da Silva Ronaldo Aparecido, Cukier Alberto, Carvalho-Pinto Regina Maria, Carvalho Celso R F
Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.
Pulmonary Division, Heart Institute (InCor), Clinics Hospital, School of Medicine, University of São Paulo, São Paulo, Brazil.
ERJ Open Res. 2024 Mar 11;10(2). doi: 10.1183/23120541.00899-2023. eCollection 2024 Mar.
The effect of aerobic training on reliever medication consumption (short-acting β-agonist (SABA)) and peak expiratory flow (PEF) in participants with asthma is poorly known. The comparison between constant-load exercise (CLE) and high-intensity interval training (HIIT) in these outcomes has never been tested. The purpose of the present study was to compare the effects of CLE or HIIT in SABA consumption and PEF improvement during an exercise programme in subjects with asthma.
Clinically stable participants were randomised into CLE (n=27; 70-85% of the maximal load (W)) or HIIT (n=28; 80-140% W). The programme lasted 12 weeks (two sessions per week, 40 min per session), and the intensity was based on cardiopulmonary exercise testing (CPET). PEF was assessed before and after each exercise session. SABA was used if PEF was <70%. Clinical control (Asthma Control Questionnaire (ACQ)-6), CPET and aerobic fitness were also assessed before and after the intervention.
Both groups were similar at baseline. CLE and HIIT reduced SABA consumption throughout the intervention (p<0.05). Before training, 14 patients required SABA before exercising, but only one needed it after the intervention. Changes in post-exercise PEF were lower in the CLE group than in the HIIT group (1.6±25.3 10.3±13.7%). Both groups improved aerobic fitness (10.1±12.8% 5.7±15.6%) and clinical asthma control; however, only the HIIT group achieved a minimal clinically important difference in the ACQ-6 post-intervention (-0.23±1.06 -0.52±0.73 Δ score).
CLE and HIIT reduced SABA consumption; however, only HIIT increased PEF and asthma clinical control after the intervention. These results reinforce the importance of exercise training in moderate-to-severe asthma.
有氧运动训练对哮喘患者缓解药物(短效β-激动剂(SABA))使用量及呼气峰值流速(PEF)的影响鲜为人知。在这些指标方面,恒负荷运动(CLE)与高强度间歇训练(HIIT)之间的比较从未得到验证。本研究旨在比较CLE或HIIT对哮喘患者运动计划期间SABA使用量及PEF改善情况的影响。
临床稳定的参与者被随机分为CLE组(n = 27;最大负荷(W)的70 - 85%)或HIIT组(n = 28;80 - 140%W)。该计划持续12周(每周两次,每次40分钟);强度基于心肺运动测试(CPET)。每次运动前后评估PEF。若PEF < 70%,则使用SABA。干预前后还评估了临床控制情况(哮喘控制问卷(ACQ)-6)、CPET及有氧适能。
两组在基线时相似。在整个干预过程中,CLE和HIIT均减少了SABA的使用量(p < 0.05)。训练前,14名患者运动前需要使用SABA,但干预后仅1人需要。CLE组运动后PEF的变化低于HIIT组(1.6±25.3对10.3±13.7%)。两组的有氧适能均有所改善(10.1±12.8%对5.7±15.6%),且哮喘临床控制情况均得到改善;然而,只有HIIT组在干预后ACQ - 6评分达到了最小临床重要差异(-0.23±1.06对-0.52±0.73分)。
CLE和HIIT均减少了SABA的使用量;然而,干预后只有HIIT提高了PEF并改善了哮喘临床控制情况。这些结果强化了运动训练在中重度哮喘中的重要性。