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Dose-response Effects Of Exercises In Children With Asthma: A Review

PURPOSE: Exercise is shown to improve pulmonary function of asthmatic children, reduce asthma-related symptoms, and reduce physician office visits. Exercise can also improve physical fitness and quality of life for both children and their parents. This systematic review provides a summary of the dose-response effects of various exercise interventions for children with asthma, specifically pulmonary function, asthma-related symptoms and quality of life. METHODS: A systematic search in several databases was performed. Fourteen randomized controlled studies of exercise interventions for children with asthma (aged 7-14 yrs.) were identified and compared. The effect size (ES) and 95 % confidence intervals (CIs) were computed and summarized. RESULTS: Fourteen studies were included in this review. Most of the studies performed a randomized controlled study design (93%), with 19 to 61 participants. Length of interventions ranged from 4 to 15 weeks. Aerobic exercises like swimming and Tai-Chi, were employed in 12 of 14 studies (86%). Anaerobic training was employed in 1 of 14 studies (7.1%). Exercise interventions with moderate to vigorous intensity, 50%~75% VO 2max, were shown to most effectively improve cardiovascular fitness as well as pulmonary function for asthma control. Interventions with a duration from 8 to 12 weeks with a frequency of 2 to 4 times a week showed statistically significant improvements in pulmonary function. Pulmonary function was indicated by forced expiratory volume (ES=0.77, 95% CI, 0.56 to 0.99, p=0.002), peak expiratory flow rate (ES=0.50, 95% CI 0.25 to 0.97, p=0.007) and maximal inspiratory/expiratory pressure (ES=0.80, 95% CI 0.36 to 1.21, p=0.008). Most of the studies demonstrated reduced symptoms and physician visits, along with increase in selfreported quality of life. CONCLUSIONS: Exercise interventions are safe and beneficial to asthmatic children. Effective interventions are suggested to have a duration of three months, with 3 training sessions per week consisting of 40-50 min of aerobic exercise. Moderate to vigorous intensity is recommended with resting period during each session.