Exercise Raises Quality of Life in Asthma

Patients with persistent asthma reported significant improvements in quality of life after four months of structured exercise in a gym, researchers reported here.

Among adult patients participating in the three-times weekly sessions, 78% reported improvements on the asthma quality of life questionnaire compared with 39.5% of controls (P=0.05), according to Thomas A.E. Platts-Mills, MD, PhD, and colleagues from the University of Virginia in Charlottesville.

"It's very difficult to get patients with asthma to exercise, even though we know that stretching the smooth muscle in the lungs decreases airway resistance," Platt-Mills said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

"We face three major obstacles to increasing exercise among asthmatics. First, patients think their asthma will worsen if they exercise. Second, gyms are resistant because they're afraid patients will have an asthma attack. And third is the insurance companies, who are just resistant against paying," Platts-Mills said.

Half of participants attended the Atlantic Coast Athletic Club, where three times weekly they did 35 minutes of aerobic exercise followed by 10 minutes of thoracic and upper body Pilates.

This was preceded by five minutes of a warm-up period, which probably was not enough, because warm-up is very important for the prevention of exercise-induced asthma, he said.

"In fact, if you can get asthmatics to warm up enough, you can really prevent exercise-induced asthma," he said.

The other half were provided with education about exercise, and all patients completed the quality of life questionnaire every month.

Patients in the exercise program also reported that they experienced fewer disease-related limitations (41%, P=0.04).

There also was a trend to better emotional state in 50% and the ability to adjust to potentially adverse environmental stimuli in 22%.

Benefits have persisted out to one year, he noted.

"Given the small numbers in the study, this really was as good as we could have expected," he said.

Patients were clearly enthusiastic about the program, and the gym adapted to having patients with asthma exercising, such as having staff members monitor the patients while exercising and making sure nebulizers were available, Platts-Mills said.

"Exercise is clearly good for humans, and therefore exercise is good for asthmatics just because they are humans. But it's doing more, because taking deep breaths is a primary form of protection for human lungs," he said.

In conclusion, the study showed that patients were able to overcome their fear of exercise; the gym was willing to work with Platts-Mills group and develop a protocol; and the insurance company was willing to pay for these patients, all of whom had health coverage.