couraged
now as part of developing a "healthy
lifestyle."' Normal individuals wishing to take
advantage of the potential health benefits or
wishing simply to pursue exercise as a recreational
activity have a wide range of sports
and activities from which to choose. Asthmatic
patients, however, for whom there is a negative
relation between severity of asthma and
capacity to exercise, have more problems in
participating in sport safely and effectively.2
This negative relation and the unnecessary
restriction of sporting activities in children
with asthma have been recognised for some
time.3 There has been an attempt to remedy
these problems through better education of
patients,4 with advice to use a beta selective
agonist before exercise5 and to avoid conditions
apt to produce exercise induced asthma, and
encouragement of swimming.6 Nevertheless
a recent study7 showed reduced cardiorespiratory
fitness in adults with asthma who
were uncertain about their physical capabilities.
In that study the asthmatic patients had
sufficient ventilatory reserve to suggest that
endurance training could be tolerated at a work
intensity adequate to permit improvements in
fitness. The present study has piloted a
carefully controlled programme of exercise
training under medical supervision in a group
of patients with asthma of moderate severity
and has evaluated the benefits in terms of (1)
cardiorespiratory fitness, as this has been
shown to improve in normal individuals following
a similar regimen;89 (2) the ventilatory
and metabolic adaptations occurring during
submaximal exercise; (3) the effects on breathlessness
during exercise; and (4) changes in
disease severity, including non-specific bronchial
responsiveness, about which there have
been conflicting reports.""'6 We have also tried
to identify which factors determine whether an
individual is successful in achieving the training
goals.