Effects of Physical Activity on Asthma Patients - A Literature Review
DOI:
https://doi.org/10.12775/QS.2026.53.68377Keywords
asthma, exercise-induced bronchoconstriction, obesity, physical activityAbstract
Introduction. Asthma is a heterogeneous chronic respiratory disease characterized by chronic airway inflammation and variable airflow limitation. Historically, patients were discouraged from engaging in physical activity (PA) due to the prevalence of Exercise-Induced Bronchoconstriction (EIB). However, emerging evidence suggests that sedentary behavior and obesity are significant contributors to poor disease control and diminished quality of life in asthmatic populations.
Aim. This review aims to evaluate the relationship between regular physical activity and asthma pathophysiology, specifically assessing how exercise influences clinical outcomes.
Methods. A systematic review of current literature was conducted, focusing on original research, as well as systematic reviews and meta-analyses that measure the physiological response to aerobic and resistance training in asthma patients.
Results. The review indicates that regular physical activity is associated with improved asthma control, enhanced lung function, and a reduction in systemic inflammation. Despite these benefits, a significant gap remains in the literature regarding the dose-response relationship of exercise. There is currently no definitive consensus on the optimal frequency, intensity, or type of physical activity tailored to specific asthma phenotypes.
Conclusion. Physical activity is a vital component of asthma management that counteracts the risks associated with a sedentary lifestyle. While the physiological benefits are evident, further research is required to establish standardized exercise prescriptions to maximize therapeutic outcomes for all patients.
References
1. Global Initiative for Asthma. 2025 GINA report, global strategy for asthma management and prevention. Global Initiative for Asthma. 2025.
2. Pijnenburg MW, Fleming L. Advances in understanding and reducing the burden of severe asthma in children. Lancet Respir Med. 2020 Oct;8(10):1032-1044. doi: 10.1016/S2213-2600(20)30399-4.
3. Zhu, Q., Zhu, J., Wang, X., & Xu, Q. (2022). A Meta Analysis of Physical Exercise on Improving Lung Function and Quality of Life Among Asthma Patients. Journal of Asthma and Allergy, 15, 939–955. doi: 10.2147/JAA.S369811.
4. Cordova-Rivera L, Gibson PG, Gardiner PA, McDonald VM. A Systematic Review of Associations of Physical Activity and Sedentary Time with Asthma Outcomes. J Allergy Clin Immunol Pract. 2018 Nov-Dec;6(6):1968-1981.e2. doi: 10.1016/j.jaip.2018.02.027.
5. Avallone KM, McLeish AC. Asthma and aerobic exercise: a review of the empirical literature. J Asthma. 2013 Mar;50(2):109-16. doi: 10.3109/02770903.2012.759963.
6. Parsons JP, Craig TJ, Stoloff SW, et al. Impact of exercise-related respiratory symptoms in adults with asthma: Exercise-Induced Bronchospasm Landmark National Survey. Allergy Asthma Proc 2011; 32: 431–437. doi: 10.2500/aap.2011.32.3501
7. McDonald VM, Fingleton J, Agusti A et al. Treatable traits: a new paradigm for 21st century management of chronic airway diseases: Treatable Traits Down Under International Workshop report. Eur Respir J. 2019 May 9;53(5):1802058. doi: 10.1183/13993003.02058-2018.
8. Scott HA, Gibson PG, Garg ML, Wood LG. Airway inflammation is augmented by obesity and fatty acids in asthma. Eur Respir J. 2011 Sep;38(3):594-602. doi: 10.1183/09031936.00139810.
9. França-Pinto A, Mendes FA et al. Aerobic training decreases bronchial hyperresponsiveness and systemic inflammation in patients with moderate or severe asthma: a randomised controlled trial. Thorax. 2015 Aug;70(8):732-9. doi: 10.1136/thoraxjnl-2014-206070.
10. Haldar P, Pavord ID. Noneosinophilic asthma: a distinct clinical and pathologic phenotype. J Allergy Clin Immunol. 2007;119(5):1043–1052. doi: 10.1016/j.jaci.2007.02.042.
11. Evaristo KB, Mendes FAR, Saccomani MG, et al. Effects of Aerobic Training Versus Breathing Exercises on Asthma Control: A Randomized Trial. J Allergy Clin Immunol Pract. 2020 Oct;8(9):2989-2996.e4. doi: 10.1016/j.jaip.2020.06.042.
12. Paula Regalado-Cabello, Laura Pérez-Gisbert, Beatriz Brea-Gómez, et al. HIGH-INTENSITY INTERVAL TRAINING IN ADULTS WITH ASTHMA: SYSTEMATIC REVIEW AND META-ANALYSIS, The Journal of Allergy and Clinical Immunology: In Practice, 2025, ISSN 2213-2198, https://doi.org/10.1016/j.jaip.2025.11.032.
13. Dogra S, Kuk JL, Baker J, Jamnik V. Exercise is associated with improved asthma control in adults. Eur Respir J. 2011 Feb;37(2):318-23. doi: 10.1183/09031936.00182209.
14. Endrigue TC, Lunardi AC, Freitas PD, Silva RA, Mendes FAR, França-Pinto A, Carvalho-Pinto RM, Carvalho CRF. Characteristics of individuals with moderate to severe asthma who better respond to aerobic training: a cluster analysis. J Bras Pneumol. 2023 Feb 3;49(1):e20220225. doi: 10.36416/1806-3756/e20220225.
15. Kuder MM, Clark M, Cooley C, Prieto-Centurion V, Danley A, Riley I, Siddiqi A, Weller K, Kitsiou S, Nyenhuis SM. A Systematic Review of the Effect of Physical Activity on Asthma Outcomes. J Allergy Clin Immunol Pract. 2021 Sep;9(9):3407-3421.e8. doi: 10.1016/j.jaip.2021.04.048.
16. Eichenberger PA, Diener SN, Kofmehl R, Spengler CM. Effects of exercise training on airway hyperreactivity in asthma: a systematic review and meta-analysis. Sports Med. 2013 Nov;43(11):1157-70. doi: 10.1007/s40279-013-0077-2.
17. Hansen ESH, Pitzner-Fabricius A, Toennesen LL, et al. Effect of aerobic exercise training on asthma in adults: a systematic review and meta-analysis. Eur Respir J. 2020 Jul 30;56(1):2000146. doi: 10.1183/13993003.00146-2020.
18. Carson KV, Chandratilleke MG, Picot J, Brinn MP, Esterman AJ, Smith BJ. Physical training for asthma. Cochrane Database Syst Rev. 2013 Sep 30;2013(9):CD001116. doi: 10.1002/14651858.CD001116.pub4.
19. Mendes FA, Almeida FM, Cukier A et al. Effects of aerobic training on airway inflammation in asthmatic patients. Med Sci Sports Exerc. 2011 Feb;43(2):197-203. doi: 10.1249/MSS.0b013e3181ed0ea3.
20. Pitzner-Fabricius A, Dall CH, Henriksen M et al. Effect of High-Intensity Interval Training on Inhaled Corticosteroid Dose in Asthma Patients: A Randomized Controlled Trial. J Allergy Clin Immunol Pract. 2023 Jul;11(7):2133-2143.e8. doi: 10.1016/j.jaip.2023.04.013.
21. Feng Z, Wang J, Xie Y, Li J. Effects of exercise-based pulmonary rehabilitation on adults with asthma: a systematic review and meta-analysis. Respir Res. 2021 Jan 30;22(1):33. doi: 10.1186/s12931-021-01627-w.
22. Garcia-Aymerich J, Varraso R, Antó JM, Camargo CA Jr. Prospective study of physical activity and risk of asthma exacerbations in older women. Am J Respir Crit Care Med. 2009 Jun 1;179(11):999-1003. doi: 10.1164/rccm.200812-1929OC.
23. Toennesen LL, Soerensen ED, Hostrup M, et al. Feasibility of high-intensity training in asthma. Eur Clin Respir J. 2018 May 11;5(1):1468714. doi: 10.1080/20018525.2018.1468714.
24. McLoughlin RF, Clark VL, Urroz PD, et al. Increasing physical activity in severe asthma: a systematic review and meta-analysis. Eur Respir J. 2022 Dec 15;60(6):2200546. doi: 10.1183/13993003.00546-2022.
25. Peters U, Dixon AE, Forno E. Obesity and asthma. J Allergy Clin Immunol. 2018 Apr;141(4):1169-1179. doi: 10.1016/j.jaci.2018.02.004.
26. Haldar P, Pavord ID, Shaw DE et al.Cluster analysis and clinical asthma phenotypes. Am J Respir Crit Care Med. 2008 Aug 1;178(3):218-224. doi: 10.1164/rccm.200711-1754OC.
27. Johnson O, Gerald LB, Harvey J et al. An Online Weight Loss Intervention for People With Obesity and Poorly Controlled Asthma. J Allergy Clin Immunol Pract. 2022 Jun;10(6):1577-1586.e3. doi: 10.1016/j.jaip.2022.02.040.
28. Loponen J, Vähätalo I, Tuomisto LE et al. Physical exercise, systemic inflammation and adult-onset asthma: a 12-year follow-up study. J Asthma. 2025 Apr;62(4):714-724. doi: 10.1080/02770903.2024.2438096.
29. Weiler JM, et al. Pathogenesis, prevalence, diagnosis, and management of exercise-induced bronchoconstriction: a practice parameter. Annals Allergy Asthma Immunol. 2010;105:S1–S47. doi: 10.1016/j.anai.2010.09.021
30. Weiler JM, Brannan JD, Randolph CC, et al. Exercise-induced bronchoconstriction update-2016. J Allergy Clin Immunol. 2016 Nov;138(5):1292-1295.e36. doi: 10.1016/j.jaci.2016.05.029.
31. Bonini M, Palange P. Exercise-induced bronchoconstriction: new evidence in pathogenesis, diagnosis and treatment. Asthma Res Pract. 2015 Jul 2;1:2. doi: 10.1186/s40733-015-0004-4.
32. Stickland MK, Rowe BH, Spooner CH, Vandermeer B, Dryden DM. Effect of warm-up exercise on exercise-induced bronchoconstriction. Med Sci Sports Exerc. 2012 Mar;44(3):383-91. doi: 10.1249/MSS.0b013e31822fb73a.
33. Parsons JP, Hallstrand TS, Mastronarde JG, et al.; American Thoracic Society Subcommittee on Exercise-induced Bronchoconstriction. An official American Thoracic Society clinical practice guideline: exercise-induced bronchoconstriction. Am J Respir Crit Care Med. 2013 May 1;187(9):1016-27. doi: 10.1164/rccm.201303-0437ST.
34. Beggs S, Foong YC, Le HC, Noor D, Wood-Baker R, Walters JA. Swimming training for asthma in children and adolescents aged 18 years and under. Cochrane Database Syst Rev. 2013 Apr 30;2013(4):CD009607. doi: 10.1002/14651858.CD009607.pub2.
35. Lomax M. Airway dysfunction in elite swimmers: prevalence, impact, and challenges. Open Access J Sports Med. 2016 May 12;7:55-63. doi: 10.2147/OAJSM.S88339.
36. Bello GL, Oliva FM, Malovini A, et al. Effect of combined strength and endurance training in adults with asthma: a randomized controlled trial. J Bras Pneumol. 2025 Dec 5;51(5):e20250009. doi: 10.36416/1806-3756/e20250009.
37. Aparecido da Silva R, Leite Rocco PG, Stelmach R, et al. Constant-Load Exercise Versus High-Intensity Interval Training on Aerobic Fitness in Moderate-to-Severe Asthma: A Randomized Controlled Trial. J Allergy Clin Immunol Pract. 2022 Oct;10(10):2596-2604.e7. doi: 10.1016/j.jaip.2022.05.023.
38. Santino TA, Chaves GS, Freitas DA, Fregonezi GA, Mendonça KM. Breathing exercises for adults with asthma. Cochrane Database Syst Rev. 2020 Mar 25;3(3):CD001277. doi: 10.1002/14651858.CD001277.pub4.
39. Liu W, Feng Z, Song S, Lei S. The effectiveness of physical activity in asthma management: An overview of systematic reviews. PLoS One. 2025 Jul 3;20(7):e0325488. doi: 10.1371/journal.pone.0325488.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Aleksandra Marchwińska-Pancer, Emilia Bolesta-Okuniewska, Konrad Borowski, Julia Ceryn, Katarzyna Kopeć, Paweł Michalak, Oskar Pastuszek, Maja Radziwon, Anna Wicher
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 86
Number of citations: 0
