Effects of continuous aerobic exercise on lung function and quality of life with asthma: a systematic review and meta-analysis

Abstract

Background: Despite the obvious benefits of aerobic exercise for asthmatic patients, controversies persist.The current study evaluated the effectiveness of continuous aerobic exercise on lung function and quality of life of asthmatic patients. Methods: We searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials databases up to May 2019 and included randomized controlled trials (RCTs) of asthmatic patients intervened with whole body continuous aerobic exercise (moderate intensity, at least 20 minutes and two times a week, over a minimum period of four weeks), in which the endpoint measures were lung function and asthmarelated quality of life. A fixed-effects model (I 2 ≤50%)or random-effects model (I 2 >50%) was applied to calculate the pooled effects according to the I 2 -and Chi-squared (χ 2 ) test, funnel plots were quantified to present publication bias, and a P value <0.05 was statistically significant. Results: Eventually, 22 trials conformed to the selection criteria. In the aerobic exercise group, the forced expiratory volume improved in one second (FEV1) (I 2 =10.2%, WMD: 0.12, P=0.011), peak expiratory flow (PEF) (I 2 =87.3%, WMD: 0.66, P=0.002), forced vital capacity (FVC) (I 2 =0.0%, WMD: 0.18, P<0.001), FVC/predict (I 2 =3.9%, WMD: 4.3, P=0.014), forced expiratory flow between 25% and 75% of vital capacity (FEF 25-75% ) (I 2 =0.0%, WMD: 9.6, P=0.005), Asthma Quality of Life Questionnaire (AQLQ) (I 2 =0.0%, WMD: 0.20, P=0.002), and Pediatric Asthma Quality of life Questionnaire (PAQLQ) (I 2 =72.1%, WMD: 0.81, P<0.001), respectively, while no statistical significance existed in FEV1%predict (I 2 =36.0%, WMD: 0.68, P=0.312) and FEV1/FVC ratio (I 2 =0.0%, WMD: 0.27, P=0.443) compared with the control group. When the exercise mode was taken into account, we observed significant improvement in FEV1, PEF, and FVC in the swimming (P<0.05) or indoor treadmill (P<0.05) training group.Conclusions: Our meta-analysis proved that regular continuous aerobic exercise benefits asthma patients on FEV1, PEF, FVC, FVC%pred, FEF 25-75% , and quality of life, and was well tolerated, while there were no improvements in FEV1%pred and FEV1/FVC%. As such, swimming and treadmill training may be appropriate options.

Physical Activity and Life Quality in Patients with Asthma and Osteoarthritis

“…In our study all groups reached the level of moderate physical activity which is in accordance with other studies that relied on IPAQ for evaluating physical activity levels in patients with asthma and OA. In a study by Gay C. et al it was shown that the median IPAQ total activity score was 2628 MET-min/week in patients with OA [26]. In a study by Verlaet A et al, the median IPAQ total activity score was 2000 MET-min/week in male asthmatics with controlled asthma, 2253 MET-min/week in uncontrolled, 1732.50 MET-min/week in female asthmatics with controlled asthma, 2273 MET-min/week in uncontrolled female asthmatics [19].…”

“…However, there are small differences. Metaanalysis by Wu X et al reports that regular continuous aerobic exercise leads to improvement of FEV1, PEF, FVC, FVC%pred, FEF25-75%, and quality of life, but there was no improvement noted in FEV1%pred and FEV1/FVC% [26]. Another study by Brumpton BM et al, which included 1329 patients, showed that physical activity slowed lung function decline, especially FEV1, FEV1 /FVC ratio and PEF [27].…”

“…Nowadays, the goal of asthma treatment is to have full control over symptoms of the disease so that patients can have normal levels of activity and achieve a good quality of life, which is why the Global Strategy for Asthma Management and Prevention (GINA) includes recommendations on regular physical activity for asthmatics that will allow them to improve their overall health. Several studies report that higher physical activity is associated with better asthma control, lung function parameters and also a decreased number of exacerbations and doctor's appointments [5,6]. However, some studies also show that patients with asthma spend less time being physically active and/or have less intense physical activities compared with those who do not suffer from BA.…”

Respiratory rehabilitation in patients recovering from severe acute respiratory syndrome: A systematic review and meta-analysis

“…Previous Cochrane and non-Cochrane reviews demonstrated the positive effects of pulmonary rehabilitation programs on increasing exercise capacity and PFT parameters in chronic lung disease [49][50][51][52][53][54][55] , including chronic obstructive pulmonary disease and interstitial lung diseases. The American Thoracic Society/European Respiratory Society defined pulmonary rehabilitation as a patient-tailored, structured, comprehensive intervention that included patient assessment, exercise training, education, and behavior training as essential for pulmonary rehabilitation.…”

Exercise-Induced Bronchoconstriction in Children

“…However, by taking appropriate precautions (avoiding or reducing activity in highly polluted areas, exposure to cold air, performing a pre-exercise warm-up and regular physical activity, and through adequate pharmacological control of asthma), exercise routinely is extremely safe in children ( 36 ). Some studies have shown that regular continuous aerobic exercise benefits asthmatic patients on FEV1, PEF, FVC, FEF 25–75% and, in general, improves patients' symptoms and quality of life ( 37 ). In childhood, EIA causes QoL (quality of life) impairment ( 38 ).…”