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Paed Asthma – Improving physical and cardiovascular fitness

Evidence Summary
Lots of studies looked at whether physical capacity and cardiovascular fitness was improved with regular physical activity. This was measured looking at maximal effort exercise testing (VO2max) or using a sub-maximal exercise test such as the 6 min walk test (6MWT).

The type of physical activity intervention used in published research was varied and included running, cycling, swimming, circuit training, aerobic strength training, balance and coordination, basketball and Tai Chi based programs. There was also a wide variety of program duration, intensity and frequency.

All studies looking at VO2max showed a significant improvement in cardiovascular fitness in the intervention groups with a large effect size, with improvements also seen in sub-maximal testing.

Quality of Evidence
Grade A – high quality
Strength of Recommendation
1A. Strong recommendation, high quality evidence from multiple studies looking at various physical activities.
Conclusion
Physical activity interventions have all consistently been shown to increase cardiovascular fitness and physical capacity significantly in asthmatic groups. There is no evidence currently to support one physical activity being more beneficial than others and no comment can be made on the optimal frequency, intensity or duration. There is no evidence however that increasing physical capacity and cardiovascular fitness has an improvement on asthma symptoms or severity.
References
Abdelbasset, W. K., S. F. Alsubaie, S. A. Tantawy, T. I. Abo Elyazed and D. M. Kamel (2018). “Evaluating pulmonary function, aerobic capacity, and pediatric quality of life following a 10-week aerobic exercise training in school-aged asthmatics: a randomized controlled trial.” Patient Prefer Adherence 12: 1015-1023.
Andrade, L. B., M. C. Britto, N. Lucena-Silva, R. G. Gomes and J. N. Figueroa (2014). “The efficacy of aerobic training in improving the inflammatory component of asthmatic children. Randomized trial.” Respir Med 108(10): 1438-1445.
Beggs, S., Y. C. Foong, H. C. Le, D. Noor, R. Wood-Baker and J. A. Walters (2013). “Swimming training for asthma in children and adolescents aged 18 years and under.” Paediatr Respir Rev 14(2): 96-97.
Geiger, K. R. and N. Henschke (2015). “Swimming for children and adolescents with asthma.” Br J Sports Med 49(12): 835-836.
Joschtel, B., S. R. Gomersall, S. Tweedy, H. Petsky, A. B. Chang and S. G. Trost (2018). “Effects of exercise training on physical and psychosocial health in children with chronic respiratory disease: a systematic review and meta-analysis.” BMJ Open Sport Exerc Med 4(1): e000409.
Latorre-Roman, P. A., A. V. Navarro-Martinez and F. Garcia-Pinillos (2014). “The effectiveness of an indoor intermittent training program for improving lung function, physical capacity, body composition and quality of life in children with asthma.” J Asthma 51(5): 544-551.
Wanrooij, V. H., M. Willeboordse, E. Dompeling and K. D. van de Kant (2014). “Exercise training in children with asthma: a systematic review.” Br J Sports Med 48(13): 1024-1031.

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