Water-based exercise for adults with asthma

BackgroundAsthma is a common condition characterised by airway inflammation and airway narrowing, which can result in intermittent symptoms of wheezing, coughing and chest tightness, possibly limiting activities of daily life. Water-based exercise is believed to offer benefits for people with asthma through pollen-free air, humidity and effects of exercise on physical function.ObjectivesTo evaluate the effectiveness and safety of water-based exercise for adults with asthma.Search methodsWe searched the Cochrane Airways Group Specialised Register of Trials (CAGR), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Allied and Complementary Medicine Database (AMED), PsycINFO, the Latin American and Caribbean Health Science Information Database (LILACS), the Physiotherapy Evidence Database (PEDro), the System for Information on Grey Literature in Europe (SIGLE) and Google Scholar on 13 May 2014. We handsearched ongoing clinical trial registers and meeting abstracts of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the British Thoracic Society (BTS).Selection criteriaWe included all randomised controlled trials (RCTs) of adults with asthma comparing a water-based exercise group versus one or more of the following groups: usual care, land-based exercise, non-exercise.Data collection and analysisTwo review authors (AJG, VS) independently extracted data fromthe primary studies using a standard form developed for this purpose, which includes methods, participants, interventions and outcomes. We contacted trial authors to request additional data. Data were input by one review author and were double-checked by a second review author.Main resultsIn this systematic review, we provide a narrative synthesis of available evidence from three small studies including 136 adult participants. the studies were at high risk of bias. No meta-analysis was possible because of methodological and interventional heterogeneity between included studies. the primary outcomes of quality of life and exacerbations leading to use of steroids were not reported by these studies. for exacerbations leading to health centre/hospital visits, uncertainty was wide because a very small number of events was reported (in a single study). Secondary outcomes symptoms, lung function, changes in medication and adverse effects, where available, described for each included study. the overall quality of the studies was very low, and no clear differences were noted between water-based exercise and comparator treatments. Therefore, we remain very uncertain about the effects of water-based exercise for adults with asthma.Authors' conclusionsThe small number of participants in the three included studies, the clinical and methodological heterogeneity observed and the high risk of bias assessed mean that we are unable to assess the place of water-based exercise in asthma. Randomised controlled trials are needed to assess the efficacy and safety of water-based exercise for adults with asthma. for future research, we suggest greater methodological rigour (participant selection, blinding of outcome assessors, reporting of all outcomes analysed and registering of the study protocol).

Reaction time and replenishment time of SP and CGRP after incision in rat skin

Background. the skin neurogenic inflammation is mainly related to Substance P (SP) and Calcitonin Gene-related Peptide (CGRP). There is no data on their availability in the dynamics of skin nerve endings, concerning their release and replenishment after a nociceptive stimulus, so this was investigated. Materials and methods. 25 rats were randomly distributed in 5 groups. the animals of the control group (CG) determined the baseline levels of neuropeptides in the skin. the groups S0 and S30 did not receive any cutaneous stimulus at 30 and 60 minutes, respectively. in the group S1, an incision stimulus was made at 30 minutes. in the group S31, a nociceptive stimulus was performed by subdermal scratching at 30 minutes and, at 60 minutes, the incision stimulus was carried out in the same location (nociceptive hyperstimulation). the skin samples of the other animals were harvested from the back 1 minute after their death. SP, pro-CGRP and CGRP were quantified by Western Blotting. Results. the incision stimulus released SP, S1 compared to S0 (p < 0.05) detected in the first minute, and the replenishment time was more than 30 minutes. Also, it cleaved pro-CGRP, S1 compared to S31 (p < 0.05) in the first minute, and its replenishment time less than 30 minutes. Release of CGRP was not detected. Conclusion. the incision released SP already detected in the first minute; its replenishment time is more than 30 minutes. the incision decreased pro-CGRP, also detected in the first minute; and its replenishment time is less than 30 minutes.