Feasibility of exercising adults with asthma: a randomized pilot study

Abstract

BackgroundAerobic exercise appears to have clinical benefits for many asthmatics, yet a complete understanding of the mechanisms underlying these benefits has not been elucidated at this time.PurposeThe objective of this study was to determine feasibility for a larger, future study that will define the effect of aerobic exercise on cellular, molecular, and functional measures in adults with mild-moderate asthma.DesignRecruited subjects were randomized into usual care (sedentary) or usual care with moderate intensity aerobic exercise treatment groups.Setting / ParticipantsNineteen adults with mild-moderate asthma but without a recent history of exercise were recruited at the UAB Lung Health Center, Birmingham, AL.InterventionThe exercise group underwent a 12 week walking program exercising at 60 – 75% of maximum heart rate (HRmax). Subjects self-monitored HRmax levels using heart rate monitors; exercise diaries and recreation center sign-in logs were also used.Main outcome measuresFunctional measures, including lung function and asthma control scores, were evaluated for all subjects at pre- and post-study time-points; fitness measures were also assessed for subjects in the exercise group. Peripheral blood and nasal lavage fluid were collected from all subjects at pre- and post-study visits in order to evaluate cellular and molecular measures, including cell differentials and eosinophilic cationic protein (ECP).ResultsSixteen subjects completed the prescribed protocol. Results show that subjects randomized to the exercise group adhered well (80%) to the exercise prescription and exhibited a trend toward improved fitness levels upon study completion. Both groups exhibited improvements in ACQ scores. No changes were observed in lung function (FEV1, FEV1/FVC), cell differentials, or ECP between groups.ConclusionsResults indicate that a moderate intensity aerobic exercise training program may improve asthma control and fitness levels without causing asthma deterioration in adult asthmatics. As such, these findings demonstrate the feasibility of the study protocol in preparation for a larger, clinical trial that will elucidate the functional consequences of aerobic exercise on asthmatic cellular and molecular responses.

Low-Intensity Aerobic Exercise Mitigates Exercise-Induced Bronchoconstriction by Improving the Function of Adrenal Medullary Chromaffin Cells in Asthmatic Rats

“…While over-exercise can provoke an increase in airway resistance, leading to EIB, regular exercise training has been shown to improve asthmatic symptoms in both asthmatic young kids and adult patients (Farid et al 2005;Mendes et al 2010;Boyd et al 2012;Avallone and McLeish 2013). The exact mechanisms underlying the action of regular exercise training are not fully understood.…”

“…A previous study has suggested that recent asthmatic attack and previous allergic rhinitis appear to be risk factors for EIB (Bransford et al 1991). Recent studies suggest that regular aerobic exercise can actually improve exercise capacity, bronchial hyperresponsiveness, EIB and lung function, or at least improve the management of asthmatic symptoms in asthmatic patients without causing asthmatic deterioration (Farid et al 2005;Mendes et al 2010;Boyd et al 2012;Avallone and McLeish 2013;Eichenberger et al 2013). However, little is known about the mechanisms underlying the benefits of regular aerobic exercise to asthmatic patients.…”

Exercise and Asthma

“…To date, there has been limited research on the cellular and molecular mechanisms of improved aerobic fitness in regard to the various asthmatic phenotypes (12,32). Although the physiological basis for the observed improvements in aerobic capacity experienced by many asthmatics from regular exercise programs is not yet fully understood, the American College Table 4 Commonly used asthma medications: type, brand names, delivery method, and mechanism of action of Sports Medicine and the American Thoracic Society support the implementation of low to moderate intensity aerobic exercise (large muscle activities such as walking, cycling, swimming, light jogging) for well-controlled mild and moderate severity asthmatic patients ranging from 2 to 5 days per week at 50-75% of maximal workload (24,44).…”

Improved preparation of nasal lavage fluid (NLF) as a noninvasive sample for proteomic biomarker discovery

“…As an alternative to theses sample sources, nasal lavage fluids (NLF) and bronchioalveolar lavage fluids (BALF) recently arose showing promising data for a supplementary way for biomarker discovery. Especially for NLF, multiple studies monitored alterations caused by disease states of the airways like asthma [5], sinusitis [6], cystic fibrosis [7], seasonal allergic rhinitis [8][9][10] or general respiratory disorders [11][12][13][14]. All these studies prove the validity of NLF as a means for the identification of biomarkers of diverse disease states.…”