Physical training for asthma

Massey University, Palmerston North City, Manawatu-Wanganui, New Zealand
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2005; 4(4):CD001116. DOI: 10.1002/14651858.CD001116.pub2
Source: PubMed


Physical training programmes have been designed for asthmatic subjects with the aim of improving physical fitness, neuromuscular coordination and self-confidence. Habitual physical activity increases physical fitness and lowers ventilation during mild and moderate exercise thereby reducing the likelihood of provoking exercise induced asthma. Exercise training may also reduce the perception of breathlessness through a number of mechanisms including strengthening respiratory muscles. Subjectively, many asthmatics 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.
The purpose of this review was to assess evidence for the efficacy and effectiveness of physical training in asthma.
We searched the Cochrane Airways Group Specialised Register, SportDiscus and the Science Citation Index up to May 2005.
Randomised trials in asthmatic subjects undertaking physical training. Subjects had to be eight years and older. Physical training had to be undertaken for at least 20 to 30 minutes, two to three times a week, over a minimum of four weeks.
Eligibility for inclusion and quality of trials were assessed independently by two reviewers.
Thirteen studies (455 participants) were included in this review. Physical training had no effect on resting lung function or the number of days of wheeze. The results of this review have shown that lung function and wheeze is not worsened by physical training in patients with asthma. Physical training improved cardiopulmonary fitness as measured by an increase in maximum oxygen uptake of 5.4 ml/kg/min (95% confidence interval 4.2 to 6.6) and maximum expiratory ventilation 6.0 L/min (95% confidence interval 1.5 to 10.4). There were no data concerning quality of life measurements.
In people with asthma, physical training can improve cardiopulmonary fitness without changing lung function. It is not known whether improved fitness is translated into improved quality of life. It is comforting to know that physical training does not have an adverse effect on lung function and wheeze in patients with asthma. Therefore, there is no reason why patients with asthma should not participate in regular physical activity.

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    • "Observational studies have shown a correlation between decreased physical activity and the development of asthma [1,2]. Other studies show that exercise training in asthma reduces asthma medications, emergency room visits, symptoms, exacerbations, and can improve lung function, and quality of life [3-9]; however, the 2012 and 2009 Cochrane Collaboration systematic reviews on this topic showed no change in lung function or days without wheeze, although they did show improved cardiopulmonary fitness [10,11]. It is unclear if the benefits of exercise seen in asthmatics result predominantly from a direct impact on airway inflammation, or if they stem from improved cardiac and peripheral muscle conditioning, or both. "
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    ABSTRACT: Background There is little data on the effect of exercise on markers of airway inflammation in human asthmatics. The main objective of this review is to determine the effects of physical training on markers of airway inflammation in animal models of asthma. Methods A peer reviewed search was applied to Medline, Embase, Web of Science, Cochrane, and DARE databases. Data extraction was performed in a blinded fashion. Results From the initial 2336 studies, a total of 10 studies were selected for the final analysis. All were randomized controlled trials with low to moderate intensity training on ovalbumin-sensitized mice. In the exercised group of mice, there was a reduction in BAL eosinophils and Th-2 cytokines, no change in Th-1 cytokines, an increase in IL-10, and a reversal of airway remodeling. The data was not pooled owing to significant heterogeneity between studies, and a funnel plot test for publication bias was not performed because there were few studies reporting on any one outcome measure. The asthma models differed between studies in age and gender of mice, as well as in timing of physical training after sensitization. The risk of bias was unclear for some studies though this may not influence outcome measures. The accuracy of data extracted from graphics is unknown. Conclusions Physical training improves airway inflammation in animal asthma models.
    BMC Pulmonary Medicine 04/2013; 13(1):24. DOI:10.1186/1471-2466-13-24 · 2.40 Impact Factor
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    • "118 01Varray(111).indd 118 3/18/06 11:34:09 AM 3/18/06 11:34:09 AM albeit an important element, is not the only factor responsible for this dysfunction, especially the fi nding that training programs fail to totally normalize this dysfunction (Troosters, Casaburi, Gooselink, & Decramer, 2005). Several studies have provided strong arguments in favor of systemic infl ammation as a mechanism for the development of muscle weakness and muscle apoptosis (Debigare et al., 2003; Spruit et al., 2003). "
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    ABSTRACT: The aim of this paper is to show how pertinent pathophysiological bases have been built for physical activity prescription for individuals with obstructive pulmonary disease (asthma and chronic obstructive pulmonary disease). The pathophysiological bases were constructed by taking into account exercise mismatching, which was analyzed in terms of both short- and long-term impact on disease outcome. Specific exercise adaptations based on a keen understanding of the underlying physiological processes provided the key to an adapted intervention with welldefined exercise program aims. The results that were achieved are striking, and one might conclude that sometimes exercise is simply the best way to improve the general well-being of individuals with chronic disease. Since this is a major concern for health professionals and chronically ill individuals, physical activity offers a means to rise to this challenge.
    Adapted physical activity quarterly: APAQ 08/2005; 0634(11):1-5. · 1.32 Impact Factor
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    ABSTRACT: Objective: To investigate the incidence of asthma symptoms in young amateur swimmers, and to describe the clinical treatment of the children with asthma in a private sports club in the city of São Paulo, Brazil. Methods: The study included 171 amateur swimmers, ranging from 6 to14 years of age. All of the participants or their legal guardians were asked to complete the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, and 119 were submitted to pulmonary function testing at rest. Results: The overall incidence of asthma symptoms (ISAAC score ≥ 6) among the swimmers was 16.8%. Of the 119 swimmers submitted to spirometry, 39 (32.7%) presented spirometric alterations (FEV1/FVC < 0.75). Among those with an ISAAC score ≥ 6, there were 10 (31.2%) who stated that they were receiving no asthma treatment. Of those who reported receiving pharmacological treatment, 24% made use of bronchodilators but not of corticosteroids. Conclusions: The incidence of asthma symptoms and pulmonary function alterations among amateur swimmers within the 6-14 age bracket was high. In addition, a relevant proportion of these athletes were receiving no treatment.
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