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. 2014 Jul 17;2014(7):CD010456.
doi: 10.1002/14651858.CD010456.pub2.

Water-based exercise for adults with asthma

Antonio Jose Grande  1 , Valter Silva, Brenda N G Andriolo, Rachel Riera, Sergio A Parra, Maria S Peccin
Affiliations

Water-based exercise for adults with asthma

Antonio Jose Grande et al. Cochrane Database Syst Rev. .

Abstract

Background: Asthma is a common condition characterised by airway inflammation and airway narrowing, which can result in intermittent symptoms of wheezing, coughing and chest tightness, possibly limiting activities of daily life. Water-based exercise is believed to offer benefits for people with asthma through pollen-free air, humidity and effects of exercise on physical function.

Objectives: To evaluate the effectiveness and safety of water-based exercise for adults with asthma.

Search methods: We searched the Cochrane Airways Group Specialised Register of Trials (CAGR), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED), PsycINFO, the Latin American and Caribbean Health Science Information Database (LILACS), the Physiotherapy Evidence Database (PEDro), the System for Information on Grey Literature in Europe (SIGLE) and Google Scholar on 13 May 2014. We handsearched ongoing clinical trial registers and meeting abstracts of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the British Thoracic Society (BTS).

Selection criteria: We included all randomised controlled trials (RCTs) of adults with asthma comparing a water-based exercise group versus one or more of the following groups: usual care, land-based exercise, non-exercise.

Data collection and analysis: Two review authors (AJG, VS) independently extracted data from the primary studies using a standard form developed for this purpose, which includes methods, participants, interventions and outcomes. We contacted trial authors to request additional data. Data were input by one review author and were double-checked by a second review author.

Main results: In this systematic review, we provide a narrative synthesis of available evidence from three small studies including 136 adult participants. The studies were at high risk of bias. No meta-analysis was possible because of methodological and interventional heterogeneity between included studies. The primary outcomes of quality of life and exacerbations leading to use of steroids were not reported by these studies. For exacerbations leading to health centre/hospital visits, uncertainty was wide because a very small number of events was reported (in a single study). Secondary outcomes symptoms, lung function, changes in medication and adverse effects, where available, described for each included study. The overall quality of the studies was very low, and no clear differences were noted between water-based exercise and comparator treatments. Therefore, we remain very uncertain about the effects of water-based exercise for adults with asthma.

Authors' conclusions: The small number of participants in the three included studies, the clinical and methodological heterogeneity observed and the high risk of bias assessed mean that we are unable to assess the place of water-based exercise in asthma. Randomised controlled trials are needed to assess the efficacy and safety of water-based exercise for adults with asthma. For future research, we suggest greater methodological rigour (participant selection, blinding of outcome assessors, reporting of all outcomes analysed and registering of the study protocol).

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Conflict of interest statement

None known.

Figures

1
1
PRISMA flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Water‐based exercise versus land‐based exercise (10 weeks): parallel groups, Outcome 1 Exacerbations leading to health centre visits or exacerbations leading to hospitalisations.
1.2
1.2. Analysis
Comparison 1 Water‐based exercise versus land‐based exercise (10 weeks): parallel groups, Outcome 2 Symptoms (general symptoms).
1.3
1.3. Analysis
Comparison 1 Water‐based exercise versus land‐based exercise (10 weeks): parallel groups, Outcome 3 Lung function (FEV1 (L)).
1.4
1.4. Analysis
Comparison 1 Water‐based exercise versus land‐based exercise (10 weeks): parallel groups, Outcome 4 Lung function (PEF (L/min)).
1.5
1.5. Analysis
Comparison 1 Water‐based exercise versus land‐based exercise (10 weeks): parallel groups, Outcome 5 Reduction in medication use.
1.6
1.6. Analysis
Comparison 1 Water‐based exercise versus land‐based exercise (10 weeks): parallel groups, Outcome 6 Adverse events.
2.1
2.1. Analysis
Comparison 2 Water‐based exercise versus land‐based exercise (1 session): cross‐over, Outcome 1 Lung function (FEV1 (L)).
2.2
2.2. Analysis
Comparison 2 Water‐based exercise versus land‐based exercise (1 session): cross‐over, Outcome 2 Lung function (PEF (L/min)).
3.1
3.1. Analysis
Comparison 3 Water‐based exercise + education versus medication only (24 weeks): parallel groups, Outcome 1 Lung function (FEV1 (L)).
3.2
3.2. Analysis
Comparison 3 Water‐based exercise + education versus medication only (24 weeks): parallel groups, Outcome 2 Lung function (PEF (L/min)).
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD010456

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