Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada.
Appl Physiol Nutr Metab. 2011 Jul;36 Suppl 1:S80-100. doi: 10.1139/h11-057.
The 2 most common respiratory diseases are chronic obstructive pulmonary disease (COPD) and asthma. Growing evidence supports the benefits of exercise for all patients with these diseases. Due to the etiology of COPD and the pathophysiology of asthma, there may be some additional risks of exercise for these patients, and hence accurate risk assessment and clearance is needed before patients start exercising. The purpose of this review was to evaluate the available literature regarding the risks of exercise for patients with respiratory disease and provide evidence-based recommendations to guide the screening process. A systematic review of 4 databases was performed. The literature was searched to identify adverse events specific to exercise. For COPD, 102 randomized controlled trials that involved an exercise intervention were included (n = 6938). No study directly assessed the risk of exercise, and only 15 commented on exercise-related adverse events. For asthma, 30 studies of mixed methodologies were included (n = 1278). One study directly assessed the risk of exercise, and 15 commented on exercise-related adverse events. No exercise-related fatalities were reported. The majority of adverse events in COPD patients were musculoskeletal or cardiovascular in nature. In asthma patients, exercise-induced bronchoconstriction and (or) asthma symptoms were the primary adverse events. There is no direct evidence regarding the risk of exercise for patients with COPD or asthma. However, based on the available literature, it would appear that with adequate screening and optimal medical therapy, the risk of exercise for these respiratory patients is low.
两种最常见的呼吸系统疾病是慢性阻塞性肺疾病（COPD）和哮喘。越来越多的证据支持运动对所有患有这些疾病的患者都有益处。由于 COPD 的病因和哮喘的病理生理学，这些患者运动可能存在一些额外的风险，因此在患者开始运动之前需要进行准确的风险评估和清除。本综述的目的是评估有关呼吸系统疾病患者运动风险的现有文献，并提供循证建议来指导筛查过程。对 4 个数据库进行了系统回顾。检索文献以确定与运动相关的特定不良事件。对于 COPD，纳入了 102 项涉及运动干预的随机对照试验（n = 6938）。没有研究直接评估运动的风险，只有 15 项研究评论了与运动相关的不良事件。对于哮喘，纳入了 30 项混合方法研究（n = 1278）。有一项研究直接评估了运动的风险，有 15 项研究评论了与运动相关的不良事件。没有报告与运动相关的死亡事件。COPD 患者的大多数不良事件是肌肉骨骼或心血管性质的。在哮喘患者中，运动诱发的支气管收缩和（或）哮喘症状是主要的不良事件。对于 COPD 或哮喘患者运动的风险，没有直接证据。然而，根据现有文献，似乎通过充分的筛查和最佳的药物治疗，这些呼吸系统患者运动的风险较低。
