Effects of Combined Aerobic and Breathing Exercises on Asthma Control: A Randomized Controlled Trial

Highlights box•What is already known about this topic?GINA recommends aerobic or breathing exercises to improve asthma control and quality of life. However, the effects of combining both techniques on asthma control has never been tested.•What does this article add to our knowledge?This is the first study to evaluate the combination of two nonpharmacological treatments with a higher level of evidence of effectiveness for asthma control.•How does this study impact current management guidelines?Our results suggest that one type of exercise was sufficient to induce asthma control in individuals with moderate-to-severe asthma. However, the combination of both exercises also improved exercise capacity.ABSTRACTBackgroundBreathing and aerobic exercises are the most recommended nonpharmacological treatments to improve asthma control and quality of life in patients with asthma. However, the benefits of combining both interventions in these outcomes have never been tested.ObjectiveWe aimed to evaluate the effects of the combination of aerobic and breathing exercises on asthma control in individuals with moderate-to-severe asthma.MethodsIndividuals with moderate-to-severe asthma were randomly assigned to the aerobic + muscle-stretching group (Control group (CG), n=25) or aerobic + breathing exercises group (Experimental group (EG), n=26). The aerobic exercise was performed using constant-load training and breathing exercises using the Buteyko technique. The training program lasted 20 sessions. All individuals were blindly assessed before and after the interventions for asthma control, health-related quality of life, anxiety and depression symptoms, sleep quality, hyperventilation, exercise capacity, lung function, levels of physical activity, and thoracoabdominal kinematics. Group x time interactions were tested using a two-way repeated measures analysis of variance. Pearson's correlation test was used to test the association between outcomes.ResultsThe groups were similar at baseline (all p>0.05). After the intervention, there were no between-group differences for all outcomes comparing EG and CG.ConclusionThese results suggest that a combination of aerobic and breathing exercises did not improve asthma control, psychosocial symptoms, sleep quality, hyperventilation, exercise capacity, lung function, levels of daily physical or thoracoabdominal kinematics compared with aerobic exercise alone in individuals with moderate-to-severe asthma.Clinical Trial RegistrationClinicalTrials.gov, NCT04412720.