Aerobic exercise, in the form of twice-a-week treadmill workouts, improved bronchial hyperresponsiveness in adults with moderate or severe persistent asthma, according to a small study published online June 10 in Thorax.
"These results suggest that adding exercise as an adjunct therapy to pharmacological treatment could improve the main features of asthma," write Andrezza França-Pinto, PT, from the Department of Clinical Immunology and the Department of Allergy at the University of São Paulo School of Medicine in Brazil, and colleagues.
Patients with asthma may avoid exercise to avoid triggering their symptoms, but more severe bronchial hyperresponsiveness has been linked to low levels of exercise. Two recent systematic reviews on exercise and bronchial hyperresponsiveness were inconclusive.
Therefore, the researchers recruited 58 nonexercising patients with moderate to severe asthma and assigned them either to a 30-minute yoga breathing session twice a week or to the same breathing exercises combined with a 35-minute treadmill workout. Of these patients, 18 from the exercise group and 19 from the control group completed the 12-week program and were healthy enough to take the bronchial provocation test.
Bronchial hyperresponsiveness improved in the exercisers by an average of one doubling dose of histamine (95% confidence interval [CI], 0.3 - 1.7 doubling dose), meaning they could tolerate twice as much before developing symptoms. There was no change in hyperresponsiveness among the nonexercising patients (0.06 doubling dose; 95% CI, −0.6 to 0.7 doubling dose; P = .039).
However, asthma symptom control did not differ between the treatment and control groups, including number of symptom-free days. The investigators tested five cytokines that are involved in airway inflammation and that were decreased by exercise in animal studies; only two of the five cytokines were reduced in the exercise group after treatment (P = .045 for monocyte chemoattractant protein 1; P = .042 for interleukin 6).
Fifteen of the patients in the treatment group showed a clinically significant improvement in their Asthma Quality of Life Questionnaire score of at least half a point. The total between group difference for the treatment group compared with the control group was −0.9 (95% CI, −1.7 to −0.1; P = .034). The investigators write that exercise may improve treatment for some patients more than others, and that these seem to be the patients with more inflammation and lower asthma control. The authors also suggest that future studies focus on identifying which patients are more likely to respond to exercise as a treatment.
The authors have disclosed no relevant financial relationships.
Thorax. Published online June 10, 2015. Full text
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Cite this: Aerobic Exercise Improved Some Asthma Symptoms - Medscape - Jun 15, 2015.