Exercise as it relates to Disease/ Effects of physical activity on asthma

Tim Eslick 3080949 This wikibooks page is an analysis of a 2006 journal article "Effects of physical exercise on quality of life, exercise capacity and pulmonary function in children with asthma". From the Journal of rehabilitation medicine, Volume 38, Issue 2, pp. 130–135.

What is the background to this research?
Asthma is considered to be one of the most prevalent chronic sicknesses in children. As research has indicated that asthma in children often results in a decrease in physical activity (PA), it is evident that this illness can cause a detrimental effect on heath of minors. Hence researching the effect of PA on asthma is important to understand the health and physiological benefits of PA on asthma.

Where is the research from?
A total of seven researchers played a part in producing this paper. The research was produced in association with the Department and Physical Medicine and Rehabilitation, Department of Physiology, Department of Biostatistics, and Department of Paediatric Allergy-Immunology, in the Faculty of Medicine, out of  Cukurova University,  in Adana, Turkey.

What kind of research was this?
There are both qualitative and quantitative elements within this research. The first aspect discussed, the Pediatric Asthma Quality of Life Questionnaire (PAQLQ), introduces qualitative data by evaluating activity limitations, symptoms, and emotional functions. Numeric data is discussed through evaluation of physical work capacity (PWC) that was performed on a cycle ergometer and via a six minute walk test, and therefore quantitative research is to also be discussed throughout this article.

Patients
This study involved sixty-two participants with a mean age of 10.4 years, that were classified as suffering from mild-moderate asthma. This was classified depending on the symptoms displayed.

Comparitive data
Baseline assessments such as physical assessments and spirometry tests (to assess lung function) were conducted to make comparisons against later in the research. Quantitative tests conducted to analyse work capacity included the PWC170 test and the six minute walk test (6MWT), with the results from these tests being normalised for comparison between participants. A specifically designed questionnaire, the PAQLQ was implemented to assess quality of life within the participants.

Training program
Participants were split into two groups. Group C-control and Group E-exercise. Group E participants were to participate in sub maximal aerobic training sessions, 3 times a week, for eight weeks in the form of basketball training. These sessions generally consisted of a fifteen minute warm up, thirty to thirty-five minutes of training, and a ten minute cool down and flexibility session. Specific exercise was not encouraged for Group C, however a home based respiratory training program was implemented to both groups of participants.

Baseline Assessment
There were no significant differences between groups E and C in the baseline assessment apart from the symptom score and the 6MWT, with the symptoms score and distance covered in the 6MWT proving significantly higher before the training program was implemented.

Participation
Not all of the participants completed the study for reasons varying from, moving city to receiving broken bones in other activities. Hence the final assessment at the end of the eight weeks was conducted on thirty participants from group E, and twent-eight for group C.

PAQLQ
The results of the three elements in the PAQLQ (activity limitation, symptoms, and emotional function) all significantly improved in both groups. The significant effects of the interventions however were significantly higher in Group E. Of the three elements in the PAQLQ the biggest significant difference was seen in activity limitation. A change in symptom score also correlated significantly with PAQLQ, with other variables including exercise capacity, pulmonary functions, duration of disease, and medication not significantly correlating to PAQLQ.

6MWT & PWC170
The distance covered in the 6MWT and the results from the PWC170 improved significantly in Group E, however no significant improvement was shown in Group C.

Medication & Symptoms
Medication scores significantly improved in both groups. Significant improvement in symptom scores in Group E were evident in the final evaluation.

How did the researchers interpret the results?
The interpretation of these results indicate that the researchers believe as a result of their intervention Group E participants improved their QoL and exercise capacity. However this also improved in the control group whereby participants completes a home based exercise program. The change in symptom score of the participants also significantly correlated to the PAQLQ, and hence the researchers suggest an improvement in health status for both groups.

6MWT
The effects of the intervention on pulmonary function and exercise capacity was also a key focus point in this research. However the current study suggest there is limited literature relevant for comparison against their participants and hence the importance of an significant increase of 26 meters in the 6MWT in Group E is stated as "unclear".

PWC170
Researchers suggest that improvements in VO2 max, reduced asthma symptoms, and medication reduction resulted from the program implementation.

What conclusions should be taken away from this research?
The conclusions of this research suggest that a sub-maximal PA program (such as playing basketball) 2-3 times a week can drastically increase the physical fitness of children with asthma, decrease medication dependency, and also assist in reducing the symptoms of asthma resulting in improved QoL. The same can be said for specific exercises performed at home resulting in an improved QoL.

However as this was a relatively small study (a total of 58 participants) perhaps more testing can be conducted to further validate the findings of this particular research program.

What are the implications of this research?
Some implications resulting from this research may include, as an alternative to medications, prescribe PA/home based programs to reduce the effects of asthma. As stated earlier asthma sufferers tend be less physically active, perhaps this research will also assist in increasing the PA in asthma patients, this may lead to a reduction in risk factors for diseases that correlate to inactivity.