Children with asthma should play hard in gym class and stop worrying they might have an attack that could leave them struggling to breathe, respiratory specialists are now recommending.
Physical activity by people with asthma isn't harmful and might even be helpful to treating the condition, doctors in the field believe. A report published last year in the Cochrane Database Systems Review, a journal that reviews health-care treatments and decision making, looked at 19 previous studies of exercise and asthma and concluded that people with the respiratory condition fared well with physical activity. The studies' results ranged from showing no difference in patients' asthma control to an increase in the number of symptom-free days and a decrease in asthma severity.
"If you have good, controlled asthma, you should be able to exercise," Dr. Craig says.Laboratory studies on animals with asthma also have shown that exercise appears to reduce the severity and frequency of attacks, says Timothy Craig, an immunologist and allergist at Pennsylvania State University College of Medicine in Hershey, Pa. The experiments with mice found that exercise calms the activity of inflammatory proteins and peptides in airways that, when stimulated, cause an attack, he says.
Fear of physical activity is real for many asthma patients. Exercise can spur an attack, in which the airways get inflamed and lung muscles contract, making it hard for people to catch their breath. If untreated, serious cases can lead to death.
With nearly 1 out of 10 children having asthma, it is important to find ways for them to engage in physical activity, health officials say. Being sedentary increases the risk of obesity. Kids with asthma may struggle socially as well. Being sidelined from gym class or other group activities may make them feel isolated, and other children may see them as fragile and a target for teasing.Asthma affects about 9% of children in the U.S. under the age of 17, and for many the condition is lifelong. Overall, more than 25 million Americans of all ages have asthma, representing about 8.4% of the population in 2010, up from 7.3% in 2001, according to data from the Centers for Disease Control and Prevention.
When exercise leads to frequent asthma attacks, it is a sign the asthma isn't well controlled and that a better treatment plan is needed, Dr. Craig says. In most of these cases, both the physicians and patients have underestimated the asthma, he says. Patients may then become frustrated and anxious and abandon efforts to exercise, he says.
Celia Vigil, a 12-year-old in Spokane, Wash., avoided strenuous exercise for years for fear of an asthma attack. When she did participate in school sports, she says she usually didn't get very far and often had to be pulled quickly out of a game. An asthma flare-up left her feeling like she couldn't get enough air. "It feels scary," she says. "You don't know when you'll get out of it."
Even when people with asthma have a good treatment plan in place, they need to take extra precautions while exercising, Dr. Craig says. Patients should warm up before walking or jogging, for example, by starting at a slower pace. They also should "warm down" afterward by reducing speed or exertion before stopping completely. Changing one's heart rate gradually appears to lower the risk of an attack, Dr. Craig says.Two years ago, Celia started seeing a new doctor who talks about the importance of exercise at each visit. She switched to a longer-acting medication, Advair, that better controls her symptoms. And she sometimes takes two puffs on her inhaler before exercising, which she wasn't doing before. Now, Celia says, she is able mostly to keep up with the other kids in gym class. "It's more fun to participate," she says. "I've come really far."
