[Physiopathological bases for retraining programs of asthma patients: adjustment to rehabilitation]

Despite current discussions promoting physical and sports activities in asthmatics, no studies have yet been done on the possible pathophysiological justifications for rehabilitation by sports programs. Consequently asthmatics are retrained in an empirical fashion and the assessment of these programs is subjective. The aim of this article is thus to review the different studies concerning the adjustment of asthmatics to muscular exercise and to deduce from these what could or should be the pathophysiological objectives of reconditioning protocols. The principal ideas which emerge from this study derive from three fundamental facts: 1) the training of asthmatics should be based on an individual approach since clinical severity leads to very unequal adaptations during muscular exercise; 2) it is advisable to strive against the declining physical fitness of the asthmatics, which is responsible for the accelerated functional deterioration, disturbances of psychomotor development and an increased risk of exercise-induce asthma; 3) the decrease of excessive exercise hyperventilation is, from the evidence, the greatest priority among the pathophysiological objectives, because hyperventilation is a principal cause implicated in the disturbance of cardiovascular adjustments to effort by heart-lung interaction.