Study of the effect of 12-week rehabilitation program on exercise capacity and disease severity in asthmatic children

الملخص EN

Background : This study was performed to investigate the effect of a 12- week exercise rehabilitation program on exercise capacity, health related quality of life and severity of the disease in children with asthma.

Twenty five asthmatic children (8 females and 17 males) with mild and moderate asthma were involved in this study.

Methods : The subjects responded to questionnaires related to clinical severity, reactivity and quality of life scores.

Pulmonary functions including FEV1, FVC, FEV1 / FVC%, FEF25-75%, flow-volume loop data, minute ventilation, MVV, respiratory muscle functions (PImax and PEmax) and ventilatory drive activity (P0.1) were assessed using computerized spirometry.

Also bronchial hyper responsiveness to exercise and meth choline were determined.

All these measurements were evaluated before and after rehabilitation program.

This rehabilitation program was interval endurance training program of submaximal cycle ergometer exercise settings, twice weekly for 12 weeks, incorporated with breathing exercise.

Results : Asthmatic children demonstrated significant improvement in clinical severity (p < 0.001), reactivity (p < 0.001) and quality of life (p < 0.001) scores.

Also, this rehabilitation program induced improvement in functional exercise capacity that manifested by reduction of minute ventilation (p < 0.001) and HR (p < 0.001) with each level of workload during exercise challenge and significant increase in PWC / 150 (p < 0.001) associated with improvement in PImax (p < 0.001) and PEmax (p < 0.02) and increasing of P0.1 (p < 0.02), FEV1 (p, < ( 0.001 FEV1 / FVC% (p < 0.01) and FEF25% (p < 0.01).

Further more physical training program improved bronchial hyper responsiveness as demonstrated by decreasing post exercise maximal fall in FEV1 (-46.62% ± 68.72%, p < 0.001) in exercise challenge and increasing PD20-FEV1 (p < 0.01) in meth choline inhalation challenge.

However, there were no correlations between the degree of baseline airway obstruction and any of the observed improvement in the studied variables.

Conclusion : In children with asthma, this exercise rehabilitation program could improve not only health related quality of life and exercise capacity but also improve severity of asthma, as assessed by clinical severity, pulmonary function and bronchial hyper responsiveness.

So, such rehabilitation program should be placed as a component of childhood asthma management.