Abstract

BackgroundPulmonary rehabilitation (PR) has been proposed as an effective method for many respiratory diseases. However, the effects of exercise-based PR on asthma are currently inconclusive. This review aimed to investigate the effects of exercise-based PR on adults with asthma.MethodsThe PubMed, Embase, Cochrane Library, Web of Science, International Clinical Trials Registry Platform and ClinicalTrials.gov databases were searched from inception to 31 July 2019 without language restriction. Randomized controlled trials (RCTs) investigating the effects of exercise-based PR on adults with asthma were included. Study selection, data extraction and risk of bias assessment were performed by two investigators independently. Meta-analysis was conducted by RevMan software (version 5.3). Evidence quality was rated by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.ResultsTen literatures from nine studies (n = 418 patients) were identified. Asthma quality of life questionnaire total scores (MD = 0.39, 95% CI: 0.02 to 0.76) improved significantly in the experimental group compared to control group, including activity domain scores (MD = 0.58, 95% CI: 0.21 to 0.94), symptom domain scores (MD = 0.52, 95% CI: 0.19 to 0.85), emotion domain scores (MD = 0.53, 95% CI: − 0.03 to 1.09) and environment domain scores (MD = 0.56, 95% CI: 0.00 to 1.11). Both the 6-min walk distance (MD = 34.09, 95% CI: 2.51 to 65.66) and maximum oxygen uptake (MD = 4.45, 95% CI: 3.32 to 5.58) significantly improved. However, improvements in asthma control questionnaire scores (MD = − 0.25, 95% CI: − 0.51 to 0.02) and asthma symptom-free days (MD = 3.35, 95% CI: − 0.21 to 6.90) were not significant. Moreover, there was no significant improvement (MD = 0.10, 95% CI: − 0.08 to 0.29) in forced expiratory volume in 1 s. Nonetheless, improvements in forced vital capacity (MD = 0.23, 95% CI: 0.08 to 0.38) and peak expiratory flow (MD = 0.39, 95% CI: 0.21 to 0.57) were significant.ConclusionsExercise-based PR may improve quality of life, exercise tolerance and some aspects of pulmonary function in adults with asthma and can be considered a supplementary therapy. RCTs of high quality and large sample sizes are required.Clinical trial registration: The review was registered with PROSPERO (The website is https://www.crd.york.ac.uk/prospero/, and the ID is CRD42019147107).

Highlights

  • Pulmonary rehabilitation (PR) has been proposed as an effective method for many respiratory diseases

  • Clinical trial registration: The review was registered with PROSPERO (The website is https://www.crd.york.ac.uk/prospero/, and the ID is CRD42019147107)

  • Detailed search strategies were developed for each database related to “asthma” and “pulmonary rehabilitation” and “randomized controlled trials (RCTs)”

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Summary

Introduction

Pulmonary rehabilitation (PR) has been proposed as an effective method for many respiratory diseases. The effects of exercise-based PR on asthma are currently inconclusive. This review aimed to investigate the effects of exercise-based PR on adults with asthma. From 1990 to 2015, the prevalence of asthma increased by 12.6%, to 358.2 million individuals, according to the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2015 study [2]. Patients who experience asthma often have impaired quality of life (QOL), low pulmonary function, descending exercise tolerance and poor symptom control, which may be life-threatening and carry a significant burden for society. While medication is the main approach to asthma, non-pharmacological strategies can be used as supplements Asthma patients, especially those with one or more risk factors for exacerbations, should consider non-pharmacological strategies and interventions to assist with symptom control and risk reduction

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