ObjectiveTo evaluate the effect of aerobic exercise training on asthma control, lung function and airway inflammation in adults with asthma.DesignSystematic review and meta-analysis (PROSPERO-ID: CRD42019130156)MethodsEligibility criteria: Randomised controlled trials investigating the effect of at least 8 weeks of aerobic exercise training on outcomes for asthma control, lung function and airway inflammation in adults with asthma. Information sources: Medline, EMBase, CINAHL, PEDro, Cochrane Central Register of Controlled Trials (CENTRAL) were searched up to 3 April 2019. Risk of bias: Risk of bias was assessed by the “Cochrane Risk of Bias Tool”.ResultsIncluded studies: We included 11 studies with a total of 543 adults with asthma. Participants' mean age was 36.5 years (range: 22 to 54 years); 74.8% of participants were women and the mean body mass index (BMI) was 27.6 kg·m−2 (range: 23.2 to 38.1 kg·m−2). Interventions had a median duration of 12 weeks (range: 8 to 12 weeks) and included walking, jogging, spinning, treadmill running and other unspecified exercise training programmes. Synthesis of results: Exercise training improved asthma control with a standard mean difference (SMD) of −0.48 (−0.81 to −0.16). Lung function slightly increased with an SMD of −0.36 (−0.72 to 0.00) in favour of exercise training. Exercise training had no apparent effect on markers of airway inflammation [SMD: −0.03 (−0.41 to 0.36)].ConclusionsIn adults with asthma, aerobic exercise training has potential to improve asthma control and lung function but not airway inflammation.

Mass gathering events in sports arenas create challenges regarding the cardiovascular safety of both athletes and spectators. A comprehensive medical action plan, to ensure properly applied cardiopulmonary resuscitation, and wide availability and use of automated external defibrillators (AEDs), is essential to improving survival from sudden cardiac arrest at sporting events. This paper outlines minimum standards for cardiovascular care to assist in the planning of mass gathering sports events across Europe with the intention of local adaptation at individual sports arenas, to ensure the full implementation of the chain of survival.

International audienceThere are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities. This paper discusses the uncertainties about available data and provides comprehensive suggestions for standard definitions and a guide for uniform registration parameters of SCA/SCD. The parameters include a definition of what constitutes an ‘athlete’, incidence calculations, enrolment of cases, the importance of gender, ethnicity and age of the athlete, as well as the type and level of sporting activity. A precise instruction for autopsy practice in the case of a SCD of athletes is given, including the role of molecular samples and evaluation of possible doping. Rational decisions about cardiac preparticipation screening and cardiac safety at sport facilities requires increased data quality concerning incidence, aetiology and management of SCA/SCD in sports. Uniform standard registration of SCA/SCD in athletes and leisure sportsmen would be a first step towards this goa

Background Improvement in exercise capacity is a main goal of cardiac rehabilitation but the effects are often lost at long-term follow-up and thus also the benefits on prognosis. We assessed whether improvement in VO2peak during a cardiac rehabilitation programme predicts long-term prognosis. Methods and results We performed a retrospective analysis of 1561 cardiac patients completing cardiac rehabilitation in 2011–2017 in Copenhagen. Mean age was 63.6 (11) years, 74% were male and 84% had coronary artery disease, 6% chronic heart failure and 10% heart valve replacement. The association between baseline VO2peak and improvement after cardiac rehabilitation and being readmitted for cardiovascular disease and/or all-cause mortality was assessed with three different analyses: Cox regression for the combined outcome, for all-cause mortality and a multi-state model. During a median follow-up of 2.3 years, 167 readmissions for cardiovascular disease and 77 deaths occurred. In adjusted Cox regression there was a non-linear decreasing risk of the combined outcome with higher baseline VO2peak and with improvement of VO2peak after cardiac rehabilitation. A similar linear association was seen for all-cause mortality. Applying the multi-state model, baseline VO2peak and change in VO2peak were associated with risk of a cardiovascular disease readmission and with all-cause mortality but not with mortality in those having an intermediate readmission for cardiovascular disease. Conclusion VO2peak as well as change in VO2peak were highly predictive of future risk of readmissions for cardiovascular disease and all-cause mortality. The predictive value did not extend beyond the next admission for a cardiovascular event.