Physical training for asthma

Abstract

BACKGROUND: People with asthma may show less tolerance to exercise due to worsening asthma symptoms during exercise or other reasons such as deconditioning as a consequence of inactivity. Some may restrict activities as per medical advice or family influence and this might result in reduced physical fitness. Physical training programs aim to improve physical fitness, neuromuscular coordination and self confidence. Subjectively, many people with asthma report that they are symptomatically better when fit, but results from trials have varied and have been difficult to compare because of different designs and training protocols. Also, as exercise can induce asthma, the safety of exercise programmes needs to be considered. OBJECTIVE: To gain a better understanding of the effect of physical training on the respiratory and general health of people with asthma, from randomised trials. METHODS: Search methods: We searched the Cochrane Airways Group Specialised Register of trials up to January 2013. Selection criteria: We included randomised trials of people over eight years of age with asthma who were randomised to undertake physical training or not. Physical training had to be undertaken for at least 20 minutes, two times a week, over a minimum period of four weeks. Data collection and analysis: Two review authors independently assessed eligibility for inclusion and undertook risk of bias assessment for the included studies. MAIN RESULTS: Twenty-one studies (772 participants) were included in this review with two additional 2012 studies identified as 'awaiting classification'. Physical training was well tolerated with no adverse effects reported. None of the studies mentioned worsening of asthma symptoms following physical training. Physical training showed marked improvement in cardiopulmonary fitness as measured by a statistically and clinically significant increase in maximum oxygen uptake (mean difference (MD) 4.92 mL/kg/min; 95% confidence interval (CI) 3.98 to 5.87; P < 0.00001; 8 studies on 267 participants); however, no statistically significant effects were observed for forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), minute ventilation at maximal exercise (VEmax) or peak expiratory flow rate (PEFR). Meta-analysis of four studies detected a statistically significant increase in maximum heart rate, and following a sensitivity analysis and removal of two studies significance was maintained (MD 3.67 bpm; 95% CI 0.90 to 3.44; P = 0.01). Although there were insufficient data to pool results due to diverse reporting tools, there was some evidence to suggest that physical training may have positive effects on healthrelated quality of life, with four of five studies producing a statistically and clinically significant benefit. AUTHORS' CONCLUSIONS: This review demonstrated that physical training showed significant improvement in maximum oxygen uptake, though no effects were observed in other measures of pulmonary function. Physical training was well tolerated among people with asthma in the inc...

The effects of exercise based on adherence to ACSM recommendations on pulmonary function and quality of life in adults with asthma: a systematic review and meta-analysis

“…Our study found that exercise intervention can improve FEV1 (SMD = 0.49; 95% CI: 0.16, 0.81), FVC (SMD = 0.66; 95% CI: 0.27, 1.06), and quality of life scores (SMD = 0.52; 95% CI: 0.17, 0.86) in patients with bronchial asthma. These results are consistent with previous research findings, indicating that exercise represents a potent non-pharmacological therapeutic approach for individuals with bronchial asthma ( Dogra et al, 2011 , Carson et al, 2013 ; Freitas et al, 2013 ; Frana-Pinto et al, 2015 ; Reddel et al, 2024 ). However, for FEV1/FVC (SMD = 0.21; 95% CI: −0.51, 0.92), the effect of exercise intervention is not significant.…”

The effects of exercise based on adherence to ACSM recommendations on pulmonary function and quality of life in adults with asthma: a systematic review and meta-analysis

“…Our study found that exercise intervention can improve FEV1 (SMD = 0.49; 95% CI: 0.16, 0.81), FVC (SMD = 0.66; 95% CI: 0.27, 1.06), and quality of life scores (SMD = 0.52; 95% CI: 0.17, 0.86) in patients with bronchial asthma. These results are consistent with previous research findings, indicating that exercise represents a potent non-pharmacological therapeutic approach for individuals with bronchial asthma ( Dogra et al, 2011 , Carson et al, 2013 ; Freitas et al, 2013 ; Frana-Pinto et al, 2015 ; Reddel et al, 2024 ). However, for FEV1/FVC (SMD = 0.21; 95% CI: −0.51, 0.92), the effect of exercise intervention is not significant.…”

Effects of resistance training with/without Photobiomodulation on muscle and respiratory function in difficult-to-control asthma: a randomized trial

“…Asthma control remained stable across both groups, with no significant between-group differences. This result is consistent with systematic reviews showing that exercise interventions primarily promote peripheral and functional adaptations, with minimal short-term impact on asthma symptoms or airway inflammation [ 50 ]. Because neither resistance training nor PBMT directly targets airway inflammation or bronchial hyperresponsiveness, changes in asthma control scores were not expected.…”

“…Physical activity level assessed by the IPAQ remained unchanged in both groups. This pattern is aligned with literature showing that improvements derived from supervised exercise programs do not automatically translate into changes in habitual daily activity without behavioral interventions [ 7 , 49 , 50 ]. Daily physical activity behavior is influenced by psychosocial and environmental factors, which are not directly modified by physiological conditioning alone.…”

Physical activity, physical capacity and sedentary behavior among asthma patients

“……”

The effects of exercise based on adherence to ACSM recommendations on pulmonary function and quality of life in adults with asthma: a systematic review and meta-analysis

“…Our study found that exercise intervention can improve FEV1 (SMD = 0.49; 95% CI: 0.16, 0.81), FVC (SMD = 0.66; 95% CI: 0.27, 1.06), and quality of life scores (SMD = 0.52; 95% CI: 0.17, 0.86) in patients with bronchial asthma. These results are consistent with previous research findings, indicating that exercise represents a potent non-pharmacological therapeutic approach for individuals with bronchial asthma ( Dogra et al, 2011 , Carson et al, 2013 ; Freitas et al, 2013 ; Frana-Pinto et al, 2015 ; Reddel et al, 2024 ). However, for FEV1/FVC (SMD = 0.21; 95% CI: −0.51, 0.92), the effect of exercise intervention is not significant.…”

Effects of resistance training with/without Photobiomodulation on muscle and respiratory function in difficult-to-control asthma: a randomized trial

“…Asthma control remained stable across both groups, with no significant between-group differences. This result is consistent with systematic reviews showing that exercise interventions primarily promote peripheral and functional adaptations, with minimal short-term impact on asthma symptoms or airway inflammation [ 50 ]. Because neither resistance training nor PBMT directly targets airway inflammation or bronchial hyperresponsiveness, changes in asthma control scores were not expected.…”

“…Physical activity level assessed by the IPAQ remained unchanged in both groups. This pattern is aligned with literature showing that improvements derived from supervised exercise programs do not automatically translate into changes in habitual daily activity without behavioral interventions [ 7 , 49 , 50 ]. Daily physical activity behavior is influenced by psychosocial and environmental factors, which are not directly modified by physiological conditioning alone.…”

Physical activity, physical capacity and sedentary behavior among asthma patients

“……”

The effects of exercise based on adherence to ACSM recommendations on pulmonary function and quality of life in adults with asthma: a systematic review and meta-analysis

“…Our study found that exercise intervention can improve FEV1 (SMD = 0.49; 95% CI: 0.16, 0.81), FVC (SMD = 0.66; 95% CI: 0.27, 1.06), and quality of life scores (SMD = 0.52; 95% CI: 0.17, 0.86) in patients with bronchial asthma. These results are consistent with previous research findings, indicating that exercise represents a potent non-pharmacological therapeutic approach for individuals with bronchial asthma ( Dogra et al, 2011 , Carson et al, 2013 ; Freitas et al, 2013 ; Frana-Pinto et al, 2015 ; Reddel et al, 2024 ). However, for FEV1/FVC (SMD = 0.21; 95% CI: −0.51, 0.92), the effect of exercise intervention is not significant.…”

Effects of resistance training with/without Photobiomodulation on muscle and respiratory function in difficult-to-control asthma: a randomized trial

“…Asthma control remained stable across both groups, with no significant between-group differences. This result is consistent with systematic reviews showing that exercise interventions primarily promote peripheral and functional adaptations, with minimal short-term impact on asthma symptoms or airway inflammation [ 50 ]. Because neither resistance training nor PBMT directly targets airway inflammation or bronchial hyperresponsiveness, changes in asthma control scores were not expected.…”

“…Physical activity level assessed by the IPAQ remained unchanged in both groups. This pattern is aligned with literature showing that improvements derived from supervised exercise programs do not automatically translate into changes in habitual daily activity without behavioral interventions [ 7 , 49 , 50 ]. Daily physical activity behavior is influenced by psychosocial and environmental factors, which are not directly modified by physiological conditioning alone.…”

Physical activity, physical capacity and sedentary behavior among asthma patients

“……”