It’s sunny here in the woodland, at last! I’m encouraging all my fellow elves to get out there and get some exercise on this lovely morning. Exercise is good for everyone, including people with asthma. But some people find that exercise triggers asthma symptoms and may avoid it; other people with asthma find they feel better for it.
This month, a Cochrane review on the effect of physical training on both the respiratory and general health of people with asthma has been updated, with nine new studies, so what does this evidence now tell us? The reviewers looked for randomised controlled trials of people over eight years of age with asthma, who undertook physical training (whole body aerobic exercise) for at least twenty minutes twice a week for at least four weeks. They found 19 studies, with 695 people, suitable for inclusion in the review. Here’s what they found:
- Physical training improved cardiopulmonary fitness as measured by a statistically and clinically significant increase in maximum oxygen uptake (MD 5.57 mL/kg/min; 95% confidence interval (CI) 4.36 to 6.78) and maximum expiratory ventilation (6.0 L/min, 95% CI 1.57 to 10.43)
- There was no significant effect on resting lung function (four studies)
- Physical training was well tolerated by the people with asthma with no ill effects reported
- Programmes which were successful in improving asthma symptoms included aerobic conditioning using a treadmill, other aerobic exercises and swimming. Three of four studies that were successful in improving asthma symptoms combined exercise with an asthma education programme and breathing exercises
- There is limited evidence that physical training may have positive effects on health-related quality of life
- None of the studies evaluated longer term benefits of physical training in patients with asthma
- Studies were small, ranging from 14 to 101 participants and differed in the types of physical training assessed, outcomes reported and how data were presented, which limited the extent to which results could be combined
- Methods and/or data were often poorly reported
The authors note that this is an area where more and larger trials are needed and that the long-term effects of aerobic exercise on people with asthma, and which types of exercise are safest and most beneficial, should be investigated. Based on the evidence currently available in this review they concluded:
“People with stable asthma should be encouraged to partake in regular exercise training, without fear of symptom exacerbation.”
Asthma UK urges people not to let asthma stop them exercising and notes that if exercise triggers asthma symtoms it may be a sign that the asthma is poorly controlled. Its website has helpful advice about exercising if you have asthma, how to avoid symptoms being triggered and when to seek advice from a GP or asthma nurse.
Chandratilleke MG, Carson KV, Picot J, Brinn MP, Esterman AJ, Smith BJ. Physical training for asthma. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD001116. DOI: 10.1002/14651858.CD001116.pub3
Cochrane summary and podcast of this review