Lower torso exercise plus respiratory training beneficial in asthma

Breathing exercise devices such as a conventional threshold loading training (TLT) device or an innovative respiratory training (IRT) device, when used in combination with lower torso sports training (LTST), proved beneficial in improving pulmonary function, exercise capacity, and quality of life (QoL) in individuals with asthma, a study suggests. However, IRT trumped TLT in terms of improvements in some respiratory and physical performance variables.

“[O]ur results confirm the effect of IRT with LTST on FEV1, maximal inspiratory pressure (PImax), QoL, baseline dyspnoea, and body weight on the physical capacity of [the participants],” said the researchers.

Postintervention, the effect of LTST with TLT (arm A) was similar to that delivered by LTST with IRT (arm B) in terms of mean body weight (71.14 vs 71.16 kg; p=0.72), SpO₂ (91.56 percent vs 91.50 percent; p=0.42), PImax (62.65 vs 62.89; p=0.06), leg extension (21.43 vs 21.24; p=0.15), and SGRQ* (50.42 vs 50.23; p=0.125). [Biomed Res Int 2023;2023:3049804]

In other variables, the between-group comparisons yielded statistical significance in favour of arm B over A, particularly for mean differences in FEV1 (0.259; p=0.05), baseline dyspnoea index (0.198; p<0.01), leg press (0.221; p=0.03), and 6-minute walking test (3.02; p<0.001). “[These suggest that] combining respiratory training with athletic training will be more beneficial vs a conventional treatment method [for improving these parameters in patients with asthma],” said the researchers.

The between-group comparisons of the postintervention values were derived using ANCOVA, with baseline values serving as covariate.

The study randomized 300 patients (mean age 58 years) who have been clinically diagnosed with asthma for >1 year to either arm A or B. The intervention period ran for 10 weeks, with thrice-weekly sessions lasting 30–40 minutes. Pre-session warmups targeting the lower torso and thoracic wall muscles were conducted. Sessions focused on regulating breathing rhythm, increasing LTST and expiratory time, improving diaphragmatic and nasal breathing, and slowing respiratory flow.

Utilizing nonpharmacologic interventions

Considering the strains of asthma on the healthcare system and the associated cost burden, it is imperative to develop low-cost alternatives to traditional pharmacotherapy and adjunctive therapies to supplement existing therapies for asthma.

“Sport exercises, with or without equipment, have been widely employed because they are simple to implement, inexpensive, safe, and are critical adjuncts to asthma treatment,” said the researchers.

The current findings provide evidence of the benefits of nonpharmacologic interventions such as respiratory training and athletic training and validates the efficacy of an IRT device for improving asthma conditions.

“Our findings highlight the importance of inspiratory training and [improving] exercise capacity in asthma patients. Peripheral muscle endurance, body weight, dyspnoea, and inspiratory muscle training all influence the capacity of asthma patients to carry out exercise and physical work,” they said.

The researchers called for longer term studies to evaluate the long-term effects of these breathing exercise regimens in this patient population. They also called for further investigation to assess the impact of IRT with upper torso training.