August 18, 2020
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Aerobic training may improve asthma control, reduce rescue medication use

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Patients with moderate to severe asthma had improved asthma control after aerobic training or breathing exercises, but those who underwent aerobic training were 2.6 times more likely to experience clinical improvement at 3 months.

“Our results demonstrate that aerobic training and breathing exercise resulted in a similar effect in asthma control evaluated by the Asthma Control Questionnaire score; however, when the improvement in asthma control was evaluated individually, aerobic training induced a longer-lasting benefit than breathing exercise and a greater reduction in rescue medication use,” Karen B. Evaristo, MSc, associate professor in the department of physical therapy in the School of Medicine at the University of Sao Paulo, and colleagues wrote in The Journal of Allergy and Clinical Immunology.

Researchers conducted a prospective, randomized controlled trial of 54 outpatients with moderate to severe asthma (mean age, 50 years; mostly women). Patients were randomly assigned to undergo treadmill-based aerobic training (n = 29) or breathing exercises, based on the Pranayama yoga breathing technique, to stimulate nasal and diaphragmatic breathing (n = 25). Patients underwent 24 sessions, twice per week in 40-minute sessions. Researchers evaluated asthma control, quality of life, asthma symptom-free days, airway inflammation, exercise capacity, psychological distress, daily-life physical activity and pulmonary function before, immediately after and 3 months after the interventions.

Both aerobic training and breathing exercises yielded similar results for asthma control, evaluated by Asthma Control Questionnaire score. When asthma-control improvement was evaluated individually, 58% of patients in the aerobic training group and 32% in the breathing exercises group had a clinically significant improvement in Asthma Control Questionnaire score after the intervention (RR = 1.8; 95% CI, 1-4.1). After 3 months of follow-up, 52% of patients in the aerobic training group and 20% in the breathing exercise group maintained that improvement (RR = 2.6; 95% CI, 1.2-10; P = .02).

Thirty-four percent of patients in the aerobic training group had a reduction in number of days without rescue medication use compared with 8% of patients in the breathing exercise group (P = .04).

The researchers reported no difference between the groups in other outcomes, including health-related quality of life, asthma symptom-free days and psychological distress.

According to a press release, these interventions should not replace prescribed medications or other treatments recommended by physicians.

“The reasons why these nonpharmacological interventions produce clinically relevant improvements are not fully understood,” Celso R.F. Carvalho, PhD, associate professor in the department of physical therapy in the School of Medicine at the University of Sao Paulo, said in the release. “While there are clear benefits to these interventions that warrant additional study, these interventions are meant to be used adjacently with medications and treatments as prescribed by a physician.”

Reference:

Press Release.