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Water-based exercise for adults with asthma.

Abstract

BACKGROUND

Asthma is a common condition characterised by airway inflammation and airway narrowing, which can result in intermittent symptoms of wheezing, coughing and chest tightness, possibly limiting activities of daily life. Water-based exercise is believed to offer benefits for people with asthma through pollen-free air, humidity and effects of exercise on physical function.

OBJECTIVES

To evaluate the effectiveness and safety of water-based exercise for adults with asthma.

SEARCH METHODS

We searched the Cochrane Airways Group Specialised Register of Trials (CAGR), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED), PsycINFO, the Latin American and Caribbean Health Science Information Database (LILACS), the Physiotherapy Evidence Database (PEDro), the System for Information on Grey Literature in Europe (SIGLE) and Google Scholar on 13 May 2014. We handsearched ongoing clinical trial registers and meeting abstracts of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the British Thoracic Society (BTS).

SELECTION CRITERIA

We included all randomised controlled trials (RCTs) of adults with asthma comparing a water-based exercise group versus one or more of the following groups: usual care, land-based exercise, non-exercise.

DATA COLLECTION AND ANALYSIS

Two review authors (AJG, VS) independently extracted data from the primary studies using a standard form developed for this purpose, which includes methods, participants, interventions and outcomes. We contacted trial authors to request additional data. Data were input by one review author and were double-checked by a second review author.

MAIN RESULTS

In this systematic review, we provide a narrative synthesis of available evidence from three small studies including 136 adult participants. The studies were at high risk of bias. No meta-analysis was possible because of methodological and interventional heterogeneity between included studies. The primary outcomes of quality of life and exacerbations leading to use of steroids were not reported by these studies. For exacerbations leading to health centre/hospital visits, uncertainty was wide because a very small number of events was reported (in a single study). Secondary outcomes symptoms, lung function, changes in medication and adverse effects, where available, described for each included study. The overall quality of the studies was very low, and no clear differences were noted between water-based exercise and comparator treatments. Therefore, we remain very uncertain about the effects of water-based exercise for adults with asthma.

AUTHORS' CONCLUSIONS

The small number of participants in the three included studies, the clinical and methodological heterogeneity observed and the high risk of bias assessed mean that we are unable to assess the place of water-based exercise in asthma. Randomised controlled trials are needed to assess the efficacy and safety of water-based exercise for adults with asthma. For future research, we suggest greater methodological rigour (participant selection, blinding of outcome assessors, reporting of all outcomes analysed and registering of the study protocol).

Authors+Show Affiliations

Department of Public Health, Universidade do Extremo Sul Catarinense, Av. Universitária, 1105, Criciúma, Santa Catarina, Brazil, 88806-000.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

25032820

Citation

Grande, Antonio Jose, et al. "Water-based Exercise for Adults With Asthma." The Cochrane Database of Systematic Reviews, 2014, p. CD010456.
Grande AJ, Silva V, Andriolo BN, et al. Water-based exercise for adults with asthma. Cochrane Database Syst Rev. 2014.
Grande, A. J., Silva, V., Andriolo, B. N., Riera, R., Parra, S. A., & Peccin, M. S. (2014). Water-based exercise for adults with asthma. The Cochrane Database of Systematic Reviews, (7), CD010456. https://doi.org/10.1002/14651858.CD010456.pub2
Grande AJ, et al. Water-based Exercise for Adults With Asthma. Cochrane Database Syst Rev. 2014 Jul 17;(7)CD010456. PubMed PMID: 25032820.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Water-based exercise for adults with asthma. AU - Grande,Antonio Jose, AU - Silva,Valter, AU - Andriolo,Brenda N G, AU - Riera,Rachel, AU - Parra,Sergio A, AU - Peccin,Maria S, Y1 - 2014/07/17/ PY - 2014/7/18/entrez PY - 2014/7/18/pubmed PY - 2015/1/13/medline SP - CD010456 EP - CD010456 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 7 N2 - BACKGROUND: Asthma is a common condition characterised by airway inflammation and airway narrowing, which can result in intermittent symptoms of wheezing, coughing and chest tightness, possibly limiting activities of daily life. Water-based exercise is believed to offer benefits for people with asthma through pollen-free air, humidity and effects of exercise on physical function. OBJECTIVES: To evaluate the effectiveness and safety of water-based exercise for adults with asthma. SEARCH METHODS: We searched the Cochrane Airways Group Specialised Register of Trials (CAGR), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED), PsycINFO, the Latin American and Caribbean Health Science Information Database (LILACS), the Physiotherapy Evidence Database (PEDro), the System for Information on Grey Literature in Europe (SIGLE) and Google Scholar on 13 May 2014. We handsearched ongoing clinical trial registers and meeting abstracts of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the British Thoracic Society (BTS). SELECTION CRITERIA: We included all randomised controlled trials (RCTs) of adults with asthma comparing a water-based exercise group versus one or more of the following groups: usual care, land-based exercise, non-exercise. DATA COLLECTION AND ANALYSIS: Two review authors (AJG, VS) independently extracted data from the primary studies using a standard form developed for this purpose, which includes methods, participants, interventions and outcomes. We contacted trial authors to request additional data. Data were input by one review author and were double-checked by a second review author. MAIN RESULTS: In this systematic review, we provide a narrative synthesis of available evidence from three small studies including 136 adult participants. The studies were at high risk of bias. No meta-analysis was possible because of methodological and interventional heterogeneity between included studies. The primary outcomes of quality of life and exacerbations leading to use of steroids were not reported by these studies. For exacerbations leading to health centre/hospital visits, uncertainty was wide because a very small number of events was reported (in a single study). Secondary outcomes symptoms, lung function, changes in medication and adverse effects, where available, described for each included study. The overall quality of the studies was very low, and no clear differences were noted between water-based exercise and comparator treatments. Therefore, we remain very uncertain about the effects of water-based exercise for adults with asthma. AUTHORS' CONCLUSIONS: The small number of participants in the three included studies, the clinical and methodological heterogeneity observed and the high risk of bias assessed mean that we are unable to assess the place of water-based exercise in asthma. Randomised controlled trials are needed to assess the efficacy and safety of water-based exercise for adults with asthma. For future research, we suggest greater methodological rigour (participant selection, blinding of outcome assessors, reporting of all outcomes analysed and registering of the study protocol). SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/25032820/Water_based_exercise_for_adults_with_asthma_ DB - PRIME DP - Unbound Medicine ER -