Aquatic exercise for people with asthma: a systematic review with meta-analysis of randomized controlled trials

Abstract

Introduction

Aquatic exercises are among the types of exercise most tolerated by people with asthma. Therefore, the objective of this study was to synthesize the evidence on the effects of aquatic exercise on lung function and quality of life in asthmatic patients.

Data sources

A systematic search encompassing the Medline, CINAHL, Cochrane Library, Embase, AMED, SPORTDiscus, and Physiotherapy Evidence Database databases was conducted to identify randomized controlled trials assessing the impact of aquatic exercise in comparison to control conditions or land-based exercise on lung function and quality of life in individuals diagnosed with asthma.

Study selections

The stages of selection, data extraction and methodological evaluation, and level of evidence of the manuscripts were carried out independently by two authors.

Results

Ten studies, comprising a total of 393 participants, were incorporated into this systematic review. Very low-quality evidence was found in favor of aquatic exercise in asthmatic patients for forced expiratory volume in 1 s (MD: 0.20 L, 95% CI: 0.02 L–0.38L N: 91) and for forced vital capacity (MD: 0.32 L, 95% CI: 0.08 L–0.56L N: 80). No effect of aquatic exercise was observed on the FEV₁/FVC ratio (MD:1.11L, 95% CI: −1.28 L–3.49L N:80) compared with control. Only one study evaluated the effect of aquatic exercise on patients’ quality of life.

Conclusions

Improvements in lung function and quality of life in asthmatic patients undergoing aquatic exercise are not supported by high-quality evidence. The present findings will need to be confirmed by new, methodologically more rigorous clinical trials.

HIGHLIGHTS

• The effect of aquatic exercise on pulmonary function and quality of life in asthma patients is still uncertain.

• The current quality of evidence for aquatic exercise in asthma patients is low.

• There is an urgent need for higher-quality studies investigating the effects of aquatic exercise among asthma patients.

Keywords:

• Lung function
• quality of life
• asthma
• swimming

Acknowledgements

We would like to thank Conselho Nacional de Desenvolvimento Científico e Tecnológico (National Council for Scientific and Technological Development) (CNPq), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Coordination for the Improvement of Higher Education Personnel) (CAPES), and Fundação de Amparo à Pesquisa do Estado de Minas Gerais (Research Support Foundation for the State of Minas Gerais) (FAPEMIG) for support and grants.

Author contributions

Vanessa Pereira Lima designed and supervised this study, helped draft the manuscript, and gave critical revisions of intellectual importance for content. Franciele Angelo Deus selected studies extracted data and drafted the manuscript. Cecylia Leiber Fernandes e Castro selected studies and extracted data. Vinícius Cunha Oliveira helped in the selection of studies and gave critical revisions important for the manuscript. Pedro Henrique Scheidt Figueiredo, Henrique Silveira Costa, Diego Mendes Xavier, and Wellington Fabiano Gomes have reviewed the manuscript. All authors have read and approved the final version of the manuscript, and agree with the order of presentation of the authors.

Ethical approval

None.

Patient consent

Not applicable.

Disclosure statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article.

Data availability statement

All data relevant to the study are included in the article or are available as supplementary files.

Additional information

Funding

This study was financed in part by the Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG) – APQ-00062-18.