Zusammenfassung
Bei Asthmatikern kann körperliche Belastung durch erhöhten bronchialen Wärme- bzw. Flüssigkeitsverlust infolge verstärkter Ventilation zu einer Zunahme der Obstruktion führen. Die Erfahrung von belastungsabhängig auftretender Dyspnoe führt bei Asthmatikern häufig zur Meidung körperlicher Anstrengung und zur Dekonditionierung. Studien an Asthmatikern belegen, dass der Grad der körperlichen Fitness nicht durch Kenngrößen des Asthmas limitiert ist, sondern aus einem Trainingsmangel resultiert. Unter der Voraussetzung einer stadiengerechten Therapie ist ein Training ohne Einschränkung möglich. Im Tiermodell konnte gezeigt werden, dass ein moderates Ausdauertraining die allergische Entzündung in den Atemwegen reduzieren kann. Dagegen kann ein Hochleistungstraining bronchiale Überempfindlichkeit und eosinophile Atemwegsentzündung verstärken. Kontrollierte Studien zum Effekt von Lungensport bei Asthmatikern sind im Vergleich zur Datenlage bei COPD spärlich. Es konnten Verbesserungen von Parametern der körperlichen Belastbarkeit ohne Änderung der Lungenfunktion gezeigt werden. Die optimale Trainingsmethodik für Asthmapatienten ist nicht abschließend geklärt. Allen Asthmapatienten sollte ein körperliches Training, z. B. in einer Lungensportgruppe, empfohlen werden.
Abstract
Physical exertion can lead to increased obstruction due to greater loss of bronchial heat and dehydration as a result of increased ventilation. Having experienced exertion-induced dyspnea, asthmatic patients often avoid physical exertion, which leads to deconditioning. Studies in asthmatic patients have shown that the level of physical fitness is not limited by asthma parameters but results from a lack of exercise. Unrestricted training is possible providing that stage-appropriate treatment is provided. Results in an animal model showed that moderate endurance training can reduce allergic inflammation in the respiratory tract. In contrast, strenuous endurance training may exacerbate bronchial hyperresponsiveness and eosinophilic airway inflammation. In comparison with the data available for chronic obstructive pulmonary disease (COPD), few controlled studies have been conducted on the effect of lung exercise in asthmatic patients. Improvements in physical exertion parameters were shown without altering pulmonary function. The best training method for asthma patients has not yet been conclusively established. Physical exercise, e.g. in a lung exercise group, should be recommended to all asthma patients.
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Meyer, A., Baumann, H. Lungensport bei asthmakranken Erwachsenen. Pneumologe 5, 66–73 (2008). https://doi.org/10.1007/s10405-008-0192-1
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DOI: https://doi.org/10.1007/s10405-008-0192-1