# Feasibility of high-intensity training in asthma

PMID: 29785255
Journal: European clinical respiratory journal
Published: 2018
Authors: Toennesen LL, Soerensen ED, Hostrup M, Porsbjerg C, Bangsbo J, Backer V

## Question

Do baseline asthma control, FEV1, airway inflammation, and airway hyperresponsiveness predict the fitness response to an 8-week supervised high-intensity interval training program in untrained adults with asthma?

## Summary

This paper analyzes the exercise arm of the EFFORT Asthma randomized trial to ask whether adults with partly controlled or uncontrolled asthma could complete an 8-week high-intensity interval cycling program and improve fitness. The protocol used supervised indoor spinning three times per week with 10-20-30 intervals. Participants improved VO2max and peak power, had no major serious events, and improved regardless of baseline asthma control, lung function, airway inflammation, or airway hyperresponsiveness.

## Population

- Untrained non-obese adults with confirmed partly controlled or uncontrolled asthma who completed the exercise intervention.
- Sample size: 29
- Age: Mean 39.4 years
- Sex: 55% men
- Fitness level: Untrained; baseline VO2max 38.4 ml/kg/min
- Health status: Asthma with ACQ at least 1.0; mostly mild-to-moderate disease.

## Methodology

- Sub-analysis of the exercise group from the EFFORT Asthma randomized controlled trial.
- 8 weeks
- Hospital-based supervised indoor cycling/spinning program in Copenhagen, Denmark.
- Randomized study design.

## Protocol

- Supervised 10-20-30 cycling HIIT.
- Modality: Indoor spinning bike.
- Work intervals: 10 s above 90% HRmax repeated inside each 1-min cycle.
- Recovery: 30 s below 30% HRmax plus 20 s below 60% HRmax; 2 min between 5-min blocks.
- Sets or repetitions: Two to four 5-min blocks.
- Intensity: Target 90-100% HRmax during 5-min interval blocks.
- Session duration: Approximately 34-46 min.
- Frequency: 3 sessions/week.
- Program length: 8 weeks.
- Progression: Two, then three, then four 5-min blocks across the program.

## Outcomes

### VO2max
Status: improved
Mean VO2max improved from 38.4 to 41.5 ml/kg/min.

Change 3.1 ml/kg/min, p<0.0001.

### Peak power output
Status: improved
Mean PPO improved from 241 to 270 W.

Change 28.3 W, p<0.0001.

### Baseline asthma markers as predictors
Status: no clear change
Baseline ACQ, FEV1, FeNO, and airway hyperresponsiveness were not significantly associated with fitness improvements.

ACQ p=0.49; FeNO p=0.80; AHR p=0.58 for VO2max association.

## Practical Insights

- Supervised HIIT can be feasible for selected adults with asthma when medication and emergency plans are explicit.
- Asthma control and airway hyperresponsiveness did not prevent fitness gains in this sample.
- For app translation, asthma-related claims need screening and severity caveats.

## Limitations

- Completer-only exercise-arm sub-analysis.
- No comparator group in this paper's analysis.
- Severe asthma was not represented.
- Minor symptom events were not systematically recorded.
- External validity limited by recruitment and supervision context.

## Safety And Adherence

- No major serious events were seen.
- Minor extra SABA use or short training breaks were not recorded.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/29785255/) (pubmed)
- [DOI](https://doi.org/10.1080/20018525.2018.1468714) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954482/) (full text)

## Agent Guidance

Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.