HIGH-INTENSITY PHYSICAL-TRAINING IN ADULTS WITH ASTHMA - A 10-WEEK REHABILITATION PROGRAM

Twenty-six adults (23 to 58 years) with mild to moderate asthma underw ent a 10-week supervised rehabilitation program, with emphasis on phys ical training. In the first 2 weeks, they exercised daily in an indoor swimming pool (33 degrees C) and received education about asthma, med ication, and principles of physical training. In the following 8 weeks , they exercised in the pool twice a Reek. Every training session last ed 45 min. The training sessions were made as suitable as possible for the individual subjects, in order to minimize ''drop outs'' from the program. The aim of the study was to evaluate the efficacy of the reha bilitation program and to determine if inactive asthmatic adults can e xercise at high intensity. The rehabilitation program was preceded by a 6-min submaximal cycle ergometry test, a 12-min walling test, spirom etry, and a methacholine provocation test. The subjects also responded to a five-item questionnaire related to anxiety about exercise, breat hlessness, and asthma symptoms using a visual analogue scale. All subj ects were able to perform physical training at a very high intensity, to 80 to 90% of their predicted maximal heart rate. No asthmatic attac ks occurred in connection with the training sessions. Twenty-two of th e 26 subjects completed the rehabilitation program, felt confident wit h physical training, and planned to continue regular physical training after the 10-week program. Improvements in cardiovascular conditionin g, measured as a decreased heart rate at the same load on the cycle er gometer (average of 12 beats/min), and as a longer distance at the 12- min walking test (average of 111 m), were observed during the program. FEV(1) increased significantly from 2.2 to 2.5 L. Forced expiratory f low at 25% of vital capacity also increased slightly but significantly . Methacholine provocation dose causing a fall in FEV(1) by 20% was un changed. Seventeen subjects had a peak expiratory flow reduction of mo re than 15% after the preprogram ergometry test and were classified as having exercise-induced asthma (ELA). Only three of these subjects ha d ELA after 10 weeks. The asthmatic subjects were less afraid of exper iencing breathlessness during exercise and less anxious about exercisi ng at a high intensity after 10 weeks (p<0.05). The asthma symptoms ab ated significantly during the rehabilitation program and the subjects needed less acute asthma care after the rehabilitation program. The re sults indicate that asthmatic persons benefit from a rehabilitation pe riod, including physical training. Rehabilitation programs are therefo re of value as a supplement to conventional pharmacologic treatment of asthma. This rehabilitation program can be adapted for use in clinica l practice.