Original Article
Effects of Aerobic Training Versus Breathing Exercises on Asthma Control: A Randomized Trial

https://doi.org/10.1016/j.jaip.2020.06.042Get rights and content

Background

Aerobic training and breathing exercises are interventions that improve asthma control. However, the outcomes of these 2 interventions have not been compared.

Objective

To compare the effects of aerobic training versus breathing exercises on clinical control (primary outcome), quality of life, exercise capacity, and airway inflammation in outpatients with moderate-to-severe asthma.

Methods

Fifty-four asthmatics were randomized into either the aerobic training group (AG, n = 29) or the breathing exercise group (BG, n = 25). Both interventions lasted for 24 sessions (2/week, 40 minutes/session). Asthma clinical control (Asthma Control Questionnaire [ACQ]), quality of life (Asthma Quality of Life Questionnaire), asthma symptom-free days (ASFD), airway inflammation, exercise capacity, psychological distress (Hospital Anxiety and Depression Scale), daily-life physical activity (DLPA), and pulmonary function were evaluated before, immediately after, and 3 months after the intervention.

Results

Both interventions presented similar results regarding the ACQ score, psychological distress, ASFD, DLPA, and airway inflammation (P > .05). However, participants in the AG were 2.6 times more likely to experience clinical improvement at the 3-month follow-up than participants in the BG (P = .02). A greater proportion of participants in the AG also presented a reduction in the number of days without rescue medication use compared with BG (34% vs 8%; P = .04).

Conclusions

Outpatients with moderate-to-severe asthma who participated in aerobic training or breathing exercise programs presented similar results in asthma control, quality of life, asthma symptoms, psychological distress, physical activity, and airway inflammation. However, a greater proportion of participants in the AG presented improvement in asthma control and reduced use of rescue medication.

Section snippets

Methods

More details on the patient inclusion criteria, study design, randomization, interventions, outcome assessments, and statistical analysis are available in the Methods section of the Online Repository at www.jaci-inpractice.org.

Results

More details on the patients and baseline characteristics, the HADS, the induced sputum, and the DLPA are available in the Results section of the Online Repository at www.jaci-inpractice.org.

Discussion

Our results demonstrate that aerobic training and breathing exercise resulted in a similar effect in asthma control evaluated by the ACQ score; however, when the improvement in asthma control was evaluated individually, aerobic training induced a longer-lasting benefit than breathing exercises and a greater reduction in rescue medication use. There were no differences between groups for the other outcomes, such as HRQoL, asthma symptom-free days, psychological distress, and DLPA and airway

Conclusion

Outpatients with moderate-to-severe asthma who participated either in aerobic training or breathing exercise programs presented similar results regarding asthma control, HRQoL, asthma symptom-free days, psychological distress, DLPA, and airway inflammation. However, a greater proportion of participants in the aerobic training presented a longer-lasting clinical control and reduced use of rescue medication than the breathing exercises. These results are relevant in clinical practice to support

Acknowledgments

The authors acknowledge Prof. Clarice Tanaka from the Department of Physical Therapy, University of São Paulo for her support; and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) (Finance Code 001).

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    This work was supported by the São Paulo Research Foundation (FAPESP, Grants 2009539049 and 2011500716), São Paulo, Brazil and the Conselho Nacional de Pesquisa (CNPq, Grant 30598720100), Brasilia, Brazil.

    Conflicts of interest: The authors declare that they have no relevant conflicts of interest.

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