human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Aerobic training has a number of well known beneficial effects in both normal and asthmatic children . However , the impact of training on the clinical management of the underlying bronchial asthma remains controversial , particularly in the most severe patients . METHODS Clinical evaluation , spirometric tests , symptom limited maximum exercise testing , and exercise challenge tests were performed in a group of children with stable moderate to severe asthma . Forty two patients ( 24 boys ) aged 8–16 were evaluated twice : before and after supervised aerobic training ( group 1 , n = 26 ) and two months apart ( untrained group 2 , n = 16 ) . RESULTS Spirometric and maximal exercise variables in the initial evaluation were significantly reduced in group 1 ( p<0.05 ) but medication and clinical scores and the occurrence of exercise induced bronchospasm ( EIB ) did not differ between the two groups . Aerobic improvement with training ( maximal oxygen uptake and /or anaerobic threshold increment > 10 % and 100 ml ) was inversely related to the baseline level of fitness and was independent of disease severity . Although the clinical score and the occurrence of EIB did not change after training , aerobic improvement was associated with a significant reduction in the medication score and the daily use of both inhaled and oral steroids ( p<0.05 ) . CONCLUSIONS Aerobic improvement with training in less fit asthmatic children is related to a short term decrease in the daily use of inhaled and oral steroids , independent of the severity of the disease Intense physical activity in  children may either improve fitness and protect against asthma , or may trigger symptoms . The aim of this study was to determine whether physical fitness in childhood has an impact on the development of asthma . In this prospect i ve , community-based study , 757 ( 84 % ) asymptomatic children with an average age at inclusion of 9.7 yrs were followed for 10.5 yrs . In both surveys a maximal progressive exercise test on a bicycle ergometer was used to measure physical fitness ( maximal workload ) and to induce airway narrowing . A methacholine provocation test was performed in the subjects at follow-up . During the 10-yr study period , 51 ( 6.7 % ) of the previously asymptomatic children developed  asthma . These subjects had a lower mean physical fitness in 1985 than their peers : ( 3.63 versus 3.89 W x kg(-1 ) ; p=0.02 ) in boys and ( 3.17 versus 3.33 W x kg(-1 ) ; p=0.02 ) in girls . A weak correlation was found between physical fitness in childhood and airway responsiveness to methacholine at follow-up when adjusted for body mass index , age and sex ( r=0.11 ; p<0.01 ) . In a multiple regression analysis , physical fitness was inversely related to the development of physician diagnosed asthma , odds ratio=0.93 ( 0.87 - 0.99 ) . Thus , the risk for the development of asthma during adolescence is reduced 7 % by increasing the maximal workload 1 W x kg(-1 ) . In conclusion , this study showed that physical fitness in childhood is weakly correlated with the development of asthma during adolescence and that high physical fitness seems to be associated with a reduced risk for the development of asthma The effects of a 3-month physical training programme on airway inflammation and clinical outcomes were studied in school-aged children with asthma . Subjects with persistent allergic asthma ( aged 12.7±3.4 yrs ; n = 34 ) were r and omly allocated into training and control groups . Exercise consisted of twice-weekly 50-min sessions for 12 weeks . Inflammation was assessed by levels of exhaled nitric oxide , blood eosinophils , eosinophil cationic protein , C-reactive protein , and total and mite-specific immunoglobulin (Ig)E. Lung volumes and bronchial responsiveness to methacholine were determined . The Paediatric Asthma Quality of Life Question naire and Paediatric Asthma Caregiver 's Quality of Life Question naire were used to evaluate activity restrictions , symptoms and emotional stress . The efficacy of the training was assessed by accelerometry . Following the programme , the exercise group spent twice as much time as the controls undertaking moderate-to-vigorous activities . No differences in changes were seen between groups for asthma outcomes . However , total IgE decreased more in the exercise group , as did mite-specific IgE. Training did not increase inflammation in children with persistent asthma , and may have decreased both total and allergen-specific immunoglobulin E levels . It is concluded that there is no reason to discourage asthmatic children with controlled disease to exercise Twenty-six adults ( 23 to 58 years ) with mild to moderate asthma underwent a 10-week supervised rehabilitation program , with emphasis on physical training . In the first 2 weeks , they exercised daily in an indoor swimming pool ( 33 degrees C ) and received education about asthma , medication , and principles of physical training . In the following 8 weeks , they exercised in the pool twice a week . Every training session lasted 45 min . The training sessions were made as suitable as possible for the individual subjects , in order to minimize " drop outs " from the program . The aim of the study was to evaluate the efficacy of the rehabilitation program and to determine if inactive asthmatic adults can exercise at high intensity . The rehabilitation program was preceded by a 6-min submaximal cycle ergometry test , a 12-min walking test , spirometry , and a methacholine provocation test . The subjects also responded to a five-item question naire related to anxiety about exercise , breathlessness , and asthma symptoms using a visual analogue scale . All subjects were able to perform physical training at a very high intensity , to 80 to 90 % of their predicted maximal heart rate . No asthmatic attacks occurred in connection with the training sessions . Twenty-two of the 26 subjects completed the rehabilitation program , felt confident with physical training , and planned to continue regular physical training after the 10-week program . Improvements in cardiovascular conditioning , measured as a decreased heart rate at the same load on the cycle ergometer ( average of 12 beats/min ) , and as a longer distance at the 12-min walking test ( average of 111 m ) , were observed during the program . FEV1 increased significantly from 2.2 to 2.5 L. Forced expiratory flow at 25 % of vital capacity also increased slightly but significantly . Methacholine provocation dose causing a fall in FEV1 by 20 % was unchanged . Seventeen subjects had a peak expiratory flow reduction of more than 15 % after the preprogram ergometry test and were classified as having exercise-induced asthma ( EIA ) . Only three of these subjects had EIA after 10 weeks . The asthmatic subjects were less afraid of experiencing breathlessness during exercise and less anxious about exercising at a high intensity after 10 weeks ( p < 0.05 ) . The asthma symptoms abated significantly during the rehabilitation program and the subjects needed less acute asthma care after the rehabilitation program . The results indicate that asthmatic persons benefit from a rehabilitation period , including physical training . Rehabilitation programs are therefore of value as a supplement to conventional pharmacologic treatment of asthma . This rehabilitation program can be adapted for use in clinical practice PURPOSE Aerobic training has been shown to be effective in improving cardiopulmonary fitness in asthmatic children . However , the actual impact of physical training on clinical indicators of disease control remains controversial . METHODS Thirty-eight children with moderate to severe persistent asthma were r and omly assigned to control ( N=17 ) and training ( N=21 ) groups . Spirometry , exercise challenge , and maximum incremental cardiopulmonary exercise tests were performed 16 wk apart . Daily doses of inhaled steroids and Pediatric Asthma Quality of Life Question naire ( PAQLQ ) scores were also recorded . RESULTS Physical training was associated with significant improvements in physiological variables at peak and submaximal exercise ( P<0.05 ) ; in contrast , no significant changes were found in controls . Severity of exercise-induced bronchoconstriction ( EIB ) and postexercise breathlessness were significantly lessened in trained patients ; improvement in fitness and EIB , however , were not linearly related ( P>0.05 ) . In addition , PAQLQ scores improved only in trained children ( P<0.01 ) . Daily doses of inhaled steroids were reduced in trained patients ( 52 % ) , but they remained unchanged or increased in controls ( 70.6 % ) ( P=0.07 ) . CONCLUSION Supervised exercise training might be associated with beneficial effects on disease control and quality of life in asthmatic children . These data suggest an adjunct role of physical conditioning on clinical management of patients with more advanced disease PURPOSE there is evidence suggesting that physical activity has anti-inflammatory effects in many chronic diseases ; however , the role of exercise in airway inflammation in asthma is poorly understood . We aim ed to evaluate the effects of an aerobic training program on eosinophil inflammation ( primary aim ) and nitric oxide ( secondary aim ) in patients with moderate or severe persistent asthma . METHODS sixty-eight patients r and omly assigned to either  control  ( CG ) or aerobic training ( TG ) groups were studied during the period between medical consultations . Patients in the CG ( educational program + breathing exercises ; N = 34 ) and TG ( educational program + breathing exercises + aerobic training ; N = 34 ) were examined twice a week during a 3-month period . Before and after the intervention , patients underwent induced sputum , fractional exhaled nitric oxide ( FeNO ) , pulmonary function , and cardiopulmonary exercise testing . Asthma symptom-free days were quantified monthly , and asthma exacerbation was monitored during 3 months of intervention . RESULTS at 3 months , decreases in the total and eosinophil cell counts in induced sputum ( P = 0.004 ) and in the levels of FeNO ( P = 0.009 ) were observed after intervention only in the TG . The number of asthma symptom-free days and VO(2max ) also significantly improved ( P < 0.001 ) , and lower asthma exacerbation occurred in the TG ( P < 0.01 ) . In addition , the TG presented a strong positive relationship between baseline FeNO and eosinophil counts as well as their improvement after training ( r = 0.77 and r = 0.9 , respectively ) . CONCLUSIONS aerobic training reduces sputum eosinophil and FeNO in patients with moderate or severe asthma , and these benefits were more significant in subjects with higher levels of inflammation . These results suggest that aerobic training might be useful as an adjuvant therapy in asthmatic patients under optimized medical treatment BACKGROUND A study was undertaken to determine whether swimming training improved aerobic capacity , exercise induced bronchoconstriction ( EIB ) , and bronchial responsiveness to inhaled histamine in children with asthma . METHODS Eight children with mild or moderate asthma participated in swimming training every day for six weeks . The intensity of training was individually determined and set at 125 % of the child ’s lactate threshold ( LT ) , measured using a swimming ergometer .  Another group of eight asthmatic children served as control subjects .  Aerobic capacity and the degree of EIB were assessed by both cycle ergometer and swimming ergometer before and after swimming training . RESULTS The mean ( SD ) aerobic capacity at LT increased by 0.26 ( 0.11 ) kp after training when assessed with the swimming ergometer and by 10.6 ( 4.5 ) W when assessed with the cycle ergometer , and these changes were significantly different from the control group . The mean ( SD ) maximum % fall in forced expiratory volume in one second ( FEV1 ) to an exercise challenge ( cycle ergometer ) set at 175 % of LT decreased from 38.7 (15.4)% before training to 17.9 (17.6)% after training , but with no significant difference from the control group . There was , however , no difference in histamine responsiveness when compared before and after the training period . CONCLUSION A six week swimming training programme has a beneficial effect on aerobic capacity but not on histamine responsiveness in children with asthma The purpose of this study was to determine whether inactive asthmatic patients could perform high-intensity physical training equally well on l and as in water , and to compare the effects of these training forms . Thirty-two adults with asthma , r and omized into two groups , underwent a 10-week supervised rehabilitation program with emphasis on physical training . All patients , irrespective of training form , were able to exercise to maximal intensity ( 80 - 90 % of estimated maximal heart rate ) . No asthmatic attacks occurred in connection with the training sessions . Respiratory variables remained almost unchanged in both groups . The asthma symptoms declined during the rehabilitation period , and the subjects needed less acute asthma care after the rehabilitation . The cardiovascular condition improved significantly and similarly in the two groups . Ten patients , 5 in each group , had exercise-induced asthma  at the start of the rehabilitation . Only 3 patients , 2 from the water group and 1 from the l and group , had exercise-induced asthma after 10 weeks . We conclude that indoor training , either on l and or in water , is beneficial . The effects of these two training forms are almost equivalent PURPOSE Data from the general population suggest that habitual exercise decreases bronchial responsiveness , but the possible role of exercise in asthmatics is undefined . The leukotriene receptor antagonist montelukast decreases bronchial responsiveness and exercise-induced symptoms in asthmatic children . This r and omized study in children 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Aerobic training has a number of well known beneficial effects in both normal and asthmatic children . However , the impact of training on the clinical management of the underlying bronchial asthma remains controversial , particularly in the most severe patients . METHODS Clinical evaluation , spirometric tests , symptom limited maximum exercise testing , and exercise challenge tests were performed in a group of children with stable moderate to severe asthma . Forty two patients ( 24 boys ) aged 8–16 were evaluated twice : before and after supervised aerobic training ( group 1 , n = 26 ) and two months apart ( untrained group 2 , n = 16 ) . RESULTS Spirometric and maximal exercise variables in the initial evaluation were significantly reduced in group 1 ( p<0.05 ) but medication and clinical scores and the occurrence of exercise induced bronchospasm ( EIB ) did not differ between the two groups . Aerobic improvement with training ( maximal oxygen uptake and /or anaerobic threshold increment > 10 % and 100 ml ) was inversely related to the baseline level of fitness and was independent of disease severity . Although the clinical score and the occurrence of EIB did not change after training , aerobic improvement was associated with a significant reduction in the medication score and the daily use of both inhaled and oral steroids ( p<0.05 ) . CONCLUSIONS Aerobic improvement with training in less fit asthmatic children is related to a short term decrease in the daily use of inhaled and oral steroids , independent of the severity of the disease Intense physical activity in  children may either improve fitness and protect against asthma , or may trigger symptoms . The aim of this study was to determine whether physical fitness in childhood has an impact on the development of asthma . In this prospect i ve , community-based study , 757 ( 84 % ) asymptomatic children with an average age at inclusion of 9.7 yrs were followed for 10.5 yrs . In both surveys a maximal progressive exercise test on a bicycle ergometer was used to measure physical fitness ( maximal workload ) and to induce airway narrowing . A methacholine provocation test was performed in the subjects at follow-up . During the 10-yr study period , 51 ( 6.7 % ) of the previously asymptomatic children developed  asthma . These subjects had a lower mean physical fitness in 1985 than their peers : ( 3.63 versus 3.89 W x kg(-1 ) ; p=0.02 ) in boys and ( 3.17 versus 3.33 W x kg(-1 ) ; p=0.02 ) in girls . A weak correlation was found between physical fitness in childhood and airway responsiveness to methacholine at follow-up when adjusted for body mass index , age and sex ( r=0.11 ; p<0.01 ) . In a multiple regression analysis , physical fitness was inversely related to the development of physician diagnosed asthma , odds ratio=0.93 ( 0.87 - 0.99 ) . Thus , the risk for the development of asthma during adolescence is reduced 7 % by increasing the maximal workload 1 W x kg(-1 ) . In conclusion , this study showed that physical fitness in childhood is weakly correlated with the development of asthma during adolescence and that high physical fitness seems to be associated with a reduced risk for the development of asthma The effects of a 3-month physical training programme on airway inflammation and clinical outcomes were studied in school-aged children with asthma . Subjects with persistent allergic asthma ( aged 12.7±3.4 yrs ; n = 34 ) were r and omly allocated into training and control groups . Exercise consisted of twice-weekly 50-min sessions for 12 weeks . Inflammation was assessed by levels of exhaled nitric oxide , blood eosinophils , eosinophil cationic protein , C-reactive protein , and total and mite-specific immunoglobulin (Ig)E. Lung volumes and bronchial responsiveness to methacholine were determined . The Paediatric Asthma Quality of Life Question naire and Paediatric Asthma Caregiver 's Quality of Life Question naire were used to evaluate activity restrictions , symptoms and emotional stress . The efficacy of the training was assessed by accelerometry . Following the programme , the exercise group spent twice as much time as the controls undertaking moderate-to-vigorous activities . No differences in changes were seen between groups for asthma outcomes . However , total IgE decreased more in the exercise group , as did mite-specific IgE. Training did not increase inflammation in children with persistent asthma , and may have decreased both total and allergen-specific immunoglobulin E levels . It is concluded that there is no reason to discourage asthmatic children with controlled disease to exercise Twenty-six adults ( 23 to 58 years ) with mild to moderate asthma underwent a 10-week supervised rehabilitation program , with emphasis on physical training . In the first 2 weeks , they exercised daily in an indoor swimming pool ( 33 degrees C ) and received education about asthma , medication , and principles of physical training . In the following 8 weeks , they exercised in the pool twice a week . Every training session lasted 45 min . The training sessions were made as suitable as possible for the individual subjects , in order to minimize " drop outs " from the program . The aim of the study was to evaluate the efficacy of the rehabilitation program and to determine if inactive asthmatic adults can exercise at high intensity . The rehabilitation program was preceded by a 6-min submaximal cycle ergometry test , a 12-min walking test , spirometry , and a methacholine provocation test . The subjects also responded to a five-item question naire related to anxiety about exercise , breathlessness , and asthma symptoms using a visual analogue scale . All subjects were able to perform physical training at a very high intensity , to 80 to 90 % of their predicted maximal heart rate . No asthmatic attacks occurred in connection with the training sessions . Twenty-two of the 26 subjects completed the rehabilitation program , felt confident with physical training , and planned to continue regular physical training after the 10-week program . Improvements in cardiovascular conditioning , measured as a decreased heart rate at the same load on the cycle ergometer ( average of 12 beats/min ) , and as a longer distance at the 12-min walking test ( average of 111 m ) , were observed during the program . FEV1 increased significantly from 2.2 to 2.5 L. Forced expiratory flow at 25 % of vital capacity also increased slightly but significantly . Methacholine provocation dose causing a fall in FEV1 by 20 % was unchanged . Seventeen subjects had a peak expiratory flow reduction of more than 15 % after the preprogram ergometry test and were classified as having exercise-induced asthma ( EIA ) . Only three of these subjects had EIA after 10 weeks . The asthmatic subjects were less afraid of experiencing breathlessness during exercise and less anxious about exercising at a high intensity after 10 weeks ( p < 0.05 ) . The asthma symptoms abated significantly during the rehabilitation program and the subjects needed less acute asthma care after the rehabilitation program . The results indicate that asthmatic persons benefit from a rehabilitation period , including physical training . Rehabilitation programs are therefore of value as a supplement to conventional pharmacologic treatment of asthma . This rehabilitation program can be adapted for use in clinical practice PURPOSE Aerobic training has been shown to be effective in improving cardiopulmonary fitness in asthmatic children . However , the actual impact of physical training on clinical indicators of disease control remains controversial . METHODS Thirty-eight children with moderate to severe persistent asthma were r and omly assigned to control ( N=17 ) and training ( N=21 ) groups . Spirometry , exercise challenge , and maximum incremental cardiopulmonary exercise tests were performed 16 wk apart . Daily doses of inhaled steroids and Pediatric Asthma Quality of Life Question naire ( PAQLQ ) scores were also recorded . RESULTS Physical training was associated with significant improvements in physiological variables at peak and submaximal exercise ( P<0.05 ) ; in contrast , no significant changes were found in controls . Severity of exercise-induced bronchoconstriction ( EIB ) and postexercise breathlessness were significantly lessened in trained patients ; improvement in fitness and EIB , however , were not linearly related ( P>0.05 ) . In addition , PAQLQ scores improved only in trained children ( P<0.01 ) . Daily doses of inhaled steroids were reduced in trained patients ( 52 % ) , but they remained unchanged or increased in controls ( 70.6 % ) ( P=0.07 ) . CONCLUSION Supervised exercise training might be associated with beneficial effects on disease control and quality of life in asthmatic children . These data suggest an adjunct role of physical conditioning on clinical management of patients with more advanced disease PURPOSE there is evidence suggesting that physical activity has anti-inflammatory effects in many chronic diseases ; however , the role of exercise in airway inflammation in asthma is poorly understood . We aim ed to evaluate the effects of an aerobic training program on eosinophil inflammation ( primary aim ) and nitric oxide ( secondary aim ) in patients with moderate or severe persistent asthma . METHODS sixty-eight patients r and omly assigned to either  control  ( CG ) or aerobic training ( TG ) groups were studied during the period between medical consultations . Patients in the CG ( educational program + breathing exercises ; N = 34 ) and TG ( educational program + breathing exercises + aerobic training ; N = 34 ) were examined twice a week during a 3-month period . Before and after the intervention , patients underwent induced sputum , fractional exhaled nitric oxide ( FeNO ) , pulmonary function , and cardiopulmonary exercise testing . Asthma symptom-free days were quantified monthly , and asthma exacerbation was monitored during 3 months of intervention . RESULTS at 3 months , decreases in the total and eosinophil cell counts in induced sputum ( P = 0.004 ) and in the levels of FeNO ( P = 0.009 ) were observed after intervention only in the TG . The number of asthma symptom-free days and VO(2max ) also significantly improved ( P < 0.001 ) , and lower asthma exacerbation occurred in the TG ( P < 0.01 ) . In addition , the TG presented a strong positive relationship between baseline FeNO and eosinophil counts as well as their improvement after training ( r = 0.77 and r = 0.9 , respectively ) . CONCLUSIONS aerobic training reduces sputum eosinophil and FeNO in patients with moderate or severe asthma , and these benefits were more significant in subjects with higher levels of inflammation . These results suggest that aerobic training might be useful as an adjuvant therapy in asthmatic patients under optimized medical treatment BACKGROUND A study was undertaken to determine whether swimming training improved aerobic capacity , exercise induced bronchoconstriction ( EIB ) , and bronchial responsiveness to inhaled histamine in children with asthma . METHODS Eight children with mild or moderate asthma participated in swimming training every day for six weeks . The intensity of training was individually determined and set at 125 % of the child ’s lactate threshold ( LT ) , measured using a swimming ergometer .  Another group of eight asthmatic children served as control subjects .  Aerobic capacity and the degree of EIB were assessed by both cycle ergometer and swimming ergometer before and after swimming training . RESULTS The mean ( SD ) aerobic capacity at LT increased by 0.26 ( 0.11 ) kp after training when assessed with the swimming ergometer and by 10.6 ( 4.5 ) W when assessed with the cycle ergometer , and these changes were significantly different from the control group . The mean ( SD ) maximum % fall in forced expiratory volume in one second ( FEV1 ) to an exercise challenge ( cycle ergometer ) set at 175 % of LT decreased from 38.7 (15.4)% before training to 17.9 (17.6)% after training , but with no significant difference from the control group . There was , however , no difference in histamine responsiveness when compared before and after the training period . CONCLUSION A six week swimming training programme has a beneficial effect on aerobic capacity but not on histamine responsiveness in children with asthma The purpose of this study was to determine whether inactive asthmatic patients could perform high-intensity physical training equally well on l and as in water , and to compare the effects of these training forms . Thirty-two adults with asthma , r and omized into two groups , underwent a 10-week supervised rehabilitation program with emphasis on physical training . All patients , irrespective of training form , were able to exercise to maximal intensity ( 80 - 90 % of estimated maximal heart rate ) . No asthmatic attacks occurred in connection with the training sessions . Respiratory variables remained almost unchanged in both groups . The asthma symptoms declined during the rehabilitation period , and the subjects needed less acute asthma care after the rehabilitation . The cardiovascular condition improved significantly and similarly in the two groups . Ten patients , 5 in each group , had exercise-induced asthma  at the start of the rehabilitation . Only 3 patients , 2 from the water group and 1 from the l and group , had exercise-induced asthma after 10 weeks . We conclude that indoor training , either on l and or in water , is beneficial . The effects of these two training forms are almost equivalent PURPOSE Data from the general population suggest that habitual exercise decreases bronchial responsiveness , but the possible role of exercise in asthmatics is undefined . The leukotriene receptor antagonist montelukast decreases bronchial responsiveness and exercise-induced symptoms in asthmatic children . This r and omized study in children 
    Output:
    