A Meta Analysis of Physical Exercise on Improving Lung Function and Quality of Life Among Asthma Patients

Pulmonary responses following cardiac rehabilitation and the relationship with functional outcomes in children and young adults with heart disease

Introduction

Patients with congenital heart disease (CHD) often have pulmonary abnormalities and exercise intolerance following cardiac surgery. Cardiac rehabilitation (CR) improves exercise capacity in patients with CHD, but minimal study has been performed to see if resting and dynamic pulmonary performance improves following CR in those with prior cardiac surgery.

Methods

This was a retrospective cohort study of all patients who completed ≥12 weeks of CR from 2018 through 2022. Demographic, cardiopulmonary exercise test (CPET), spirometry, 6-minute walk, functional strength measures, and outcomes data were collected. Data are presented as median[IQR]. A Student's t-test was used for comparisons between groups and serial measurements were measured with a paired t-test. A p < 0.05 was considered significant.

Results

There were a total of 37 patients [age 16.7 (14.2-20.1) years; 46% male] included. Patients with prior surgery (n = 26) were more likely to have abnormal spirometry data than those without heart disease (n = 11) (forced vital capacity [FVC] 76.7 [69.1-84.3]% vs. 96.4 [88.1-104.7]%, p = 0.002), but neither group experienced a significant change in spirometry. On CPET, peak oxygen consumption increased but there was no change in other pulmonary measures during exercise. Percent predicted FVC correlated with hand grip strength (r = 0.57, p = 0.0003) and percent predicted oxygen consumption (r = 0.43, p = 0.009). The number of prior sternotomies showed negative associations with both percent predicted FVC (r = -0.43, p = 0.04) and FEV1 (r = -0.47, p = 0.02).

Discussion

Youth and young adults with a prior history of cardiac surgery have resting and dynamic pulmonary abnormalities that do not improve following CR. Multiple sternotomies are associated with worse pulmonary function.

Non-pharmacological interventions for asthma prevention and management across the life course: Umbrella review

BACKGROUND

The impact of non-pharmacological interventions (NPIs) on asthma prevention and management is insufficiently examined. We aim to comprehensively evaluate and synthesize existing evidence regarding the effectiveness of various NPIs throughout the life course.

METHODS

We conducted a systematic search and screening of reviews that examined the effectiveness of various NPIs on asthma prevention and control in the Cochrane Library, PubMed, Embase, and Ovid databases. Data extraction was performed by considering the type of NPIs and the life course stages of the target population. Recommendations were provided by considering the quality of review assessed using the AMSTAR2 tool and the consistency of findings across reviews.

RESULTS

We identified 145 reviews and mapped the evidence on the impact of 25 subtypes of NPIs on asthma prevention and control based on five stages of life course. Reviews indicated a shift of focus and various impacts of major NPIs on asthma prevention and control across life courses, while a few types of NPIs, such as physical exercise, appeared to be beneficial in children, adolescents and adults. Consistent and high-level evidence was observed only for psychological intervention on asthma control and quality of life among adults and older adults. Potential benefit with high-level evidence was reported on certain NPIs, such as vitamin D in reducing risk of developing asthma in offsprings in the prenatal stage, digital health interventions in improving asthma control from childhood to older adulthood, and breathing exercise in improving quality of life, asthma-related symptoms and lung function in adulthood and older adulthood.

CONCLUSION

This study emphasizes the significance of delivering NPIs to improve asthma prevention and management and highlights the heterogeneity regarding the impact of NPIs across life courses. High-quality research is urgently needed to further strengthen the evidence base of NPIs and tailored interventions should be considered in guideline development.

Sociodemographic factors, health behavior, parental or workplace smoking, and adult asthma risk in the United States

BACKGROUND

Although several studies have found a link between parental or workplace smoking and asthma risk, particularly in children and adolescents, only a few studies have found this link in adults.

OBJECTIVE

This study aimed to investigate the associations of sociodemographic factors, health behavior, and parental or workplace smoking with adult asthma risk in the United States (US).

METHODS

A secondary data analysis on 874 participants aged 25-45 was performed using data from the 2011-2014 National Survey of Midlife Development in the United States Refresher. Participants were divided into smokers and nonsmokers. Participants were further divided into groups A (a father or mother with a smoking history) and B (others in the house or colleagues in the workplace who had a smoking history).

RESULTS

Findings from the FREQ procedure revealed that sociodemographic (female, black, school or college education, unmarried/divorced, and employed) and lifestyle (no alcohol intake, physically inactive, and obese) and clinical (diabetes and joint disease) factors were significantly associated with one- or more-fold odds of asthma among adult smokers than nonsmokers. Adult smokers in group A, particularly females, those with a high school or college education, physically inactive, and overweight or obese, had a higher risk of asthma than those in group B.

CONCLUSION

Adult smokers' risk of developing asthma is increased in the US by having smoked with their parents, being a woman, being black, having a school or college education, being single or divorced, working, not drinking alcohol, being physically inactive, being obese, having diabetes, and having a joint disease.

Physical training in adults with asthma: An integrative approach on strategies, mechanisms, and benefits

Asthma is a chronic airway disease characterized by airflow limitation and respiratory symptoms associated with chronic airway and systemic inflammation, bronchial hyperreactivity (BHR), and exercise-induced bronchoconstriction (EIB). Asthma is a heterogeneous disease classified according to distinct airway and systemic inflammation. Patients commonly present with several comorbidities, including anxiety, depression, poor sleep quality, and reduced physical activity levels. Individuals with moderate to severe asthma often have more symptoms and difficulty achieving adequate clinical control, which is associated with poor quality of life, despite proper pharmacological treatment. Physical training has been proposed as an adjunctive therapy for asthma. Initially, it was suggested that the effect of physical training might be attributed to the improved oxidative capacity and reduced production of exercise metabolites. However, in the last decade, there has been evidence that aerobic physical training promotes anti-inflammatory effects in asthma patients. Physical training improves BHR and EIB, asthma symptoms, clinical control, anxiety, and depression levels, sleep quality, lung function, exercise capacity, and dyspnea perception. Furthermore, physical training reduces medication consumption. The most commonly used exercise strategies are moderate aerobic and breathing exercises; however, other techniques, such as high-intensity interval training, have shown promising effects. In the present study, we reviewed the strategies and beneficial effects of exercise on clinical and pathophysiological asthma outcomes.