Exercise training in children with asthma: a systematic review. Wanrooij Vera H M,Willeboordse Maartje,Dompeling Edward,van de Kant Kim D G British journal of sports medicine Exercise can provoke asthma symptoms, such as dyspnoea, in children with asthma. Exercise-induced bronchoconstriction (EIB) is prevalent in 40-90% of children with asthma. Conversely, exercise can improve physical fitness. The purpose of this paper is to provide a systematic review of the literature regarding the effects of exercise training in children with asthma, particularly in relation to: EIB, asthma control, pulmonary function, cardiorespiratory parameters and parameters of underlying pathophysiology. A systematic search in several databases was performed. Controlled trials that undertook a physical training programme in children with asthma (aged 6-18 years) were selected. Twenty-nine studies were included. Training had positive effects on several cardiorespiratory fitness parameters. A few studies demonstrated that training could improve EIB, especially in cases where there was sufficient room for improvement. Peak expiratory flow was the only lung function parameter that could be improved substantially by training. The effects of training on asthma control, airway inflammation and bronchial hyper-responsiveness were barely studied. Owing to the overall beneficial effects of training and the lack of negative effects, it can be concluded that physical exercise is safe and can be recommended in children with asthma. A training programme should have a minimum duration of 3 months, with at least two 60 min training sessions per week, and a training intensity set at the (personalised) ventilatory threshold. Further research is recommended regarding the effects of exercise on underlying pathophysiological mechanisms and asthma control in children with asthma. 10.1136/bjsports-2012-091347

Effect of exercise rehabilitation on exercise capacity and quality of life in children with bronchial asthma: a systematic review. Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics OBJECTIVES:To systematically evaluate the effect of exercise rehabilitation on exercise capacity and quality of life in children with bronchial asthma. METHODS:PubMed, Cochrane Library, Web of Science, EBSCO, China National Knowledge Infrastructure, Weipu Data, and Wanfang Data were searched for randomized controlled trials (RCTs) on the effect of exercise rehabilitation on children with bronchial asthma published up to February 2021. RevMan 5.3 was used to perform a Meta analysis. RESULTS:A total of 14 studies were included, with 990 subjects in total. The Meta analysis showed that compared with the conventional treatment group, the exercise rehabilitation group had significantly better exercise capacity (distance covered in the 6-minute walk test: =108.13, <0.01; rating of perceived effort: =-2.16, <0.001; peak power: =0.94, =0.001) and significantly higher total score of quality of life (=1.28, =0.0002), activity score (=1.38, =0.0002), symptom score (=1.02, <0.001), and emotional score (=0.86, <0.001) assessed by the Pediatric Asthma Quality of Life Questionnaire. CONCLUSIONS:Current evidence shows that exercise rehabilitation has a positive effect in improving exercise capacity and quality of life in children with bronchial asthma. Due to limited number and quality of studies included in the analysis, further research is needed. 10.7499/j.issn.1008-8830.2104124

Advances in pulmonary rehabilitation for children with bronchial asthma. Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences Bronchial asthma is a heterogeneous disease characterized by chronic airway inflammation and airway hyperresponsiveness. With the development of the whole-life-cycle health concept, the focus of treatment for bronchial asthma in children has gradually shifted from pharmacological control to an integrated management model of functional rehabilitation and pharmacological assistance. As a non-pharmacological integrated approach, pulmonary rehabilitation plays an equally important role in the management of childhood asthma as pharmacological treatments. Breathing techniques such as Buteyko breathing, pursed lip breathing, diaphragmatic breathing training, threshold-pressure inspiratory muscle training and yoga breathing can improve lung function indicators such as forced expiratory volume in first second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and maximal voluntary ventilation (MVV) in children. Comprehensive pre-exercise assessment, development of exercise prescriptions, and implementation and evaluation of exercise effects can improve physical fitness, neuromuscular coordination, and self-confidence of children with asthma. The comprehensive interventions of health education, psychological support and nutritional intervention can improve the compliance and effectiveness of rehabilitation training. This article reviews the research progress on respiratory training, physical exercise, and comprehensive interventions in the pulmonary rehabilitation of asthmatic children, to provide theoretical basis and practical guidance for the scientific and rational management of pulmonary rehabilitation of asthmatic children in clinical settings. 10.3724/zdxbyxb-2023-0081

Exercise and lifestyle changes in pediatric asthma. Current opinion in pulmonary medicine PURPOSE OF REVIEW:The purpose of this review is to discuss the most recent studies on lifestyle interventions in pediatric asthma. We include studies on physical activity and exercise, sedentary time, nutrition, behavioral therapy and the role of schools. RECENT FINDINGS:Several small studies in children with asthma suggest that exercise interventions can improve aerobic fitness, asthma symptoms or control and quality of life. Existing evidence supports recommending higher intake of fruits and vegetables for asthma risk and control. In contrast, the 'Western diet' - high in refined grains, highly processed foods, red meats and fried foods with low intake of fruits and vegetables - has a proinflammatory effect and may alter microbiota composition leading to worse asthma outcomes. Finally, there are opportunities to utilize schools to promote physical activity, though standardization of asthma management in the schools is needed. SUMMARY:Assessing physical activity/fitness levels, sedentary time and nutritional status is important in the management of children with asthma, as they are modifiable factors. Larger rigorous studies evaluating lifestyle interventions are needed to better inform current asthma guidelines as well as to understand the underlying mechanism(s) related to physical activity and diet in asthma. 10.1097/MCP.0000000000000636

Exercise rehabilitation in pediatric asthma: A systematic review and network meta-analysis. Pediatric pulmonology OBJECTIVE:This systematic review delineates various exercise-based pulmonary rehabilitation (PR) designs and quantifies how they may be optimized in pediatric asthma treatment. DESIGN:Comprehensive systematic review, network meta-analysis, and quality analyses using PubMed, Embase, Cochrane Library, Web of Science Core Collection, and Medline searches. INTERVENTIONS:Discrete and combined endurance, respiratory, resistance, strength, and interval training. MAIN OUTCOME MEASURES:Forced expiratory volume at 1 s to predicted value ratio (FEV % pred), forced vital capacity to predicted value ratio (FVC% pred), forced expiratory flow between 25% and 75% of vital capacity ratio (FEF25%-75%), the Pediatric Asthma Quality of Life Questionnaire (PAQLQ), and the 6-min walk test (6MWT). RESULTS:Twenty-four randomized controlled trials (RCTs) involving a combined 1031 patients were included. Endurance training was the most common form of PR (58.3%), typically conducted through outpatient clinics (29.2%). Network meta-analysis showed that compared with other PR, interval training significantly improved PAQLQ total scores, and activity, symptom, and emotional domains. Interval training also had a significant effect on the 6MWT. No adverse events were reported. Exercise training did not have a significant effect on FEV % pred; however, combined endurance and respiratory training significantly improved both FVC% pred and FEF25%-75%. CONCLUSIONS:Exercise-based PR is safe and effective in childhood asthma treatment. Interval training may be a core component for improving quality of life and exercise capacity in this patient population, while combined respiratory and endurance training may significantly affect lung function. The clinical efficacy of these results should be confirmed through high-quality RCTs. 10.1002/ppul.26134