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Effects of exercise training on physical and psychosocial health in children with chronic respiratory disease: a systematic review and meta-analysis
  1. Barbara Joschtel1,
  2. Sjaan R Gomersall2,
  3. Sean Tweedy1,
  4. Helen Petsky3,
  5. Anne B Chang4,5,6,
  6. Stewart G Trost5
  1. 1 School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
  2. 2 School of Health & Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
  3. 3 School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
  4. 4 Child Health Division, Menzies School of Health Research, Charles Darwin University, Tiwi, Australia
  5. 5 Institute of Health and Biomedical Innovation, Centre for Children’s Health Research, Queensland University of Technology, Brisbane, Queensland, Australia
  6. 6 Department of Respiratory Medicine, Lady Cilento Children’s Hospital, Children’s Health Queensland, Brisbane, Queensland, Australia
  1. Correspondence to Dr Stewart G Trost; s.trost{at}


Introduction Chronic disease in children is increasing, including the prevalence of chronic respiratory diseases such as asthma, cystic fibrosis (CF), bronchiectasis and bronchopulmonary dysplasia (BPD). The aim of this systematic review and meta-analysis was to evaluate the effects of exercise training on health outcomes in children with chronic respiratory disease.

Method Five databases were searched for randomised controlled trials investigating the effects of exercise training on children with chronic respiratory disease. Following the PRISMA guidelines, eligible studies were identified and data were extracted. A meta-analysis was conducted for the outcomes cardiovascular fitness, lung function and quality of life (QoL).

Results The initial search returned 3688 papers. Twenty-seven (17 in children with asthma, 10 in children with CF) were included in the systematic review and 24 of these were included in the meta-analysis. No studies were identified in children with bronchiectasis or BPD. Included papers had a total of 1009 participants aged 8–20 years. In addition to cardiovascular fitness, lung function and QoL, studies also assessed pulmonary function, respiratory muscle strength, muscular strength and inflammation. Meta-analysis showed a large significant effect size in favour of exercise for cardiovascular fitness (peak VO2) (standard mean difference (SMD)=1.16, 95%  CI 0.61 to 1.70) and QoL (SMD=1.27, 95% CI 0.72 to 1.82) as well as a small, non-significant effect size for lung function (FEV1) (SMD=0.02, 95% CI -0.38 to 0.42).

Conclusion Exercise training significantly improves cardiovascular fitness and QoL in children with asthma and CF. Further research is needed, particularly in children with bronchiectasis and BPD.

  • chronic pulmonary disease
  • children
  • exercise

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  • Contributors BJ devised the research question, completed the search, screened papers, extracted and analysed data and wrote the paper. ST was a major contributor in designing the research question, screening papers, analysing data and writing the paper. SRG contributed to the quality assessment and writing the paper. HP assisted in devising the research question and writing the paper. SGT and ABC contributed to manuscript development. All authors read and approved the final manuscript.

  • Funding Professor Chang is supported by an Australian National Health and Medical Research Council (NHMRC) Practitioner Fellowship (Grant APP1058213).

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available from the corresponding author on request

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