Chest
Volume 138, Issue 2, August 2010, Pages 331-337
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Original Research
Asthma
Effects of Aerobic Training on Psychosocial Morbidity and Symptoms in Patients With Asthma: A Randomized Clinical Trial

https://doi.org/10.1378/chest.09-2389Get rights and content

Background

Asthma symptoms reduce patients' daily activities, impair their health-related quality of life (HRQoL), and increase their reports of anxiety and depression, all of which seem to be related to a decrease in asthma control. Aerobic exercise training is known to improve aerobic fitness and reduce dyspnea in asthmatics; however, its effect in reducing psychologic distress and symptoms remains poorly understood. We evaluated the role of an aerobic training program in improving HRQoL (primary aim) and reducing psychologic distress and asthma symptoms (secondary aims) for patients with moderate or severe persistent asthma.

Methods

A total of 101 patients were randomly assigned to either a control group or an aerobic training group and studied during the period between medical consultations. Control group patients (educational program plus breathing exercises) (n = 51) and training group patients (educational program plus breathing exercises plus aerobic training) (n = 50) were followed twice a week during a 3-month period. HRQoL and levels of anxiety and depression were quantified before and after treatment. Asthma symptoms were evaluated monthly.

Results

At 3 months, the domains (physical limitations, frequency of symptoms, and psychosocial) and total scores of HRQoL significantly improved only in the training group patients (P < .001); the number of asthma-symptom-free days and anxiety and depression levels also significantly improved in this group (P < .001). In addition, a linear relationship between improvement in aerobic capacity and the days without asthma symptoms was observed (r = 0.47; P < .01).

Conclusions

Our results suggest that aerobic training can play an important role in the clinical management of patients with persistent asthma. Further, they may be especially useful for patients with higher degrees of psychosocial distress.

Trial registration

clinicaltrials.gov; Identifier: NCT-00989365

Section snippets

Patients

A total of 101 (79 women/22 men) patients between 20 to 50 years old with moderate or severe persistent asthma were recruited at a university hospital. Asthma diagnosis was based on the Global Initiative for Asthma.1 Patients were under medical treatment of ≥ 6 months and considered clinically stable (ie, no crises and changes in medication for ≥ 30 days). Patients with cardiovascular, pulmonary, or musculoskeletal diseases that would impair exercise training were excluded from the study. The

Results

Twelve patients (6 control group, 6 training group) withdrew from the study because of health problems other than asthma, scheduling difficulties, or personal problems. Eighty-nine patients completed the study (45 control group, 44 training group). Before the study, both groups had similar distributions with regard to sex, age, BMI, daily dose of corticosteroids (P > .05) (Table 1), asthma-specific HRQoL (P > .05) (Table 2), anxiety and depression levels (P > .05) (Table 3), asthma symptoms (P

Discussion

The present study shows that an aerobic training program in adults with moderate-to-severe persistent asthma improves asthma-specific HRQoL and reduces anxiety and depression levels and asthma symptoms. These benefits were associated with baseline values, suggesting that the patients who started with worse psychosocial levels demonstrated greater improvement.

Acknowledgments

Author contributions: Mr Mendes: contributed to manuscript writing, the study concept and design, data acquisition, and data analysis and interpretation.

Ms Gonçalves: contributed to manuscript writing, the study concept and design, data acquisition, and data analysis and interpretation.

Dr Nunes: contributed to manuscript revision and the study concept and design.

Dr Saraiva-Romanholo: contributed to manuscript revision, data acquisition, and data analysis and interpretation.

Dr Cukier:

References (35)

  • RJ Adams et al.

    Psychological factors and asthma quality of life: a population based study

    Thorax

    (2004)
  • DM Orestein

    Asthma and sports

  • A Fanelli et al.

    Exercise training on disease control and quality of life in asthmatic children

    Med Sci Sports Exerc

    (2007)
  • British Thoracic Society Standards of Care Subcommittee on Pulmonary Rehabilitation

    BTS statement: pulmonary rehabilitation

    Thorax

    (2001)
  • LM Cochrane et al.

    Benefits and problems of a physical training programme for asthmatic patients

    Thorax

    (1990)
  • FS Ram et al.

    Physical training for asthma

    Cochrane Database Syst Rev

    (2005)
  • BM Wipfli et al.

    The anxiolytic effects of exercise: a meta-analysis of randomized trials and dose-response analysis

    J Sport Exerc Psychol

    (2008)
  • Cited by (0)

    Funding/Support: This work was supported by Fundação de Amparo à Pesquisa de São Paulo (grants 02/08422-7 and 07/56937-0) and Conselho Nacional de Pesquisa (grants 480869/04-9).

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

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