EFFECT OF PHYSICAL TRAINING ON EXERCISE-INDUCED BRONCHOSPASM IN YOUNG ASTHMATICS

Lopes, Wendell Arthur; Porto, Fernanda Errero; Leite, Neiva

doi:10.1590/1517-869220202601201675

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Brasil

Revista Brasileira de Medicina do Esporte

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Systematic Review Article, Medical Clinic • Rev Bras Med Esporte 26 (1) • Jan-Feb 2020 • https://doi.org/10.1590/1517-869220202601201675 copy

EFFECT OF PHYSICAL TRAINING ON EXERCISE-INDUCED BRONCHOSPASM IN YOUNG ASTHMATICS

EFEITO DO TREINAMENTO FÍSICO NO BRONCOESPASMO INDUZIDO PELO EXERCÍCIO EM JOVENS ASMÁTICOS

EFECTO DEL ENTRENAMIENTO FÍSICO EN EL BRONCOESPASMO INDUCIDO POR EL EJERCICIO EN JÓVENES ASMÁTICOS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction:

Asthma is the most common chronic disease in childhood and its prevalence has increased in recent years. Although regular physical activity (PA) is considered to be beneficial for the health of asthmatics, especially children and adolescents, it can also be one of the elements that triggers asthma. This is known as exercise-induced bronchospasm (EIB), and is considered one of the factors that limits asthmatics’ participation in PA.

Objective:

This study aims to review the effects of physical conditioning on EIB in asthmatic children and adolescents.

Methods:

A systematic review was carried out on the Pubmed, Bireme and Web of Science databases, considering publications from 1998 to April 2019.

Results:

Eight articles were retrieved; five of the articles presented no significant difference in EIB parameters after physical training, and three demonstrated significant benefits in EIB.

Conclusion:

There is insufficient evidence that physical training helps reduce the frequency and severity of EIB in young asthmatics. There are still few studies that seek to show the effect of a physical training program on the improvement of EIB in children and adolescents. It is suggested that further randomized clinical trials be conducted, to investigate the effects of physical training on EIB parameters in children and adolescents. Level of Evidence II; Systematic review.

Keywords:
Asthma; Adolescents; Young people; Physical exercise; Bronchospasm

Year	Author	1	2	3	4	5	6	7	8	9	10	Total
1999	Matsumoto et al.²¹21. Matsumoto I, Araki H, Odajima H, Nishima S, Higaki Y, Tanaka H, et al. Effects of swimming training on aerobic capacity and exercise induced bronchoconstriction in children with bronchial asthma. Thorax. 1999;54(3):196-201.	+	+	+	+	–	+	+	–	+	+	8
1999	Neder et al.²²22. Neder JA, Nery LE, Silva AC, Cabral AL, Fernandes AL. Short term effect of aerobic training in the clinical management of moderate to severe asthma in children. Thorax. 1999;54(3):202-6.	+	–	–	–	–	+	+	–	+	+	5
2000	Hallstrand et al.²³23. Hallstrand TS, Bates PW, Schoene RB. Aerobic conditioning in mild asthma decreases the hyperpnea of exercise and improves exercise and ventilatory capacity. Chest. 2000;118(5):1460-9.	+	–	–	–	–	+	+	–	–	+	4
2002	Natali et al.²⁴24. Natali AJ, Regazzi AJ, De Rose EH. Efeito do treinamento em natação sobre a severidade do broncoespasmo induzido pelo exercício. Rev Paul Educ Fís. 2002;16(2):198-210.	+	–	+	–	–	+	+	–	+	+	5
2006	Silva et al.²⁵25. Silva CS, Torres LA, Rahal A, Terra Filho J, Vianna EO. Comparison of morning and afternoon exercise training for asthmatic children. Braz J Med Biol Res. 2006;39(1):71-8.	+	–	–	–	–	+	+	+	–	+	5
2007	Sidiropoulou et al.²⁶26. Sidiropoulou MP, Fotiadou EG, Tsimaras VK, Zakas AP, Angelopoulou NA. The effect of interval training in children with exercise-induced asthma competing in soccer. J Strength Cond Res. 2007;21(2):446-50.	+	–	–	–	–	+	+	–	+	+	5
2007	Fanelli et al.²⁷27. Fanelli A, Cabral AL, Neder JA, Martins MA, Carvalho CR. Exercise training on disease control and quality of life in asthmatic children. Med Sci Sports Exerc. 2007;39(9):1474-80.	+	+	–	–	–	+	–	+	+	+	6
2014	Tahan et al.²⁸28. Tahan F, Eke Gungor H, Bicici E. Is Yoga Training Beneficial for Exercise-induced Bronchoconstriction? Altern Ther Health Med. 2014;20(2):18-23.	–	–	–	–	–	+	+	+	+	+	5

Author/Year	Sample	Exercised-induced asthma assessment instruments	Intervention	Results
Matsumoto et al.²¹21. Matsumoto I, Araki H, Odajima H, Nishima S, Higaki Y, Tanaka H, et al. Effects of swimming training on aerobic capacity and exercise induced bronchoconstriction in children with bronchial asthma. Thorax. 1999;54(3):196-201.	n=16 (total) Age= 8-10 years n=8 (experimental) n=8 (control) Randomized	6 weeks; bronchial provocation test with 6-minute exercise on cycle ergometer; above LT; FEV₁ assessment right after, 5 and 15 minutes after exercise.	Type= swimming (crawl) Intensity= acima do LT Duration= 30 minutes Frequency= 6x/week	↑ work load ↔ % FEV₁ after exercise
Neder et al.²²22. Neder JA, Nery LE, Silva AC, Cabral AL, Fernandes AL. Short term effect of aerobic training in the clinical management of moderate to severe asthma in children. Thorax. 1999;54(3):202-6.	n= 42 (total) Age = 8-16 years n=26 (experimental) n=16 (control)	8 weeks; bronchial provocation test with 6-minute exercise on cycle ergometer; 80% HR_max; FEV₁ assessment 5, 10 and 20 minutes after exercise; positive EIB for FEV₁>10% fall.	Type = running, with or without ball Intensity= 50-60% and 80-90%HR_max Duration = 45 minutes Frequency = 3x/week	↑ Aerobic fitness ↓ Anti-inflammatory medication ↔ % FEV₁ after exercise ↔ EIB Frequency
Hallstrand et al.²³23. Hallstrand TS, Bates PW, Schoene RB. Aerobic conditioning in mild asthma decreases the hyperpnea of exercise and improves exercise and ventilatory capacity. Chest. 2000;118(5):1460-9.	n= 10 (total) Age = 10-16 years n=5(experimental) n=5 (control)	10 weeks; bronchial provocation test with 12-minute exercise on cycle ergometer; progressive intensity until exhaustion; FEV₁ assessment 3, 6, 10 and 15 minutes after exercise; positive EIB for FEV₁>10% fall.	Type = aerobic exercise Intensity= 70-80%VO_2max Duration = 30 minutes Frequency = 3x/week.	↑ Aerobic fitness ↓ Exercise dyspnea ↔% FEV₁ after exercise
Natali et al.²⁴24. Natali AJ, Regazzi AJ, De Rose EH. Efeito do treinamento em natação sobre a severidade do broncoespasmo induzido pelo exercício. Rev Paul Educ Fís. 2002;16(2):198-210.	n= 32 (total) Age = 10-16 years n=16(experimental) n=16 (control)	10 weeks; bronchial provocation test with 8-minute exercise on treadmill, 85 to 90% HR_max; PEF assessment 5 and 10 minutes after exercise; positive EIB for FEV₁>10% fall.	Type = swimming (crawl) Intensity= 80-85% HR_max Duration = 45 minutes Frequency = 3 x/week	↓ PEF after exercise
Silva et al.²⁵25. Silva CS, Torres LA, Rahal A, Terra Filho J, Vianna EO. Comparison of morning and afternoon exercise training for asthmatic children. Braz J Med Biol Res. 2006;39(1):71-8.	n= 69 (total) Age = 8-11 years n=46 (experimental, bring 23 morning training and 23 afternoon training) n=23 (control)	16 weeks; Bronchial provocation test with 6-minute exercise on treadmill, 80% HR_max; FEV₁ assessment 5, 10, 15, 20, 30 and 45 minutes after exercise; positive EIB for FEV₁>10% fall.	Type = walking/running, swimming, stretching and calisthenics Intensity = not mentioned Duration = 90 minutes Frequency = 2 x/week	↑ Distance covered ↑ Abdominal muscle endurance ↔ % FEV₁ after exercise
Sidiropoulou et al.²⁶26. Sidiropoulou MP, Fotiadou EG, Tsimaras VK, Zakas AP, Angelopoulou NA. The effect of interval training in children with exercise-induced asthma competing in soccer. J Strength Cond Res. 2007;21(2):446-50.	n= 29 (total) Age = 10-12 years n=18 (experimental) n=11 (control)	8 weeks; Bronchial provocation test with 6-minute running, 80-90% HR_max; FEV₁ assessment 2, 5, 10, 15 and 20 minutes after exercise; positive EIB for FEV₁>10% fall.	Type = cycling, calisthenics and stretching Intensity = above LT Duration = 45 minutes Frequency = 3 x/week	↑ Distance covered ↓ % FEV₁ after exercise
Fanelli et al.²⁷27. Fanelli A, Cabral AL, Neder JA, Martins MA, Carvalho CR. Exercise training on disease control and quality of life in asthmatic children. Med Sci Sports Exerc. 2007;39(9):1474-80.	n=38 (total) Age = 8-15 years n=17 (experimental) n=21 (control) Randomized	16 weeks; Bronchial provocation test with 6-minute exercise, 80% HR_max; FEV₁ assessment 2, 5, 10 and 20 minutes after exercise; positive EIB for FEV₁>10% fall.	Type = running and cycling, streching and resistance exercise Intensity= between LT and RCP and 15RM Duration = 90 minutes Frequency = 2x/week	↑ Aerobic fitness ↓ Exercise dyspnea ↑ Quality of Life ↔ Anti-inflammatory medication ↔ % FEV₁ after exercise
Tahan et al.²⁸28. Tahan F, Eke Gungor H, Bicici E. Is Yoga Training Beneficial for Exercise-induced Bronchoconstriction? Altern Ther Health Med. 2014;20(2):18-23.	n= 20 (total) Age = 6-17 years n=10 asthmatic children (EIB+) 10 (EIB-) No control group	12 weeks; Bronchial provocation test with 6-minute exercise on treadmill with submaximal load, FEV₁ assessment 5, 10, 15 and 20 minutes after exercise; FEF _{25% -75%}, FVC, PEF%, PEFR and IgE levels, number of número de eosinophils. positive EIB for FEV₁>15% fall.	Type = hatha yoga Intensity= not mentioned Duration = 60 minutes Frequency = 2 x/week	↓ % FEV₁ after exercise (Only EIB+ group)

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[1] Correspondence: Wendell Arthur Lopes. Rua Topázio, 1183, Jd. Brasil, Maringá, Paraná, Brazil. 87.083-279. warthurlopes@gmail.com