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Swimming and Asthma

Benefits and Deleterious Effects

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Summary

Swimming is a common pastime activity and competitive sport for patients with asthma. One reason for such popularity may be the low asthmogenicity of swimming compared with land-based activities. Review of available evidence suggests that swimming induces less severe bronchoconstriction than other sports. The mechanisms for this protective effect of swimming are not clear, but there is some experimental evidence intimating that it results in part from the high humidity of inspired air at water level, which reduces respiratory heat loss (and possibly osmolality of airways mucus). Beneficial roles of horizontal posture and of water immersion have been tested but not confirmed. Swimming poses two potentially deleterious effects to the patient with asthma. One is the exaggerated parasympathetic tone due to the ‘diving reflex’, that has been shown to trigger bronchoconstriction. The other is airway irritation because of chlorine and its derivatives. Swimming as a training modality has definite benefits for the patient with asthma. These include an increase in aerobic fitness and a decrease in asthma morbidity. There is no conclusive evidence, however, that swim training causes a decrease in the severity or frequency of exercise-induced bronchoconstriction.

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References

  • Anderson SD. Physiological aspects of exercise-induced broncho-constriction, Ph.D Thesis, University of London, 1972

    Google Scholar 

  • Anderson SD, Schoeffel RE, Follet R, Perry CP, Daviskas E, et al. Sensitivity to heat and water loss at rest and during exercise in asthmatic patients. European Journal of Respiratory Disease 63: 459–471, 1982

    CAS  Google Scholar 

  • Bar-Or O. Paediatric sports medicine for the practitioner, Springer-Verlag, New York, 1983

    Book  Google Scholar 

  • Bar-Or O. Physical conditioning in children with cardiopulmonary disease. Exercise and Sport Sciences Reviews 13: 305–334, 1985

    Article  PubMed  CAS  Google Scholar 

  • Bar-Or O, Neuman I, Dotan R. Effects of dry and humid climates on exercise-induced asthma in children and preadolescents. Journal of Allergy and Clinical Immunology 60: 163–168, 1977

    Article  PubMed  CAS  Google Scholar 

  • Bar-Yishay E, Gur I, Inbar O, Neuman I, Dlin RA, et al. Differences between swimming and running as stimuli for exercise-induced asthma. European Journal of Applied Physiology 48: 387–397, 1982

    Article  CAS  Google Scholar 

  • Baydur A, Behrakis PK, Zim WA, Jaeger MJ, Weiner JM, et al. Effect of posture on ventilation and breathing pattern during room air breathing at rest. Lung 165: 341–351, 1987

    Article  PubMed  CAS  Google Scholar 

  • Boushey HA, Holtzman MJ, Sheller JR, Nadel JA. Bronchial hyperreactivity. American Review of Respiratory Disease 121: 389–413, 1980

    PubMed  CAS  Google Scholar 

  • Bundgaard A, Schmidt A, Ingemann-Hansen T, Halkjaer-Kristensen J, Bloch I. Exercise-induced asthma after swimming and bicycle exercise. European Journal of Respiratory Disease 63: 245–248, 1982

    CAS  Google Scholar 

  • Chen WY, Horton DJ. Heat and water loss from the airways and exercise-induced asthma. Respiration 34: 305–313, 1977

    Article  PubMed  CAS  Google Scholar 

  • Craig DB, Wahba WM, Don HF, Couture JG, Becklake MR. ‘Closing volume’ and its relationship to gas exchange in seated and supine positions. Journal of Applied Physiology 30: 717–721, 1971

    Google Scholar 

  • Dally PJ, Sagan KB, Wann SL. Doppler echocardiography measurement of flow velocity in the ascending aorta during supine and upright exercise. British Heart Journal 54: 562–567, 1985

    Article  Google Scholar 

  • Daskalovic IY, Reddan WG, Hashimoto A, Lanphier EG. Respiratory response to prone and upright immersion exercise in patients with chronic obstructive pulmonary disease (COPD). Medicine and Science in Sports and Exercise 14: 132, 1982

    Google Scholar 

  • Deal EC, McFadden ER, Ingram RH, Jaeger JJ. Hyperpnea and heat flux: initial reaction sequence in exercise-induced asthma. Journal of Applied Physiology: Respiratory, Environmental, Exercise Physiology 46: 476–483, 1979a

    Google Scholar 

  • Deal EC, McFadden ER, Ingram RH, Straus RH, Jaeger JJ et al. Role of respiratory heat exchange in production of exercise-induced asthma. Journal of Applied Physiology: Respiratory, Environmental, Exercise Physiology 46: 467–475, 1979ba

    Google Scholar 

  • Donnelly PM. Exercise induced asthma: the protective role of CO2 during swimming. Lancet 337: 179–180, 1991

    Article  PubMed  CAS  Google Scholar 

  • Fitch KD. Exercise-induced asthma and competitive athletics. Pediatrics 56: 942–943, 1975

    PubMed  CAS  Google Scholar 

  • Fitch K. Swimming medicine and asthma. In Eriksson & Furberg (Eds) Swimming medicine IV, pp. 16–31, University Park Press, Baltimore, 1978

    Google Scholar 

  • Fitch K, Morton AR. Specificity of exercise in exercise-induced asthma. British Medical Journal 4: 577–581, 1971

    Article  PubMed  CAS  Google Scholar 

  • Fitch K, Morton AR, Blanksby BA. Effects of swimming training on children with asthma. Archives of Disease in Childhood 51: 190–194, 1976

    Article  PubMed  CAS  Google Scholar 

  • Godfrey S, Silverman M. Anderson SD. Problems of interpreting exercise-induced asthma. Journal of Allergy and Clinical Immunology 52: 199–209, 1973

    Article  PubMed  CAS  Google Scholar 

  • Holmer I, Stein EM, Saltin B, Ekblom B, Astrand P-O. Hemodynamic and respiratory responses compared in swimming and running. Journal of Applied Physiology 37: 149–154, 1974

    Google Scholar 

  • Huang SW, Veiga R, Sila U, Reed E, Hines S. The effect of swimming in asthmatic children — participants in a swimming program in the city of Baltimore. Journal of Asthma 26: 117–121, 1989

    Article  PubMed  CAS  Google Scholar 

  • Inbar O, Dotan R, Dlin RA, Neuman I, Bar-Or O. Breathing dry or humid air and exercise-induced asthma during swimming. European Journal of Applied Physiology 44: 43–50, 1980

    Article  CAS  Google Scholar 

  • Inbar O, Naiss S, Neuman I, Daskalovich J. The effect of body posture on exercise- and hyperventilation-induced asthma. Chest 100: 1229–1234, 1991

    Article  PubMed  CAS  Google Scholar 

  • Irving L. Bradycardia in human divers. Journal of Applied Physiology 18: 489–491, 1963

    Google Scholar 

  • Kelly L, Mitzner E, Spannhake W, Bromberger-Bamea B, Menkes HA. Pulmonary blood flow affects recovery from constriction in dog lung periphery. Journal of Applied Physiology 60: 1554–1560, 1986

    PubMed  CAS  Google Scholar 

  • McArdle WD, Glaser RM, Magel JR. Metabolic and cardiorespiratory response during swimming and treadmill walking. Journal of Applied Physiology 30: 733–738, 1971

    PubMed  CAS  Google Scholar 

  • Mitsubayashi T. Effect of physical training on exercise-induced bronchospasm of institutionalized asthmatic children. Arerugi 33: 318–327, 1984

    PubMed  CAS  Google Scholar 

  • Mukhtar MR, Patrick JM. Bronchoconstriction: a component of the ‘diving response’ in man. European Journal of Applied Physiology 53: 155–158, 1984

    Article  CAS  Google Scholar 

  • Nishima S, Kaizuka H. Comparison of exercise-induced bronchospasm (EIB) with bicycle ergometer and swimming. Arerugi 30: 1157–1162, 1981

    PubMed  CAS  Google Scholar 

  • Onda T, Nagakura T. Asthmatic children and swimming training: 3. Comparison of NCF and FEVi o changes. Arerugi 34: 1015–1020, 1985

    PubMed  CAS  Google Scholar 

  • Penny, PT. Swimming pool wheezing. British Medical Journal 287: 442–461, 1983

    Article  Google Scholar 

  • Plaut GS. Exercise training, fitness, and asthma. Lancet 1: 1147, 1989

    Article  PubMed  CAS  Google Scholar 

  • Prefaut CH, Dubois F, Roussos C, Amaral-Marques R, Macklem PT, et al. Influence of immersion to the neck in water on airway closure and distribution of perfusion in man. Respiratory Physiology 37: 313–323, 1979

    Article  CAS  Google Scholar 

  • Reggiani E, Marugo L, Delpino A, Piastar G, Chiodini G, et al. A comparison of various exercise challenge tests on airway reactivity in atopical swimmers. Journal of Sports Medicine and Physical Fitness 28: 394–401, 1988

    PubMed  CAS  Google Scholar 

  • Schnall R, Ford P, Gillam I, Landau L. Swimming and dry land exercises in children with asthma. Australiam Paediatric Journal 18: 23–27, 1982

    CAS  Google Scholar 

  • Simonsson BJ, Jacobs FM, Nadel JA. Role of autonomic nervous system and the cough reflex in the increased responsiveness of airways in patients with obstructive airway disease. Journal of Clinical Investigation 46: 1812–1818, 1967

    Article  PubMed  CAS  Google Scholar 

  • Sturani C, Sturani A, Tosi I. Parasympathetic activity assessed by diving reflex and by airway response to metacholine in bronchial asthma and rhinitis. Respiration 48: 321–328, 1985

    Article  PubMed  CAS  Google Scholar 

  • Svenonius E, Kautto R, Arborelius M. Improvement after training of children with exercise-induced asthma. Acta Paediatrica Scandinavica 72: 23–30, 1983

    Article  PubMed  CAS  Google Scholar 

  • Szentagothal K, Gyene I, Szocska M, Osvath P. Physical exercise program for children with bronchial asthma. Pediatric Pulmonology 3: 166–172, 1987

    Article  Google Scholar 

  • Tanizaki Y, Komagoe H, Sudo M, Morinaga H. Swimming training in a hot spring pool as therapy for steroid-dependent asthma. Arerugi 33: 389–395, 1984

    PubMed  CAS  Google Scholar 

  • Weinstein RE, Anderson JA, Kvale P, Sweet LC. Effects of humidification on exercise-induced asthma. Abstract. Journal of Allergy and Clinical Immunology 57: 250–251, 1976

    Google Scholar 

  • Wison BA, Evans JN. Standardisation of work intensity for evaluation of exercise-induced bronchoconstriction. European Journal of Applied Physiology 47: 287–294, 1981

    Google Scholar 

Download references

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Authors and Affiliations

  1. Children’s Exercise and Nutrition Centre, Chedoke Hospital Division, McMaster University, Evel 4, Sanatorium Road, Hamilton, Ontario, L8N 3Z5, Canada

    Oded Bar-Or (Professor of Pediatrics, Director)

  2. Department of Research, Wingate Institute, Israel

    Omri Inbar

Authors
  1. Oded Bar-Or
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  2. Omri Inbar
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Bar-Or, O., Inbar, O. Swimming and Asthma. Sports Medicine 14, 397–405 (1992). https://doi.org/10.2165/00007256-199214060-00006

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