title: Effects of swimming on spirometric parameters and bronchial hyperresponsiveness in children and adolescents with moderate persistent atopic asthma.
abstract: OBJECTIVE
  To investigate the medium-term benefits of a swimming program in schoolchildren and adolescents with moderate persistent atopic asthma (MPAA).
  
  
  METHODS
  A randomized, prospective study of children and adolescents (age 7-18 years) with MPAA was carried out at the Hospital de Clínicas of Universidade Estadual de Campinas (UNICAMP), Campinas, Brazil. After a 1-month run-in period, 61 patients (34 female) were randomized into two groups, a swimming group (n = 30) and a control group (n = 31), and followed for 3 months. Both patient groups received inhaled fluticasone (dry powder, 250 mcg twice a day) and salbutamol as needed. The swim training program consisted of two weekly classes over a 3-month period for a total of 24 sessions. Both groups underwent spirometric assessment and methacholine challenge test--provocative concentration of methacholine causing a 20% fall in FEV1 (PC₂₀)--before and after the study period. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured only in the swimming group.
  
  
  RESULTS
  Significant increases in PC₂₀ (pre-training, 0.31±0.25; post-training, 0.63±0.78; p = 0.008), MIP (pre-training, 67.08±17.13 cm H₂O; post-training 79.46±18.66; p < 0.001), and MEP (pre-training, 71.69±20.01 cm H₂O; post-training, 78.92±21.45 cm H₂O; p < 0.001) were found in the swimming group.
  
  
  CONCLUSIONS
  Children and adolescents with MPAA subjected to a swim training program experienced a significant decrease in bronchial hyperresponsiveness, as determined by increased PC₂₀ values, when compared with asthmatic controls who did not undergo swim training. Participants in the swimming group also showed improvement in elastic recoil of the chest wall.
authors.affiliation: Saúde da Criança e do Adolescente, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil.
authors.forename: Ivonne Bernardo
authors.initials: IB
authors.lastname: Wicher
authors.forename: Maria Angela Gonçalves de Oliveira
authors.initials: MA
authors.lastname: Ribeiro
authors.forename: Denise Barbieri
authors.initials: DB
authors.lastname: Marmo
authors.forename: Camila Isabel da Silva
authors.initials: CI
authors.lastname: Santos
authors.forename: Adyleia Aparecida Dalbo Contrera
authors.initials: AA
authors.lastname: Toro
authors.forename: Roberto Teixeira
authors.initials: RT
authors.lastname: Mendes
authors.forename: Flávia Maria de Brito Lira
authors.initials: FM
authors.lastname: Cielo
authors.forename: José Dirceu
authors.initials: JD
authors.lastname: Ribeiro
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000503:physiopathology* / Q000534:rehabilitation*; D016535:Bronchial Hyperreactivity / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D016085:Bronchoconstrictor Agents; D002648:Child; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D016210:Methacholine Chloride; D011446:Prospective Studies; D013147:Spirometry; D018709:Statistics, Nonparametric; D013550:Swimming / Q000502:physiology*
chemical_list: D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride