The effect of interval training in children with exercise-induced asthma competing in soccer.

A lot of emphasis has been placed in screening individuals with exercise-induced bronchospasm in order to avoid persistence bronchial hyperactivity and consequent chronic silent inflammation of the respiratory tract. The purpose of this study was to evaluate the effect of interval training on the respiratory function and endurance in children with exercise-induced asthma (EIA) participating in the sport of soccer. Twenty-nine boys ages 10-14, who developed EIA after a 6-minute free running test (decline in forced expiratory volume in 1 second: FEV(1)10%), participated in the study. They were divided into 2 groups (experimental: n = 18, and control: n = 11), fulfilling the same criteria (i.e., age, body height and weight, and severity of asthma). The experimental group exercised with the interval training method for a period of 8 weeks, (3 sessions per week), whereas the control group exercised with the usual football program. Measurements were made for FEV(1) and endurance in both groups, before and after the application of training (8 weeks). Following the implementation of the training program, a significant improvement in FEV(1) and endurance was documented in the experimental group, as well as significant differences between the 2 groups. In conclusion, duration and aerobic training via the interval method seems to be beneficial to soccer players with EIA.

[Practical advice for exercise-induced asthma in children: experience of the exercise training centre of Necker-Enfants malades hospital]. / Conseils pratiques pour l'asthme de l'enfant déclenché par l'exercice physique: expérience du centre de réentraînement à l'effort de l'hôpital Necker-Enfants-malades .

Now, to care exercise-induced asthma is not only to prescribe drugs. It is a global and interdisciplinary approach: the pulmonary rehabilitation, matching a therapeutic education and a physical training, with the goal of promoting a regular physical activity in the asthmatic child, achieving physiological benefits and improvement of quality of life. Getting from the experience of Necker-Enfants Malades Hospital's Training Centre, a few advises encourage the physical practice of the asthmatic child, and decrease risks of exercise-induced asthma: optimisation of treatments;progressive beginning and end of exercises; use of the diaphragmatic breathing, keeping up with the exercise; use of the ventilatory threshold (or dysponea threshold) as intensity of the aerobic training; practice of different activities promoting play and conviviality in sports and allowing the integration of sports in the daily life of the asthmatic child.

[Physical activity and respiratory tract diseases asthma and allergy]. / Fysisk aktivitet og luftveissykdommer, astma og allergi.

BACKGROUND: This article presents a review of the relationship between physical training and airways diseases: the relationship between physical activity and the development of airways diseases, and the effect of physical training in rehabilitation after airways diseases. MATERIAL AND METHODS: The article is a systematic review of exercise-induced asthma (EIA), the effect of physical training upon bronchial hyperresponsiveness and the development of asthma; how chronic lung diseases affect the ability to participate in physical activity; and the use of physical training in rehabilitation after airways diseases. RESULTS AND INTERPRETATION: Physical training may provoke EIA in asthmatic patients. Furthermore, heavy regular training over long periods of time may contribute to the development of asthma. Mastering EIA is an important goal in the management of asthma, especially in children and adolescents, in order to foster normal physical and mental development. Physical training improves fitness and the mastering of asthma, but not of bronchial hyperresponsiveness and asthma activity. In other airways disorders like cystic fibrosis or chronic obstructive lung disease, a reduced lung function may limit the ability to participate in physical activity. Training is an important tool in the rehabilitation of patients with pulmonary disorders as it improves physical fitness and quality of life.

Physical activity and asthma.

The relationship between asthma and exercise and the resultant disability (ie, the impact on activities of daily living, including physical activity) shows wide interpatient and intrapatient variability, being influenced not only by the disease but additional psychosocial variables. There are a variety of helpful pharmacologic and nonpharmacologic measures in dealing with simple exercise-induced asthma, and new therapeutic options are being developed. The cardiorespiratory performance characteristics of asthmatic patients are very frequently suboptimal, either because of symptom-limited exercise tolerance or secondary deconditioning consequent upon inactivity. Medically supervised physical training can produce significant beneficial change. Recommendations for rehabilitation of asthmatic patients would include individualized exercise prescription and advice based on objective criteria of exercise capability, with flexibility in the programs offered, in order to cater to the broadest spectrum of patient disability.

[Effect of ambulatory sports therapy on bronchial asthma in children]. / Der Einfluss einer ambulanten Sporttherapie auf das Asthma bronchiale bei Kindem.

Exercise-induced asthma (EIA) is very common in children with asthma. For this reason they avoid every strenuous exercise because they fear a new asthma attack. Working capacity and maturation of motor performance can be insufficient as a consequence. We investigated whether a special training programme in an asthma sports group has positive effects not only on asthma, but also on working capacity and motor performance. 11 children with extrinsic asthma (4 girls, 7 boys), 8 to 14 years old, were studied before and after a 6-month out-patient rehabilitative sports therapy (sports group) with regard to their degree of bronchial hyperreactivity (BHR), frequency of EIA, cardiopulmonary capacity for exercise; knowledge about their asthma, level of coordination and condition, and their movement-related anxiety. There were 9 children with extrinsic asthma (2 girls, 7 boys), 8 to 15 years old, in a control group. They did not take part in any special training programme. After the sports therapy we found in 3 children of the sports group a decrease in BHR, EIA was now present in only 2 of formerly 4 children. Physical working capacity (PWC) at the aerobic/anaerobic threshold improved in the sports group by about 1 W/kg body weight (p = 0.008), efficiency of work from 23.7% to 27.9% (p = 0.009). We also found a remarkable improvement of motor abilities. Movement-related anxiety decreased in the sports group both in Indoor sports (p = 0.0089) and aquatics (p = 0.026). In the control group there was no significant change. Physical training in children with asthma has many positive effects on lung function and motor performance. We believe that the limit for an EIA release is shifted to a higher PWC. The reduction of the anxiety over sports at a higher level of PWC contributes to an improved quality of life for children with asthma.

Rehabilitación integral y tolerancia al ejercicio físico en escolares asmáticos severos / Total rehabilitation and tolerance to physical exercise in schoolchildren suffering from severe asthma

Se realizó un estudio en 99 escolares asmáticos severos, incluidos en un programa de rehabilitación integral en el centro para niños asmáticos de la Ciudad de los Pioneros "José Martí" en Tarará, durante el curso escolar 1991-1992. A todos los escolares se les sometió antes de comenzar el programa, a una prueba de tolerancia al ejercicio físico mediante la carrera libre, y acorde con los resultados de ésta se clasificaron en 2 grupos; grupo I, con asma inducida por el ejercicio (AIE) y grupo II, sin AIE. Al finalizar el programa de rehabilitación al grupo I se le sometió nuevamente a la prueba de tolerancia al ejercicio físico. Todos los escolares se evaluaron mediante la espirometría en condiciones basales antes del programa de rehabilitación y al finalizar éste. En 55 escolares (55,5 porciento) se constató la presencia inicial de AIE. Al finalizar el programa de rehabilitación sólo en 23 de ellos se mantuvo este fenómeno. Con excepción de un escolar perteneciente al grupo I el resto de los niños toleraron sin dificultad las actividades físicas programadas. En relación con los parámetros de función respiratoria no se hallaron diferencias significativas en ninguno de ellos, cuando se compararon ambos grupos entre sí antes del programa de rehabilitación, y después de él. Comparando cada grupo consigo mismo sólo se observó un incremento significativo del flujo máximo medio (MMF) en ambos grupos, lo que reflejó una disminución del componente obstructivo bronquial periférico (AU)

Rehabilitación integral y tolerancia al ejercicio físico en escolares asmáticos severos / Total rehabilitation and tolerance to physical exercise in schoolchildren suffering from severe asthma

Se realizó un estudio en 99 escolares asmáticos severos, incluidos en un programa de rehabilitación integral en el centro para niños asmáticos de la Ciudad de los Pioneros "José Martí" en Tarará, durante el curso escolar 1991-1992. A todos los escolares se les sometió antes de comenzar el programa, a una prueba de tolerancia al ejercicio físico mediante la carrera libre, y acorde con los resultados de ésta se clasificaron en 2 grupos; grupo I, con asma inducida por el ejercicio (AIE) y grupo II, sin AIE. Al finalizar el programa de rehabilitación al grupo I se le sometió nuevamente a la prueba de tolerancia al ejercicio físico. Todos los escolares se evaluaron mediante la espirometría en condiciones basales antes del programa de rehabilitación y al finalizar éste. En 55 escolares (55,5 porciento) se constató la presencia inicial de AIE. Al finalizar el programa de rehabilitación sólo en 23 de ellos se mantuvo este fenómeno. Con excepción de un escolar perteneciente al grupo I el resto de los niños toleraron sin dificultad las actividades físicas programadas. En relación con los parámetros de función respiratoria no se hallaron diferencias significativas en ninguno de ellos, cuando se compararon ambos grupos entre sí antes del programa de rehabilitación, y después de él. Comparando cada grupo consigo mismo sólo se observó un incremento significativo del flujo máximo medio (MMF) en ambos grupos, lo que reflejó una disminución del componente obstructivo bronquial periférico

[Judo in a training group for children with asthma]. / Judosport in einer Trainingsgruppe mit asthmakranken Kindern.

15 asthmatics of 7-14 years of age were trained in a special judo training group together with healthy children. The step-like training programme was composed in such a manner that an exercise-induced bronchospasm was kept as low as possible whereas the coordination, flexibility, physical and psychical resistance were improved. By means of adapted lung function tests the children were controlled, the aim was not so much to prove an improvement of functional values but rather to avoid injuries. Reactions confirmed by means of the sensitive flow-volume curve method did not present any clinical problems. Exercise-induced reactions occurred most frequently, if at all, after a warming-up phase and in the middle of the 14 training weeks. Both at the end of every lesson and at the end of the whole training course the number and internity of reactions decreased. Children suffering from exercise-induced asthma could be trained by means of judo sport without any problems. A combatant sport, such as judo, is particularly qualified for the improvement of motivation, coordination, dexterity and integration into the community of healthy children to increase self-confidence. Asthma sport groups are a medical and paedagogical necessity.

[The asthmatic child and sports]. / Il bambino asmatico e lo sport.

Many asthmatic children are more disabled by exercise-induced asthma (EIA) than by other asthmatic attacks. Recent attention has focused on the pathophysiology of EIA and its prevention. Only within the past few years the effects of exercise programs have been examined carefully in children with asthma. Thus, they can increase work tolerance and fitness with a beneficial effect of physical training on EIA. Adequate training intensities would be possible if EIA could be prevented by premedication and if a type of exercise was chosen which gave good cardiopulmonary training. Although swimming is their optimum sport (experience of authors), asthmatic children should be encouraged to embrace a full and varied program of sport. Many sportsmen and women who have asthma are able to compete at the highest level and gain olympic and world honours.