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...

Exercise training in children with asthma: a systematic review

“…The results of our review are in accordance with the results of three previous systematic reviews 17 75 76. Alongside an update of the literature we provided an overview of additional parameters, such as the effects of exercise training on EIB and pathophysiological pathways.…”

Exercise training in children with asthma: a systematic review

“…The results of our review are in accordance with the results of three previous systematic reviews 17 75 76. Alongside an update of the literature we provided an overview of additional parameters, such as the effects of exercise training on EIB and pathophysiological pathways.…”

A comparative study of the effects of aerobic and resisted exercises on selected cardiopulmonary parameters in patients with asthma

“…The finding that pulmonary variables in group B were not significant implies that resisted exercise did not bring about any significant improvement in patients with asthma. This observation, which is consistent with the results of several previous studies such as Satta (2000), Ram et al (2005) and Fanelli et al (2007), showed that there were no significant changes in any of the variables for lung function after exercise training as well as when compared with the control group. A systematic review of studies on exercise and asthma revealed that 9 out of the 13 that assessed lung 1 function (FEV and FVC) found no changes following exercise intervention (Ram et al, 2005).…”

Beyond muscles: The untapped potential of creatine

“…Additionally, reduced levels of IL-4 and IL-5, as well as decreased thickening of the airway walls were observed in the exercised animals as compared with the non-exercised animals. These findings reflect reports in humans that showed exercise improved cardiorespiratory fitness in individuals with asthma [204], and that individuals who trained at moderate intensity were more likely to demonstrate improvements in their asthma symptoms than those who exercised at a low intensity [205–210]. Based upon these data, it seems reasonable to suggest that athletes would have a lower incidence of asthma compared to the general public; however, in reality, the opposite may be true [211–214].…”

Exercise training in children with asthma: a systematic review

“…The results of our review are in accordance with the results of three previous systematic reviews 17 75 76. Alongside an update of the literature we provided an overview of additional parameters, such as the effects of exercise training on EIB and pathophysiological pathways.…”

A comparative study of the effects of aerobic and resisted exercises on selected cardiopulmonary parameters in patients with asthma

“…The finding that pulmonary variables in group B were not significant implies that resisted exercise did not bring about any significant improvement in patients with asthma. This observation, which is consistent with the results of several previous studies such as Satta (2000), Ram et al (2005) and Fanelli et al (2007), showed that there were no significant changes in any of the variables for lung function after exercise training as well as when compared with the control group. A systematic review of studies on exercise and asthma revealed that 9 out of the 13 that assessed lung 1 function (FEV and FVC) found no changes following exercise intervention (Ram et al, 2005).…”

Beyond muscles: The untapped potential of creatine

“…Additionally, reduced levels of IL-4 and IL-5, as well as decreased thickening of the airway walls were observed in the exercised animals as compared with the non-exercised animals. These findings reflect reports in humans that showed exercise improved cardiorespiratory fitness in individuals with asthma [204], and that individuals who trained at moderate intensity were more likely to demonstrate improvements in their asthma symptoms than those who exercised at a low intensity [205–210]. Based upon these data, it seems reasonable to suggest that athletes would have a lower incidence of asthma compared to the general public; however, in reality, the opposite may be true [211–214].…”

Exercise training in children with asthma: a systematic review

“…The results of our review are in accordance with the results of three previous systematic reviews 17 75 76. Alongside an update of the literature we provided an overview of additional parameters, such as the effects of exercise training on EIB and pathophysiological pathways.…”

A comparative study of the effects of aerobic and resisted exercises on selected cardiopulmonary parameters in patients with asthma

“…The finding that pulmonary variables in group B were not significant implies that resisted exercise did not bring about any significant improvement in patients with asthma. This observation, which is consistent with the results of several previous studies such as Satta (2000), Ram et al (2005) and Fanelli et al (2007), showed that there were no significant changes in any of the variables for lung function after exercise training as well as when compared with the control group. A systematic review of studies on exercise and asthma revealed that 9 out of the 13 that assessed lung 1 function (FEV and FVC) found no changes following exercise intervention (Ram et al, 2005).…”

Beyond muscles: The untapped potential of creatine

“…Additionally, reduced levels of IL-4 and IL-5, as well as decreased thickening of the airway walls were observed in the exercised animals as compared with the non-exercised animals. These findings reflect reports in humans that showed exercise improved cardiorespiratory fitness in individuals with asthma [204], and that individuals who trained at moderate intensity were more likely to demonstrate improvements in their asthma symptoms than those who exercised at a low intensity [205–210]. Based upon these data, it seems reasonable to suggest that athletes would have a lower incidence of asthma compared to the general public; however, in reality, the opposite may be true [211–214].…”