Physical inactivity is common in asthma and is recognised as an important modifiable risk for poor clinical outcomes such as impaired asthma control and health-related quality of life (HRQoL). Despite evidence supporting the role of physical activity in reducing the risk of these outcomes, little is known about optimal interventions for increasing physical activity in those with severe disease. This systematic review and meta-analysis evaluates the effectiveness of interventions in increasing physical activity in severe asthma.

MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed, Informit, SPORTDiscus and Cochrane databases were searched up to September 2021 for physical activity-based intervention studies that assessed physical activity outcomes (e.g. steps per day, time spent undertaking physical activity) in adults with severe asthma. Data on asthma-related (e.g. asthma control) and health-related outcomes (e.g. HRQoL) were assessed as secondary outcomes. The revised Cochrane Risk of Bias tool was used to assess risk of bias. Random-effects meta-analyses synthesised data where possible.

Four randomised controlled trials (all 12 weeks in duration) including 176 adults with moderate-to-severe asthma were included. An increase in physical activity was reported with a moderate-vigorous intensity aerobic and resistance training intervention (steps per day and time spent undertaking physical activity), and an unsupervised pedometer-based intervention (steps per day). Meta-analyses showed that physical activity interventions had an overall positive effect on steps per day (mean difference (MD) 1588, 95% CI 399–2778; p=0.009, I²=23), asthma control (MD –0.65, 95% CI –0.95––0.35; p<0.0001, I²=0%) and HRQoL (MD 0.56, 95% CI 0.10–1.01; p=0.02, I²=16%) compared to control.

While there is some evidence supporting the effectiveness of interventions in improving physical activity in adults with severe asthma, higher-quality, large-scale studies of longer duration are needed to determine the optimal intervention.

缺乏身体活动在哮喘中很常见，并且被认为是导致不良临床结果（例如哮喘控制和健康相关生活质量（HRQoL）受损）的重要可改变风险。尽管有证据支持体力活动在降低这些结果风险方面的作用，但对于增加患有严重疾病的人的体力活动的最佳干预措施却知之甚少。这项系统评价和荟萃分析评估了增加严重哮喘体力活动的干预措施的有效性。

截至 2021 年 9 月，对 MEDLINE、护理和联合健康文献累积索引、Embase、PubMed、Informit、SPORTDiscus 和 Cochrane 数据库进行了基于身体活动的干预研究的检索，这些研究评估了身体活动结果（例如每天的步数、进行身体活动所花费的时间）活动）患有严重哮喘的成人。哮喘相关（例如哮喘控制）和健康相关结局（例如HRQoL）的数据被评估为次要结局。修订后的 Cochrane 偏倚风险工具用于评估偏倚风险。随机效应荟萃分析尽可能合成数据。

纳入了四项随机对照试验（全部持续 12 周），纳入了 176 名患有中度至重度哮喘的成年人。据报道，中等强度的有氧运动和阻力训练干预（每天的步数和进行体育活动所花费的时间）以及基于计步器的无监督干预（每天的步数）增加了身体活动。荟萃分析显示，体力活动干预对每日步数（平均差 (MD) 1588，95% CI 399–2778；p = 0.009，I 2 ⁼ 23）、哮喘控制（MD –0.65、95）具有总体积极影响。与对照相比，% CI –0.95––0.35；p<0.0001，I ² =0%）和 HRQoL（MD 0.56，95% CI 0.10–1.01；p = 0.02，I ^{2 =16%）。}

虽然有一些证据支持干预措施在改善患有严重哮喘的成人身体活动方面的有效性，但仍需要进行更高质量、更大规模、持续时间更长的研究来确定最佳干预措施。