Effects of Physical Exercises on Pulmonary Rehabilitation, Exercise Capacity, and Quality of Life in Children with Asthma: A Meta-Analysis

OBJECTIVE: This study aimed to systematically evaluate the effect of exercise on pulmonary function, exercise capacity, and quality of life in children with bronchial asthma. METHODS: A comprehensive search was performed using PubMed, Cochrane Library, Web of Science, EBSCO, CNKI, and Wanfang Data Knowledge Service platform to identify any relevant randomized controlled trials (RCTs) published from inception to April 2021. The Cochrane risk of the bias tool was utilized to evaluate the methodological quality of the included studies, and RevMan 5.3 was applied to perform data analyses. RESULTS: A total of 22 RCTs involving 1346 patients were included. The results of the meta-analysis showed that exercise had significant advantages in improving lung function and exercising capacity and quality of life in children with asthma compared with conventional treatment, such as the forced vital capacity to predicted value ratio (SMD = 0.27; 95% CI: 0.13, 0.40, and P < 0.0001), the peak expiratory flow to predicted value ratio (MD = 4.53; 95% CI: 1.27, 7.80, and P=0.007), the 6-minute walk test (MD = 110.65; 95% CI: 31.95, 189.34, and P=0.006), rating of perceived effort (MD = −2.28; 95% CI: −3.21, −1.36, and P < 0.0001), and peak power (MD = 0.94; 95% CI: 0.37, 1.52, and P=0.001) on exercise capacity and pediatric asthma quality of life questionnaire (MD = 1.28; 95% CI: 0.60, 1.95, and P=0.0002) on quality of life. However, no significant difference was observed in the forced expiratory flow between 25% and 75% of vital capacity (P=0.25) and the forced expiratory volume at 1 second to predicted value ratio(P=0.07). CONCLUSIONS: Current evidence shows that exercise has a certain effect on improving pulmonary function recovery, exercise capacity, and quality of life in children with bronchial asthma. Given the limitation of the number and quality of included studies, further research and verification are needed to guide clinical application.