PURPOSE: Asthmatics show less tolerance to exercise because of shortness of breath and exercise induced bronchoconstriction. A number of studies have reported asthmatics to have a lower cardio respiratory fitness than their peers. This is mainly due to inactivity and sedentary lifestyle rather than a ventilatory limitation to exercise. Physical training programs aim to improve physical fitness, neuromuscular coordination, and self confidence. The purpose of this review was to assess the evidence for the effectiveness of physical training in asthma.
METHODS: Search methods: We searched the Cochrane Airways Group Specialised Register, SportDiscus and the Science Citation Index up to December 2010. Selection criteria: Randomized trials of asthmatic subjects undertaking physical training. Subjects had to be eight years or older. Physical training had to be undertaken for at least twenty minutes, two times a week, over a minimum period of four weeks. Data collection and analysis: Eligibility for inclusion and quality of trials were assessed independently by two reviewers.
RESULTS: Eighteen studies (653 participants) were included in this review. Physical training was well tolerated with no adverse effects identified. None of the studies mentioned worsening of asthma symptoms following physical training. Physical training improved cardiopulmonary fitness as measured by an increase in maximum oxygen uptake of 5.57 ml/kg/min (95% confidence interval 4.36 to 6.78) and maximum expiratory ventilation 6.0 L/min (95% confidence interval 1.57 to 10.43) with no effect on resting lung function. Although there were insufficient data to meta analyse, there is some evidence available to suggest that physical training may have positive effects on health related quality of life.
CONCLUSIONS: This review demonstrated that physical training can improve cardiopulmonary fitness and was well tolerated. Patients with asthma should be able to participate in regular physical activity.
CLINICAL IMPLICATIONS: Physical training can improve cardiopulmonary fitness and may have positive effects on health related quality of life in patients with asthma. These benefits are unrelated to effects on lung function. This review indicates that physical training is well tolerated. There was no evidence of adverse effects of physical training on asthma symptoms which is reassuring. Therefore, there is no reason to refrain stable asthmatic subjects from regular exercise
DISCLOSURE: The following authors have nothing to disclose: Madhu Chandratilleke, Kristin Carson, Joanna Picot, Brinn Malcolm, Brian Smith
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