Effects of swimming on spirometric parameters and bronchial hyperresponsiveness in children and adolescents with moderate persistent atopic asthma.
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.
Wicher
Ivonne Bernardo
IB
Saúde da Criança e do Adolescente, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil.
Ribeiro
Maria Angela Gonçalves de Oliveira
MA
Marmo
Denise Barbieri
DB
Santos
Camila Isabel da Silva
CI
Toro
Adyleia Aparecida Dalbo Contrera
AA
Mendes
Roberto Teixeira
RT
Cielo
Flávia Maria de Brito Lira
FM
Ribeiro
José Dirceu
JD
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*
D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride