title: Effects of aerobic training on psychosocial morbidity and symptoms in patients with asthma: a randomized clinical trial.
abstract: BACKGROUND
  Asthma symptoms reduce patients' daily activities, impair their health-related quality of life (HRQoL), and increase their reports of anxiety and depression, all of which seem to be related to a decrease in asthma control. Aerobic exercise training is known to improve aerobic fitness and reduce dyspnea in asthmatics; however, its effect in reducing psychologic distress and symptoms remains poorly understood. We evaluated the role of an aerobic training program in improving HRQoL (primary aim) and reducing psychologic distress and asthma symptoms (secondary aims) for patients with moderate or severe persistent asthma.
  
  
  METHODS
  A total of 101 patients were randomly assigned to either a control group or an aerobic training group and studied during the period between medical consultations. Control group patients (educational program plus breathing exercises) (n = 51) and training group patients (educational program plus breathing exercises plus aerobic training) (n = 50) were followed twice a week during a 3-month period. HRQoL and levels of anxiety and depression were quantified before and after treatment. Asthma symptoms were evaluated monthly.
  
  
  RESULTS
  At 3 months, the domains (physical limitations, frequency of symptoms, and psychosocial) and total scores of HRQoL significantly improved only in the training group patients (P < .001); the number of asthma-symptom-free days and anxiety and depression levels also significantly improved in this group (P < .001). In addition, a linear relationship between improvement in aerobic capacity and the days without asthma symptoms was observed (r = 0.47; P < .01).
  
  
  CONCLUSIONS
  Our results suggest that aerobic training can play an important role in the clinical management of patients with persistent asthma. Further, they may be especially useful for patients with higher degrees of psychosocial distress.
  
  
  BACKGROUND
  clinicaltrials.gov; Identifier: NCT-00989365.
authors.affiliation: Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo 01246-903, Brazil.
authors.forename: Felipe A R
authors.initials: FA
authors.lastname: Mendes
authors.forename: Raquel C
authors.initials: RC
authors.lastname: Gonçalves
authors.forename: Maria P T
authors.initials: MP
authors.lastname: Nunes
authors.forename: Beatriz M
authors.initials: BM
authors.lastname: Saraiva-Romanholo
authors.forename: Alberto
authors.initials: A
authors.lastname: Cukier
authors.forename: Rafael
authors.initials: R
authors.lastname: Stelmach
authors.forename: Wilson
authors.initials: W
authors.lastname: Jacob-Filho
authors.forename: Milton A
authors.initials: MA
authors.lastname: Martins
authors.forename: Celso R F
authors.initials: CR
authors.lastname: Carvalho
mesh_terms: D000328:Adult; D001007:Anxiety; D001249:Asthma / Q000523:psychology* / Q000628:therapy*; D003863:Depression; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome; D055815:Young Adult