the mechanisms of dyspnoea in asthma have largely utilised direct bronchoprovocation challenges, rather than exercise, which may invoke different physiological mechanisms. Thus, the description of dyspnoea during methacholine challenge can differ from what is experienced during daily activities, including exercise. Dyspnoea perception during exercise is influenced by many interacting variables, such as asthma severity and phenotype, bronchoconstriction, dynamic hyperinflation, respiratory drive and psychological factors. In addition to the intensity of dyspnoea, the qualitative description of dyspnoea may give important clues as to the underlying mechanism and may be an important endpoint for future interventional studies. There is currently little evidence demonstrating whether pharmacological or non-pharmacological interventions specifically improve exertional dyspnoea, which is an important area for future research.

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Aerobic training decreases bronchial hyperresponsiveness and systemic inflammation in patients with moderate or severe asthma: a randomised controlled trial

Cited by 179 publications

References 34 publications

Feasibility of high-intensity training in asthma

Feasibility of high-intensity training in asthma

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Mechanisms, measurement and management of exertional dyspnoea in asthma

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