Short term effects of aerobic training in the clinical management of moderate to severe asthma in children
a Respiratory
Division, Department of Medicine, b Department of Physiology, c Federal University of Sao
Paulo-Paulista School of Medicine (UNIFESP-EPM), Sao Paulo, Brazil
Center of Sport Practices of the University of
Sao Paulo (CEPEUSP), Sao Paulo, Brazil
Correspondence to: Dr J A Neder, Department of Physiology, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK.
Received 11 December 1997; Returned to authors 27 February 1998; Revised version received 23 March 1998; Accepted for publication 3 June 1998
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.
METHODSClinical
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).
RESULTSSpirometric
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).
CONCLUSIONSAerobic
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.
© 1999 by Thorax
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