Effect of exercise intervention on lung function in asthmatic adults: a network meta-analysis

Objective Exercise has traditionally been viewed as a contraindication for individuals with asthma, as it was believed to trigger or worsen acute asthma attacks. However, with scientific and appropriate exercise training, it has been proven that respiratory function and exercise capacity can be effectively improved and enhanced in asthma patients. This study aimed to compare the effects of different types of exercise on pulmonary function in adult patients with asthma using Network Meta-analysis.Methods We conducted a comprehensive search of electronic databases such as PubMed, Cochrane Library, Web of Science, CNKI for randomized controlled trials (RCTs) that investigated the effects of exercise on lung function in adult patients with asthma from inception to February 2023. Information including on first author, publication time, total sample size, intervention period, interventions, and outcome indicators were collected, and relevant statistical analyses were performed using Stata 17.0 software and Revman 5.4.Results A total of 28 randomized controlled trials with 2,155 patients with asthma were finally included. The results of Network Meta-analysis showed that compared with control group, breathing training (BT)、aerobic training (AT)、relaxation training (RT)、yoga training (YG) and breathing combined with aerobic training (BT + AT) improved Forced Expiratory Volume in the first second (FEV1) levels; AT、BT、YG and BT + AT improved the level of Forced Vital Capacity (FVC); BT、AT、RT、YG and BT + AT improved Peak Expiratory Flow (PEF); BT、AT、and YG improved Forced Expiratory Volume in the first second/Forced Vital Capacity (FEV1/FVC).The results of SUCRA probability ranking showed that RT had the most significant effect on improving the FEV1[SMD = 1.13,95%CI(0.83,1.43), p<0.001] levels, BT + AT had the most significant effect on improving the FVC[SMD = 0.71,95%CI(0.47,0.95), p<0.001] level; YG had the most significant effect on improving the PEF[SMD = 0.79,95%CI(0.55,1.02), p<0.001] level.Conclusions BT + AT and YG may be more advantageous in improving lung function in adult asthmatics.