Pulmonary Rehabilitation Combining Education and Exercise Training in Adults With Asthma: A Systematic Review and Meta-analysis of Clinical Outcomes and Program Duration Effects.

In 30 seconds

This systematic review and meta-analysis assessed pulmonary rehabilitation (PR) that included education and exercise training in adults with asthma, drawing on randomized clinical trials. Sixteen studies were included, with 13 contributing to at least one meta-analysis; most enrolled people with moderate-to-severe asthma. Compared with control groups, PR was associated with significant improvements in asthma control, exercise capacity, quality of life, anxiety, and depression. No significant differences were found in lung function or airway inflammation. The authors advise caution because most studies had high risk of bias and evidence certainty was very low for some outcomes.

Key findings

• Across 13 studies in at least one meta-analysis, PR favored control for asthma control, exercise capacity, quality of life, anxiety, and depression.
• At short-term follow-up, PR showed significant differences in asthma control and quality of life.
• No significant differences were observed in lung function, airway inflammation, physical activity levels, or body composition.
• Most studies had high risk of bias, and certainty of evidence was very low for some outcomes.

Why it matters

The findings suggest that rehabilitation combining education and exercise may benefit several patient-centred outcomes in adults with asthma, beyond lung function alone. However, the evidence does not establish a reliable magnitude of benefit, and methodological concerns and uncertainty in sensitivity analyses limit confidence. These results help frame PR as a potentially useful approach requiring cautious interpretation.

What to keep in mind

Most included studies had high risk of bias; certainty was very low for some outcomes, and sensitivity analyses were uncertain.