The Effects of Breathing and Aerobic Exercises on Physical Fitness and Quality of Life in Patients with Asthma
DOI:
https://doi.org/10.64960/srimedj.v40i5.267389Keywords:
aerobic exercise, asthma, breathing exercise, physical fitness, pulmonary rehabilitationAbstract
Background and Objective: Breathing and aerobic exercises are known to be beneficial for patients with asthma. However, research on combining these exercises is limited. Therefore, this study investigated the effects of a combining breathing with aerobic exercise on physical fitness and quality of life in asthmatic patients.
Methods: This study was a single-blind, randomized controlled trial. Thirty patients with asthma were randomly allocated to either a control group (CG) or a training group (TG) in 1:1 ratio. Participants in the CG performed aerobic exercise only, whereas those in the TG participated in both aerobic exercise and breathing exercise program. Both groups exercised for 50 minutes per session, 3 times per week, for a duration of 12 weeks. Physical fitness parameters including static balance (one leg stand test; OLST), dynamic balance (time up and go test; TUGT), and lower limb strength (five-time sit to stand test; FTSST), along with quality of life (mini asthma quality of life questionnaire; mini-AQLQ) were evaluated at baseline, mid-intervention (6 weeks), and post-intervention (12 weeks).
Results: Both exercise interventions significantly increased OLST, TUGT, FTSST, and mini-AQLQ scores at both 6 and 12 weeks of the study period when compared with baseline (p < 0.05). Interestingly, the TG showed significantly greater improvements in OLST, TUGT, FTSST, and mini-AQLQ (total scores and symptom domain) compared to the CG at 12 weeks (p < 0.05).
Conclusions: These results suggest that the combination of breathing and aerobic exercises effectively improve physical fitness and quality of life in asthmatic patients.
References
Global initiative for asthma. Global strategy for asthma management and prevention. 2025. [cited Feb 1, 2025]. Available from: https://ginasthma.org/2025-gina-strategy-report/.
Cordova-Rivera L, Gibson PG, Gardiner PA, Powell H, McDonald VM. Physical activity and exercise capacity in severe asthma: key clinical associations. J Allergy Clin Immunol Pract 2018;6(3):814-22. doi:10.1016/j.jaip.2017.09.022.
Basso RP, Jamami M, Labadessa IG, Regueiro EM, Pessoa BV, Oliveira AD Jr., et al. Relationship between exercise capacity and quality of life in adolescents with asthma. J Bras Pneumol 2013;39(2):121-7. doi:10.1590/s1806-37132013000200002.
de Lima FF, Pinheiro DHA, de Carvalho CRF. Physical training in adults with asthma: an integrative approach on strategies, mechanisms, and benefits. Front Rehabil Sci 2023;4:1115352. doi:10.3389/fresc.2023.1115352.
Cote A, Turmel J, Boulet LP. Exercise and asthma. Semin Respir Crit Care Med 2018;39(1):19-28. doi:10.1055/s-0037-1606215.
Bruton A, Thomas M. The role of breathing training in asthma management. Curr Opin Allergy Clin Immunol 2011;11(1):53-7. doi:10.1097/ACI.0b013e3283423085.
Santino TA, Chaves GS, Freitas DA, Fregonezi GA, Mendonca KM. Breathing exercises for adults with asthma. Cochrane Database Syst Rev 2020;3(3):CD001277. doi:10.1002/14651858.CD001277.pub4.
Evaristo KB, Mendes FAR, Saccomani MG, Cukier A, Carvalho-Pinto RM, Rodrigues MR, et al. Effects of aerobic training versus breathing exercises on asthma control: a randomized trial. J Allergy Clin Immunol Pract 2020;8(9):2989-96 e4. doi:10.1016/j.jaip.2020.06.042.
Erdogan Yuce G, Tasci S. Effect of pranayama breathing technique on asthma control, pulmonary function, and quality of life: a single-blind, randomized, controlled trial. Complement Ther Clin Pract 2020;38:101081. doi:10.1016/j.ctcp.2019.101081.
Chomiak T, Pereira FV, Hu B. The single-leg-stance test in parkinson's disease. J Clin Med Res 2015;7(3):182-5. doi:10.14740/jocmr1878w.
Marques A, Cruz J, Quina S, Regencio M, Jacome C. Reliability, agreement and minimal detectable change of the timed up & go and the 10-meter walk tests in older patients with COPD. COPD 2016;13(3):279-87. doi:10.3109/15412555.2015.1079816.
Zampogna E, Pignatti P, Ambrosino N, Cherubino F, Maria Fadda A, Zappa M, et al. The 5-repetition sit-to-stand test as an outcome measure for pulmonary rehabilitation in subjects with asthma. Respir Care 2021;66(5):769-76. doi:10.4187/respcare.08452.
Juniper EF, Guyatt GH, Cox FM, Ferrie PJ, King DR. Development and validation of the mini asthma quality of life questionnaire. Eur Respir J 1999;14(1):32-8. doi:10.1034/j.1399-3003.1999.14a08.x.
Juniper EF, Guyatt GH, Willan A, Griffith LE. Determining a minimal important change in a disease-specific quality of life questionnaire. J Clin Epidemiol 1994;47(1):81-7. doi:10.1016/0895-4356(94)90036-1.
Balady GJ, Weiner DA. Exercise testing for sports and the exercise prescription. Cardiol Clin 1987;5(2):183-96 doi:10.1016/s0733-8651(18)30545-9.
American College of Sports Medicine (ACSM). ACSM’s resources for the group exercise instructor. 2nd ed. Baltimore: Wolters Kluwer Health; 2022.
Sarinukul C, Janyacharoen T, Donpunha W, Nakmareong S, Ruksapukdee W, Sawanyawisuth K. The effects of stepping exercise on blood pressure, physical performance, and quality of life in female older adults with stage 1 hypertension: a randomized controlled trial. Can Geriatr J 2023;26(1):144-9. doi:10.5770/cgj.26.632.
Charee J, Yupaporn K, Khaothin T, Kusump S, Ashira H. The effects of step aerobic training on muscle power and agility in female badminton players. Int J Exerc Sci 2022;15(6):1317-25. doi:10.70252/AMXG6734.
Wakeling JM. Motor units are recruited in a task-dependent fashion during locomotion. J Exp Biol 2004;207(Pt 22):3883-90. doi:10.1242/jeb.01223.
Stephens RJ, Haas M, Moore WL, 3rd, Emmil JR, Sipress JA, Williams A. Effects of diaphragmatic breathing patterns on balance: a preliminary clinical trial. J Manipulative Physiol Ther 2017;40(3):169-75. doi:10.1016/j.jmpt.2017.01.005.
Hodges PW, Eriksson AE, Shirley D, Gandevia SC. Intra-abdominal pressure increases stiffness of the lumbar spine. J Biomech 2005;38(9):1873-80. doi:10.1016/j.jbiomech.2004.08.016.
HajGhanbari B, Yamabayashi C, Buna TR, Coelho JD, Freedman KD, Morton TA, et al. Effects of respiratory muscle training on performance in athletes: a systematic review with meta-analyses. J Strength Cond Res 2013;27(6):1643-63. doi:10.1519/JSC.0b013e318269f73f.
Janssens L, McConnell AK, Pijnenburg M, Claeys K, Goossens N, Lysens R, et al. Inspiratory muscle training affects proprioceptive use and low back pain. Med Sci Sports Exerc 2015;47(1):12-9. doi:10.1249/MSS.0000000000000385.
Lee DK, Kim SH. The effect of respiratory exercise on trunk control, pulmonary function, and trunk muscle activity in chronic stroke patients. J Phys Ther Sci 2018;30(5):700-3. doi:10.1589/jpts.30.700.
Bordoni B, Purgol S, Bizzarri A, Modica M, Morabito B. The influence of breathing on the central nervous system. Cureus 2018;10(6):e2724. doi:10.7759/cureus.2724.
Franca-Pinto A, Mendes FA, de Carvalho-Pinto RM, Agondi RC, Cukier A, Stelmach R, et al. Aerobic training decreases bronchial hyperresponsiveness and systemic inflammation in patients with moderate or severe asthma: a randomised controlled trial. Thorax 2015;70(8):732-9. doi:10.1136/thoraxjnl-2014-206070.
Valkenborghs SR, Wood LG, Callister R, Upham JW, Grainge CL, Anderson S, et al. Effects of moderate- versus vigorous-intensity exercise training on asthma outcomes in adults. J Allergy Clin Immunol Pract 2024;12(10):2744-53 e8. doi:10.1016/j.jaip.2024.06.015.
Dogra S, Kuk JL, Baker J, Jamnik V. Exercise is associated with improved asthma control in adults. Eur Respir J 2011;37(2):318-23. doi:10.1183/09031936.00182209.
Prem V, Sahoo RC, Adhikari P. Effect of diaphragmatic breathing exercise on quality of life in subjects with asthma: a systematic review. Physiother Theory and Pract 2013;29(4):271–7. doi:10.3109/09593985.2012.731626.
Hamasaki H. Effects of diaphragmatic breathing on health: a narrative review. Medicines (Basel) 2020;7(10):65. doi: 10.3390/medicines7100065.
Seo Y, Yates B, LaFramboise L, Pozehl B, Norman J.F, Hertzog M. A home-based diaphragmatic breathing retraining in rural patients with heart failure. West J Nurs Res 2016;38(3):270–91. doi:10.1177/0193945915584201.
Gosselink R. Breathing techniques in patients with chronic obstructive pulmonary disease (COPD). Chron Respir Dis 2004;1(3):163–72. doi:10.1191/1479972304cd020rs.
Rossi A, Aisanov Z, Avdeev S, Di Maria G, Donner CF, Izquierdo JL, et al. Mechanisms, assessment and therapeutic implications of lung hyperinflation in COPD. Respir Med 2015;109(7):785–802. doi:10.1016/j.rmed.2015.03.010.
Gosselink R. Controlled breathing and dyspnea in patients with chronic obstructive pulmonary disease (COPD). J Rehabil Res Dev 2003;40(5 suppl 2):25-33. doi:10.1682/jrrd.2003.10.0025.
Nguyen JD, Duong H. Pursed-lip breathing. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Srinagarind Medical Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
