CHEST Original Research ASTHMA www.chestpubs.org CHEST / 138 / 2 / AUGUST, 2010 331 A sthma is a chronic inflammatory disorder of the airways that causes recurring episodes of wheez- ing, breathlessness, chest tightness, and coughing. 1 The dyspnea experienced during exercise or the fear of triggering it are responsible for keeping patients with asthma from participating in sports or physical group activities 2 and might explain why these patients are less physically fit than their peers without asthma. 3 Adults with asthma who are bothered by the symp- toms report impairment in daily activities. 4 As a result, they feel irritated or frustrated and report limitations in their social life and deterioration in psychologic well being, all of which lead to impairments in health-related quality of life (HRQoL). 5-8 In addition, increased anxiety and depression levels have been associated with decreased asthma control 9 and adher- ence to medication 10 and increased rates of the diag- nosis of severe asthma. 11 Although aerobic exercise can provoke exercise- induced bronchoconstriction in most patients with asthma, regular physical activity is included in the overall management of asthma 12,13 and as part of pul- monary rehabilitation programs. 14,15 Nevertheless, a recent metaanalysis 16 evaluated 13 randomized trials Background: Asthma symptoms reduce patients’ daily activities, impair their health-related qual- ity of life (HRQoL), and increase their reports of anxiety and depression, all of which seem to be related to a decrease in asthma control. Aerobic exercise training is known to improve aerobic fitness and reduce dyspnea in asthmatics; however, its effect in reducing psychologic distress and symptoms remains poorly understood. We evaluated the role of an aerobic training program in improving HRQoL (primary aim) and reducing psychologic distress and asthma symptoms (sec- ondary aims) for patients with moderate or severe persistent asthma. Methods: A total of 101 patients were randomly assigned to either a control group or an aerobic training group and studied during the period between medical consultations. Control group patients (educational program plus breathing exercises) (n 5 51) and training group patients (educational program plus breathing exercises plus aerobic training) (n 5 50) were followed twice a week during a 3-month period. HRQoL and levels of anxiety and depression were quantified before and after treatment. Asthma symptoms were evaluated monthly. Results: At 3 months, the domains (physical limitations, frequency of symptoms, and psychosocial) and total scores of HRQoL significantly improved only in the training group patients ( P , .001); the number of asthma-symptom-free days and anxiety and depression levels also significantly improved in this group ( P , .001). In addition, a linear relationship between improvement in aerobic capacity and the days without asthma symptoms was observed ( r 5 0.47; P , .01). Conclusions: Our results suggest that aerobic training can play an important role in the clinical management of patients with persistent asthma. Further, they may be especially useful for patients with higher degrees of psychosocial distress. Trial registration: clinicaltrials.gov ; Identifier: NCT-00989365 CHEST 2010; 138(2):331–337 Abbreviations: HRQoL 5 health-related quality of life; Vo 2 max 5 maximum oxygen consumption Effects of Aerobic Training on Psychosocial Morbidity and Symptoms in Patients With Asthma A Randomized Clinical Trial Felipe A. R. Mendes, MSc; Raquel C. Gonçalves, MSc; Maria P. T. Nunes, MD; Beatriz M. Saraiva-Romanholo, PhD; Alberto Cukier, MD; Rafael Stelmach, MD; Wilson Jacob-Filho, MD; Milton A. Martins, MD; and Celso R. F. Carvalho, PhD