A Cochrane review [Abstract] 1 included 21 studies with a total of 772 subjects. Eight studies included adult-aged subjects, while 13 examined children. Physical training consisting of whole body aerobic exercise (lasting for at least 20-30 min 2-3 times weekly) was well tolerated with no adverse effects or worsening of asthma symptoms reported. Physical training improved cardiopulmonary fitness as measured by a statistically and clinically significant increase in maximum oxygen uptake (4.92 ml/kg/min, 95% CI 3.98 to 5.87; 8 studies, n=267). No statistically significant effects were observed for forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), minute ventilation at maximal exercise (VEmax) or peak expiratory flow rate (PEFR). Meta-analysis of 4 studies detected a statistically significant increase in maximum heart rate, and following a sensitivity analysis and removal of 2 studies significance was maintained (MD 3.67 bpm, 95% CI 0.90 to 3.44). Although there were insufficient data to pool due to diverse reporting tools, there is some evidence available to suggest that physical training may have positive effects on health-related quality of life, with four of five studies producing a statistically and clinically significant benefit.
Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment and lack of blinding) and by inconsistency (unexplained variability in results).
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