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. 1999 Mar;54(3):202–206. doi: 10.1136/thx.54.3.202

Short term effects of aerobic training in the clinical management of moderate to severe asthma in children

J Neder 1, L Nery 1, A Silva 1, A Cabral 1, A Fernandes 1
PMCID: PMC1745434  PMID: 10325894

Abstract

BACKGROUND—Aerobic training has a number of well known beneficial effects in both normal and asthmatic children. However, the impact of training on the clinical management of the underlying bronchial asthma remains controversial, particularly in the most severe patients.
METHODS—Clinical evaluation, spirometric tests, symptom limited maximum exercise testing, and exercise challenge tests were performed in a group of children with stable moderate to severe asthma. Forty two patients (24 boys) aged 8-16 were evaluated twice: before and after supervised aerobic training (group 1, n = 26) and two months apart (untrained group 2, n =16).
RESULTS—Spirometric and maximal exercise variables in the initial evaluation were significantly reduced in group 1 (p<0.05) but medication and clinical scores and the occurrence of exercise induced bronchospasm (EIB) did not differ between the two groups. Aerobic improvement with training (maximal oxygen uptake and/or anaerobic threshold increment >10% and 100 ml) was inversely related to the baseline level of fitness and was independent of disease severity. Although the clinical score and the occurrence of EIB did not change after training, aerobic improvement was associated with a significant reduction in the medication score and the daily use of both inhaled and oral steroids (p<0.05).
CONCLUSIONS—Aerobic improvement with training in less fit asthmatic children is related to a short term decrease in the daily use of inhaled and oral steroids, independent of the severity of the disease.



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Selected References

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  1. Beaver W. L., Wasserman K., Whipp B. J. A new method for detecting anaerobic threshold by gas exchange. J Appl Physiol (1985) 1986 Jun;60(6):2020–2027. doi: 10.1152/jappl.1986.60.6.2020. [DOI] [PubMed] [Google Scholar]
  2. Brodal P., Ingjer F., Hermansen L. Capillary supply of skeletal muscle fibers in untrained and endurance-trained men. Am J Physiol. 1977 Jun;232(6):H705–H712. doi: 10.1152/ajpheart.1977.232.6.H705. [DOI] [PubMed] [Google Scholar]
  3. Bundgaard A., Ingemann-Hansen T., Schmidt A., Halkjaer-Kristensen J. The importance of ventilation in exercise-induced asthma. Allergy. 1981 Aug;36(6):385–389. doi: 10.1111/j.1398-9995.1981.tb01843.x. [DOI] [PubMed] [Google Scholar]
  4. Cochrane L. M., Clark C. J. Benefits and problems of a physical training programme for asthmatic patients. Thorax. 1990 May;45(5):345–351. doi: 10.1136/thx.45.5.345. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cooper D. M. Rethinking exercise testing in children: a challenge. Am J Respir Crit Care Med. 1995 Oct;152(4 Pt 1):1154–1157. doi: 10.1164/ajrccm.152.4.7551363. [DOI] [PubMed] [Google Scholar]
  6. Cooper D. M., Weiler-Ravell D., Whipp B. J., Wasserman K. Aerobic parameters of exercise as a function of body size during growth in children. J Appl Physiol Respir Environ Exerc Physiol. 1984 Mar;56(3):628–634. doi: 10.1152/jappl.1984.56.3.628. [DOI] [PubMed] [Google Scholar]
  7. Eggleston P. A., Rosenthal R. R., Anderson S. A., Anderton R., Bierman C. W., Bleecker E. R., Chai H., Cropp G. J., Johnson J. D., Konig P. Guidelines for the methodology of exercise challenge testing of asthmatics. Study Group on Exercise Challenge, Bronchoprovocation Committee, American Academy of Allergy. J Allergy Clin Immunol. 1979 Dec;64(6 Pt 2):642–645. doi: 10.1016/0091-6749(79)90028-9. [DOI] [PubMed] [Google Scholar]
  8. Engström I., Fällström K., Karlberg E., Sten G., Bjure J. Psychological and respiratory physiological effects of a physical exercise programme on boys with severe asthma. Acta Paediatr Scand. 1991 Nov;80(11):1058–1065. doi: 10.1111/j.1651-2227.1991.tb11783.x. [DOI] [PubMed] [Google Scholar]
  9. Fink G., Kaye C., Blau H., Spitzer S. A. Assessment of exercise capacity in asthmatic children with various degrees of activity. Pediatr Pulmonol. 1993 Jan;15(1):41–43. doi: 10.1002/ppul.1950150107. [DOI] [PubMed] [Google Scholar]
  10. Garfinkel S. K., Kesten S., Chapman K. R., Rebuck A. S. Physiologic and nonphysiologic determinants of aerobic fitness in mild to moderate asthma. Am Rev Respir Dis. 1992 Apr;145(4 Pt 1):741–745. doi: 10.1164/ajrccm/145.4_Pt_1.741. [DOI] [PubMed] [Google Scholar]
  11. Godfrey S., Davies C. T., Wozniak E., Barnes C. A. Cardio-respiratory response to exercise in normal children. Clin Sci. 1971 May;40(5):419–431. doi: 10.1042/cs0400419. [DOI] [PubMed] [Google Scholar]
  12. Hanania N. A., Chapman K. R., Kesten S. Adverse effects of inhaled corticosteroids. Am J Med. 1995 Feb;98(2):196–208. doi: 10.1016/S0002-9343(99)80404-5. [DOI] [PubMed] [Google Scholar]
  13. Harkema J. R., Mauderly J. L., Gregory R. E., Pickrell J. A. A comparison of starvation and elastase models of emphysema in the rat. Am Rev Respir Dis. 1984 Apr;129(4):584–591. [PubMed] [Google Scholar]
  14. Knudson R. J., Lebowitz M. D., Holberg C. J., Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis. 1983 Jun;127(6):725–734. doi: 10.1164/arrd.1983.127.6.725. [DOI] [PubMed] [Google Scholar]
  15. Ludwick S. K., Jones J. W., Jones T. K., Fukuhara J. T., Strunk R. C. Normalization of cardiopulmonary endurance in severely asthmatic children after bicycle ergometry therapy. J Pediatr. 1986 Sep;109(3):446–451. doi: 10.1016/s0022-3476(86)80115-9. [DOI] [PubMed] [Google Scholar]
  16. Robinson D. M., Egglestone D. M., Hill P. M., Rea H. H., Richards G. N., Robinson S. M. Effects of a physical conditioning programme on asthmatic patients. N Z Med J. 1992 Jul 8;105(937):253–256. [PubMed] [Google Scholar]
  17. Santuz P., Baraldi E., Filippone M., Zacchello F. Exercise performance in children with asthma: is it different from that of healthy controls? Eur Respir J. 1997 Jun;10(6):1254–1260. doi: 10.1183/09031936.97.10061254. [DOI] [PubMed] [Google Scholar]
  18. Strunk R. C., Mrazek D. A., Fukuhara J. T., Masterson J., Ludwick S. K., LaBrecque J. F. Cardiovascular fitness in children with asthma correlates with psychologic functioning of the child. Pediatrics. 1989 Sep;84(3):460–464. [PubMed] [Google Scholar]
  19. Strunk R. C., Rubin D., Kelly L., Sherman B., Fukuhara J. Determination of fitness in children with asthma. Use of standardized tests for functional endurance, body fat composition, flexibility, and abdominal strength. Am J Dis Child. 1988 Sep;142(9):940–944. doi: 10.1001/archpedi.1988.02150090038019. [DOI] [PubMed] [Google Scholar]
  20. Thio B. J., Nagelkerke A. F., Ketel A. G., van Keeken B. L., Dankert-Roelse J. E. Exercise-induced asthma and cardiovascular fitness in asthmatic children. Thorax. 1996 Feb;51(2):207–209. doi: 10.1136/thx.51.2.207. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Yiallouros P. K., Milner A. D., Conway E., Honour J. W. Adrenal function and high dose inhaled corticosteroids for asthma. Arch Dis Child. 1997 May;76(5):405–410. doi: 10.1136/adc.76.5.405. [DOI] [PMC free article] [PubMed] [Google Scholar]

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