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* From the Division of Pulmonary and Critical Care Medicine (Drs. Hallstrand and Schoene), University of Washington, Seattle, WA; and the Department of Medicine (Dr. Bates), Maine Medical Center, Portland, ME.
Correspondence to: Teal S. Hallstrand, MD, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, 1959 NE Pacific St, BB-1253 Health Sciences Center, Box 356522, Seattle, WA 98195-8673;e-mail: tealh{at}u.washington.edu
Study objective: To determine the effect of an aerobic conditioning program on fitness, respiratory physiology, and resting lung function in patients with mild asthma.
Design: Prospective cohort study.
Setting: Outpatient rehabilitation facility.
Methods: Five patients with mild intermittent asthma and five normal control subjects completed a 10-week aerobic conditioning program. Pulmonary function studies and noninvasive cardiopulmonary exercise tests were performed before and after the conditioning program.
Results: After aerobic
conditioning, there were significant gains in maximum oxygen
consumption (
O2max; 22.73 mL/kg/min vs
25.29 mL/kg/min, p = 0.01, asthma; 22.94 mL/kg/min vs 27.85
mL/kg/min, p = 0.03, control) and anaerobic threshold (0.99 L/min vs
1.09 L/min, p = 0.03, asthma; 0.89 L/min vs 1.13 L/min, p = 0.01,
control) in both groups. Although FEV1 was unchanged, the
maximum voluntary ventilation (MVV) improved in the asthma group (96.0
L/min vs 108.2 L/min, p = 0.08, asthma; 134.0 L/min vs 131.2 L/min,
p = 0.35, control). During exercise, minute ventilation
(E) for each level of work was decreased in the
asthma group after conditioning, while little change occurred in the
control group (68.48 L/min vs 51.70 L/min at initial
O2max, p = 0.02, asthma; 65.82 L/min
vs 63.12 L/min at initial O2max,
p = 0.60, control). A significant decrease in the ventilatory
equivalent (E/oxygen consumption, 40.8 vs 30.4 at
O2max, p = 0.02, asthma; 37.2 vs 35.8
4 at O2max, p = 0.02,
control) and the dyspnea index (E/MVV) at submaximal
(0.44 vs 0.38, p = 0.05, asthma; 0.32 vs 0.38, p < 0.01, control)
and maximal exercise (0.72 vs 0.63, p = 0.03, asthma; 0.49 vs 0.62,
p = 0.02, control) occurred in the asthma group.
Conclusions: Exercise rehabilitation improves aerobic fitness in both asthmatic and nonasthmatic participants of a 10-week aerobic fitness program. Additional benefits of improved ventilatory capacity and decreased hyperpnea of exercise occurred in patients with mild asthma.
Key Words: asthma • exercise-induced bronchospasm • rehabilitation
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