Swimming is a good way for children with asthma to keep fit, according to a systematic review of eight trials.

Swimming was well tolerated by children with stable symptoms and helped improve aerobic fitness and lung function compared with no prescribed exercise or golf (one trial).

Swimming training made no difference to quality of life in one small study and little difference to asthma symptoms in two small studies. Trial data on exacerbations were limited and inconclusive.

In combined analyses, swimming several times a week for at least half an hour improved children’s FEV (forced expiratory volume in one second) by 100 mL more than usual care (95% CI 0 to 200).

The difference was modest but clinically meaningful, say the authors, and comparable to the kind of improvements associated with low dose fluticasone. Swimming had a more noticeable impact on fitness (25% greater improvement than controls in maximal oxygen consumption: an extra 9.67 mL/kg/min, 95% CI 5.84 to 13.51).

The 262 children and adolescents in these trials had stable asthma of varying severity. Trials reported few side effects, although only four of the eight specified whether pools contained chlorine.

Bigger, better trials looking at quality of life and asthma control are now needed, say the authors. Parents and children still want to know how swimming compares with other forms of exercise.

Source: Cochrane Database Systematic Reviews 2013;4:CD009607.

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