Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD 11,10 Medical Drive, Singapore 117597, Singapore.
Int J Nurs Stud. 2021 Aug;120:103953. doi: 10.1016/j.ijnurstu.2021.103953. Epub 2021 Apr 25.
Swimming has been considered the most appropriate activity for children with asthma for its lower asthmogenicity compared to land-based activities. However, the benefits of swimming have been hampered by reports of increased asthma risks, airway inflammation and bronchial hyper-responsiveness from exposure to chlorine by-products in swimming pools. Thus, the role of swimming for children with asthma remains unclear.
To determine the effectiveness of swimming as an intervention on lung function and asthma control in children below the age of 18 years. Any adverse effects from swimming on asthma were also examined.
Searches were performed across six databases systematically (PubMed, CINAHL, Embase, CENTRAL, Scopus, and PsycINFO). Randomized controlled trials (RCTs), quasi-experimental studies and interventional studies with at least one control/comparator group that were published in English were included. All eligible studies were screened with risk of bias examined by two independent reviewers. Meta-analyses were conducted using Review Manager 5.4 software while narrative syntheses were performed where meta-analysis was inappropriate and heterogeneity was present.
1710 records were retrieved from the search. A total of 9 studies with 387 participants were included in this review after screening. Swimming was found to have favourable effects on forced expiratory volume in one second (L) and forced vital capacity (%), but not for forced expiratory volume in one second (%) and peak expiratory flow (%). Narrative synthesis on asthma control and adverse effects were in favour of the swimming group.
Future studies that are adequately powered, involve swimming interventions of sufficient intensity, frequency and duration, examine cumulative exposures to chlorine by-products and take into account potential cofounders are warranted.
与陆地活动相比，游泳因致喘性较低而被认为是最适合哮喘儿童的活动。然而，由于游泳池中氯副产物暴露会增加哮喘风险、气道炎症和支气管高反应性，游泳的益处受到了阻碍。因此，游泳对哮喘儿童的作用仍不清楚。
确定游泳作为干预措施对 18 岁以下儿童肺功能和哮喘控制的有效性。还检查了游泳对哮喘的任何不良影响。
系统地在六个数据库（PubMed、CINAHL、Embase、CENTRAL、Scopus 和 PsycINFO）中进行了检索。纳入了发表英文的随机对照试验（RCT）、准实验研究和干预性研究，这些研究至少有一个对照组/比较组。所有符合条件的研究均由两名独立评审员进行了偏倚风险筛查。使用 Review Manager 5.4 软件进行荟萃分析，而在不适合进行荟萃分析且存在异质性的情况下则进行叙述性综合分析。
从检索中检索到 1710 条记录。经过筛选，共有 9 项研究（387 名参与者）纳入本综述。游泳被发现对一秒用力呼气容积（L）和用力肺活量（%）有有利影响，但对一秒用力呼气容积（%）和呼气峰值流量（%）没有影响。关于哮喘控制和不良影响的叙述性综合分析对游泳组有利。
未来需要进行充分有力的研究，涉及足够强度、频率和持续时间的游泳干预，检查氯副产物的累积暴露，并考虑潜在的混杂因素。
