[Physical training program in the long-term care of children with bronchial asthma. A concept]

The planning of future training programs for children with asthma should be based on existent practical experience plus the results of the scarce relevant literature. Participation can be limited to patients with moderate to severe airway hyperreactivity; training programs should ideally follow after pharmacological stabilization of airway reactivity, thereby supporting reintegration into age-related normal physical activity and school sports. There are several pathophysiological similarities between allergen- and exercise-induced bronchoconstriction; this indicates the risk of an exercise-induced increase in bronchial reactivity and underlines the necessity for future assessment of reactivity before and after exercise training programs. Carefully controlled premedication should protect the patients against exercise-induced bronchoconstriction and the risk of a possible subsequent increase in airway reactivity. Exercise programs should be planned and conducted by a team, consisting of a physiotherapist, a physician and a physical education teacher; they should offer physical training and treatment of secondary handicaps, and should ideally offer an initial less asthmogenic swimming course and a follow-up program of gymnastics, sports, and group games.