Resistance training in asthma: clinical benefits, safety and implications for exercise prescription – a narrative review
DOI:
https://doi.org/10.12775/QS.2026.51.68676Keywords
asthma, strenth training, resistance training, strength exercise, aerobic training, exercise-induced bronchoconstriction, pulmonary rehabilitationAbstract
Background: Asthma is a chronic inflammatory airway disease that can limit exercise tolerance and promote physical deconditioning. While aerobic exercise is widely studied and recommended, resistance training remains under-investigated despite potential clinical benefits.
Objective: This narrative review summarizes the rationale, physiological mechanisms, and clinical effects of resistance training in adults with asthma, with a focus on practical exercise prescription.
Methods: Evidence from randomized controlled trials, systematic reviews, and observational studies addressing resistance, aerobic, and combined exercise interventions in adults with asthma was reviewed. Outcomes included asthma control, muscle strength, exercise capacity, and quality of life.
Results: Resistance training improves muscle strength, functional capacity, and exercise tolerance, with a low risk of exercise-induced bronchoconstriction. Combined resistance and aerobic programs further enhance cardiorespiratory fitness, muscle function, and quality of life. Physiological mechanisms involve counteracting deconditioning, enhancing muscle mass, and modulating dyspnoea perception. Structured exercise programs with warm-up, progressive intensity, and symptom monitoring optimize safety and effectiveness.
Conclusion: Resistance training is a safe and clinically relevant adjunct to aerobic exercise in asthma management, offering complementary benefits for physical function and quality of life. Further well-designed studies are needed to define optimal protocols, particularly for older adults and severe asthma populations.
References
1. Billany, R. E., Vadaszy, N., Lightfoot, C. J., Graham-Brown, M. P., Smith, A. C., & Wilkinson, T. J. (2020). Characteristics of effective home-based resistance training in patients with noncommunicable chronic diseases: a systematic scoping review of randomised controlled trials. Journal of Sports Sciences, 39(10), 1174–1185. https://doi.org/10.1080/02640414.2020.1861741
2. Bonini, M., & Palange, P. (2015). Exercise-induced bronchoconstriction: new evidence in pathogenesis, diagnosis and treatment. Asthma Research and Practice, 1(1). https://doi.org/10.1186/s40733-015-0004-4
3. de Lima, F. F., Pinheiro, D. H. A., & Carvalho, C. R. F. de. (2023b). Physical training in adults with asthma: An integrative approach on strategies, mechanisms, and benefits. In Frontiers in Rehabilitation Sciences (Vol. 4). Frontiers Media SA. https://doi.org/10.3389/fresc.2023.1115352
4. Freitas, P. D., Silva, A. G., Ferreira, P. G., da Silva, A., Salge, J. M., Carvalho-Pinto, R. M., Cukier, A., Brito, C. M., Mancini, M. C., & Carvalho, C. R. F. (2018). Exercise Improves Physical Activity and Comorbidities in Obese Adults with Asthma. Medicine and Science in Sports and Exercise, 50(7), 1367–1376. https://doi.org/10.1249/MSS.0000000000001574
5. Global Initiative for Asthma (GINA). (2025). Global Strategy for Asthma Management and Prevention. Available from: http://ginasthma.org
6. Guarnieri, G., Pozza, M., & Vianello, A. (2025). The role of pulmonary rehabilitation in severe asthma: a comprehensive review. In Frontiers in Medicine (Vol. 12). Frontiers Media SA. https://doi.org/10.3389/fmed.2025.1709710
7. Hansen, E. S. H., Pitzner-Fabricius, A., Toennesen, L. L., Rasmusen, H. K., Hostrup, M., Hellsten, Y., Backer, V., & Henriksen, M. (2020). Effect of aerobic exercise training on asthma in adults: A systematic review and meta-analysis. In European Respiratory Journal (Vol. 56, Issue 1). European Respiratory Society. https://doi.org/10.1183/13993003.00146-2020
8. Hong, J. H., Baek, M. S., & Park, B. (2025). Association between handgrip strength and quality of life among adults with asthma: Findings from a nationally representative Korean population. PloS One, 20(12), e0338197. https://doi.org/10.1371/journal.pone.0338197
9. Jaakkola, J. J. K., Aalto, S. A. M., Hernberg, S., Kiihamäki, S. P., & Jaakkola, M. S. (2019a). Regular exercise improves asthma control in adults: A randomized controlled trial. Scientific Reports, 9(1). https://doi.org/10.1038/s41598-019-48484-8
10. Lage, S. M., Pereira, D. A. G., Corradi Magalhães Nepomuceno, A. L., Castro, A. C. de, Araújo, A. G., Hoffman, M., Silveira, B. M. F., & Parreira, V. F. (2021). Efficacy of inspiratory muscle training on inspiratory muscle function, functional capacity, and quality of life in patients with asthma: A randomized controlled trial. Clinical Rehabilitation, 35(6), 870–881. https://doi.org/10.1177/0269215520984047
11. Lista-Paz, A., Bouza Cousillas, L., Jácome, C., Fregonezi, G., Labata-Lezaun, N., Llurda-Almuzara, L., & Pérez-Bellmunt, A. (2023). Effect of respiratory muscle training in asthma: A systematic review and meta-analysis. In Annals of Physical and Rehabilitation Medicine (Vol. 66, Issue 3). Elsevier Masson s.r.l. https://doi.org/10.1016/j.rehab.2022.101691
12. Liu, W., Feng, Z., Song, S., & Lei, S. (2025). The effectiveness of physical activity in asthma management: An overview of systematic reviews. In PLOS ONE (Vol. 20, Issue 7 July). Public Library of Science. https://doi.org/10.1371/journal.pone.0325488
13. lo Bello, G., Mattia Oliva2, F., Malovini3, A., Ambrosino4, N., Tarasconi1, M., Zanini5, A., & Zampogna1, E. (2025). Effect of combined strength and endurance training in adults with asthma: a randomized controlled trial. Jornal Brasileiro de Pneumologia, e20250009. https://doi.org/10.36416/1806-3756/e20250009
14. McLoughlin, R. F., Clark, V. L., Urroz, P. D., Gibson, P. G., & McDonald, V. M. (2022). Increasing physical activity in severe asthma: a systematic review and meta-analysis. European Respiratory Journal, 60(6). https://doi.org/10.1183/13993003.00546-2022
15. Merlini, M., Whyte, G., Marcora, S., Loosemore, M., Chester, N., & Dickinson, J. (2019). Improved sprint performance with inhaled long-acting β2-agonists combined with resistance exercise. International Journal of Sports Physiology and Performance, 14(10), 1344–1349. https://doi.org/10.1123/ijspp.2018-0921
16. Olenich, S., Waterworth, G., Badger, G. J., Levy, B., Israel, E., & Langevin, H. M. (2018). Flexibility and strength training in asthma: A pilot study. Journal of Asthma, 55(12), 1376–1383. https://doi.org/10.1080/02770903.2017.1414236
17. Orooj, M., Moiz, J. A., Mujaddadi, A., Ali, M. S., & Talwar, D. (2020). Effect of pulmonary rehabilitation in patients with asthma COPD overlap syndrome: A randomized control trial. Oman Medical Journal, 35(3), 1–8. https://doi.org/10.5001/omj.2020.54
18. Sanz-Santiago, V., Diez-Vega, I., Santana-Sosa, E., Lopez Nuevo, C., Iturriaga Ramirez, T., Vendrusculo, F. M., Donadio, M. V. F., Villa Asensi, J. R., & Pérez-Ruiz, M. (2020). Effect of a combined exercise program on physical fitness, lung function, and quality of life in patients with controlled asthma and exercise symptoms: A randomized controlled trial. Pediatric Pulmonology, 55(7), 1608–1616. https://doi.org/10.1002/ppul.24798
19. Vermeulen, F., Garcia, G., Ninane, V., & Laveneziana, P. (2016). Activity limitation and exertional dyspnea in adult asthmatic patients: What do we know? In Respiratory Medicine (Vol. 117, pp. 122–130). W.B. Saunders Ltd. https://doi.org/10.1016/j.rmed.2016.06.003
20. Visser, E., de Jong, K., van Zutphen, T., Kerstjens, H. A. M., & ten Brinke, A. (2023). Muscle Function in Moderate to Severe Asthma: Association With Clinical Outcomes and Inflammatory Markers. Journal of Allergy and Clinical Immunology: In Practice, 11(5), 1439-1447.e3. https://doi.org/10.1016/j.jaip.2022.12.043
21. Xiong, T., Bai, X., Wei, X., Wang, L., Li, F., Shi, H., & Shi, Y. (2023). Exercise Rehabilitation and Chronic Respiratory Diseases: Effects, Mechanisms, and Therapeutic Benefits. In International Journal of COPD (Vol. 18, pp. 1251–1266). Dove Medical Press Ltd. https://doi.org/10.2147/COPD.S408325
22. Xu, H. Z., Lin, N., Bai, G. N., Liu, Y. L., Jia, X. H., Huang, C., Hu, L., Shao, H. Q., Shang, Q. Y., Zhang, L. F., Wang, Y. S., Zhang, Y. Y., Tang, L. F., Zhou, Y. L., Zhu, G. H., Hong, J. G., & Chen, Z. M. (2025). Comprehensive exercise recommendations for pediatric asthma: an evidence synthesis. In World Journal of Pediatrics. Zhejiang University School of Medicine Children’s Hospital. https://doi.org/10.1007/s12519-025-00976-6
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Copyright (c) 2026 Agata Pszczółka, Patryk Matuszczak, Joanna Kozak, Gabriela Bajor, Kacper Melka, Mikołaj Szulewski, Aleksandra Salagierska, Patrycja Machno, Wiktoria Jurczyk-Florkiewicz, Zofia Gniadek

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