it is the most common chronic respiratory disease in the world and one of the most common chronic diseases among children .
this disease is characterized by variable and recurring symptoms , reversible airflow obstruction , and bronchospasm .
asthma is clinically classified according to the frequency of symptoms , forced expiratory volume in 1 second ( fev1 ) , and peak expiratory flow rate .
but , especially in iran , the general opinion is not so certain about the benefits of exercise for asthmatic patients .
the incidences of eia among the asthmatic patients were differed according to season ( 48% in summer , 73% in spring / fall , and 91% in winter .
this phenomenon is widespread among allergic children and can not be accurately predicted from the history . because of the risk of eia , some people generally believe exercise might be harmful for asthmatic patients .
it is contrary to a medically accepted claim that states asthmatic patients need exercise as much as healthy people do , provided they consider some precautions to secure safety and avoid eia in exercise . with appropriate medical intervention and knowledge of asthma triggers ,
this problem is so controlled that many olympic champions have come from asthma sufferers . in the contemporary world , exercise rehabilitation is known as a complementary and necessary treatment for asthmatic patients.[810 ] therefore , today 's question asks about the type of exercise modality that leads to more benefits for asthmatic patients . until now
it is showed that about 8 to 12 weeks aerobic exercise is effective in controling asthma symptoms , and improves pulmonary indices and quality of life.[1113 ] recently , some evidences emerged that verified rebound training as another beneficial method of exercise .
it creates a safe and efficient framework for people of all age and ability groups .
trampoline is also introduced as a safe and useful equipment for exercising all different parts of body .
trampoline allows a person to bounce up and down on one or two legs with various upper and lower extremities movements .
a national aeronautics and space administration ( nasa ) study demonstrated that at a certain level of oxygen intake , the pulse rate is lower on trampoline compared to running on treadmill .
there is an evidence that suggests 12 week rebound exercises on rebounder shoes also improve the aerobic capacity.[17 spirometry indices such as forced vital capacity ( fvc ) , fev1 , and fev1/fvc ratio along with peak aerobic capacity ( vo2peak ) are traditionally used to document the progression in asthmatic patients .
fvc is the volume of air that can forcibly be blown out after full inspiration , measured in liters .
fev1 is the volume of air that can forcibly be blown out in one second , after full inspiration . in respiratory inflammatory diseases , the required time for forced expiratory increases and , as a result ,
fev1/fvc ratio ( fev1% ) is the ratio of fev1 to fvc . in young healthy people ,
this ratio is around 85% which gradually decreases to 75% by aging . in obstructive diseases ( asthma , chronic obstructive pulmonary disease ( copd ) , chronic bronchitis , emphysema ) , both values of fev1 and fvc
is diminished , but the drop in fev1 is higher and this will cause the value of fev1% to drop down to below threshold values .
the average values of fvc , fev1 , and fev1% for untrained healthy 30-year males are respectively 5.25 , 4.5 liter , and 85% .
vo2max is the maximum capacity of body to transport and use oxygen during incremental exercise .
it is widely accepted as the single best measure of cardiovascular fitness and maximal aerobic power .
the average values for untrained healthy male and female are respectively 35 - 40 and 27 - 31 ml / kg / min .
would be too risky , as any problem with respiratory and cardiovascular systems may be greatly exacerbated when a person exercise at his / her highest capacity .
thus , some cautious protocols have been developed to measure the peak of vo2 at sub - maximal workloads .
the procedure of sub - maximal tests is generally similar to maximal tests , but a certain percent ( usually 75 - 80% of maximum capacity ) of cardio - respiratory system is attained .
values measured during sub - maximal tests are called vo2peak . aerobic exercise , alone or along with strength training , increases spirometry indices .
it is indicated that exercise improves the pulmonary performance and reduces symptoms such as wheezing , coughing , chest tightness , and shortness of breath in asthmatic patients . in this study
, we document the effects of aerobic and rebound exercises on fev1 , fvc , fev1% , and vo2peak of asthmatic patients .
this study was approved by isfahan university research board . it was a quasi - experimental study conducted on one control and two experimental groups , namely aerobic and rebound training .
as random group assignment had confliction with obtaining informed consent , group formation was voluntarily .
experimental group , further to routine medical treatment , participated in their specific exercise programs .
both exercise programs were supervised , consisted of two sessions of 45 to 60 minutes per week , and continued for 8 weeks .
sample included asthmatic patients from the respiratory clinic of alzahra hospital in isfahan , iran .
inclusion / exclusion criteria were being male aged 20 to 40 years , suffering intermittent to mild asthma for at least one year , being under routine medical treatment of the same respiratory clinic , ability of performing offered exercises , and suffering from no other disease complications
. subjects , who experienced any radical changes in their routine medical treatment during the study , were excluded .
every exercise session consisted of three parts : 15 minutes warm - up exercises , main exercises , and 15 minutes cool down exercises .
main exercises of the first session lasted for 15 minutes and consisted of low intensity movements .
session by session , the length and intensity of the main exercises were gradually increased , so that the final session lasted for 30 minutes and consisted of moderate to high intensity movements .
the main exercise of aerobic group was jogging and was performed on a soccer pitch .
time and intensity of exercises of aerobic group were matched to rebound group . in both groups ,
the intensity of exercises was controlled by interval self - monitoring of hr on radial pulse .
exercise testing guidelines ( published by the american college of sports medicine ) were observed . before exercise , each subject was familiarized with the testing procedures .
subjects were then encouraged to exercise to the limit of their tolerance on an automated treadmill ( power jack , england ) .
vo2peak and peak heart rate ( hr ) were defined as the highest values achieved during exercise .
all subjects were monitored during exercise recovery until hr returned to within 20% of baseline values .
as measurement of vo2peak , fev1 , and fvc are influenced by asthma medications , for every subject the time and dosage of medication were fixed for pre- and post tests .
other measurements : in this study , we also measured plasma endothelin level ( by enzyme - linked immunosorbent assays ( elisa ) method ) and quality of life ( by asthma quality of life questionnaire ) .
this study was approved by isfahan university research board . it was a quasi - experimental study conducted on one control and two experimental groups , namely aerobic and rebound training .
as random group assignment had confliction with obtaining informed consent , group formation was voluntarily .
experimental group , further to routine medical treatment , participated in their specific exercise programs .
both exercise programs were supervised , consisted of two sessions of 45 to 60 minutes per week , and continued for 8 weeks .
sample included asthmatic patients from the respiratory clinic of alzahra hospital in isfahan , iran .
inclusion / exclusion criteria were being male aged 20 to 40 years , suffering intermittent to mild asthma for at least one year , being under routine medical treatment of the same respiratory clinic , ability of performing offered exercises , and suffering from no other disease complications .
subjects , who experienced any radical changes in their routine medical treatment during the study , were excluded . for every group ,
in both groups , every exercise session consisted of three parts : 15 minutes warm - up exercises , main exercises , and 15 minutes cool down exercises .
main exercises of the first session lasted for 15 minutes and consisted of low intensity movements .
session by session , the length and intensity of the main exercises were gradually increased , so that the final session lasted for 30 minutes and consisted of moderate to high intensity movements .
the main exercise of aerobic group was jogging and was performed on a soccer pitch .
time and intensity of exercises of aerobic group were matched to rebound group . in both groups ,
the intensity of exercises was controlled by interval self - monitoring of hr on radial pulse .
exercise testing guidelines ( published by the american college of sports medicine ) were observed . before exercise , each subject was familiarized with the testing procedures .
subjects were then encouraged to exercise to the limit of their tolerance on an automated treadmill ( power jack , england ) .
vo2peak and peak heart rate ( hr ) were defined as the highest values achieved during exercise .
all subjects were monitored during exercise recovery until hr returned to within 20% of baseline values .
fev1 and fvc were measured by spirometer ( jager , germany ) . as measurement of vo2peak , fev1 , and fvc
are influenced by asthma medications , for every subject the time and dosage of medication were fixed for pre- and post tests .
other measurements : in this study , we also measured plasma endothelin level ( by enzyme - linked immunosorbent assays ( elisa ) method ) and quality of life ( by asthma quality of life questionnaire ) .
descriptive information about fev1 , fvc , fev1% , and vo2peak of asthmatic patients are shown in table 2 .
compared to values reported in introduction section for healthy untrained male adults , the data shows that fev1 , fvc , fev1% , and vo2peak of asthmatic patients are dramatically dropped .
the interaction comparison is the most important one and when it is significant , it would be enough to focus on it .
they demonstrate that , during the study , control group had no progress , while experimental groups made significant improvement .  
patients demographics ( meanstandard deviation ) patients descriptive statistics and result of repeated measure analysis of variance chartline of vo2 peak
the present study suggests that exercise is better than no exercise . to understand which kind of exercise is more beneficial ,
it is necessary to pay attention to the slope of improvement lines in figures 1 to 4 .
present study has shown that fev1 , fvc , fev1% , and vo2peak of asthmatic participants were much lower than healthy adults .
it seems that there is still much room for more improvement with longer periods of exercise .
it is well - documented that exercise improves work tolerance by decreasing ventilation rate for a given workload .
improvement in respiratory muscles strength , cellular respiration , and cardio - vascular systems along with re - vascularization of skeletal muscles are among the direct physiologic reasons suggested for this claim . also , it seems that exercise rehab indirectly raises the knowledge and experience of patients for better care and management of the disease , and it subsequently alleviate the symptoms and reduces the consumption of bronchodilators .
although benefits of aerobic exercises such as jogging and walking are evident , some patients still are not interested in such activities and would withdraw from them sooner or later .
we decided to examine the effects of a totally different exercise such as rebound training .
present study showed that by good supervision , patients could achieve self - management in rebound exercise without any risk of injury .
therefore , it is not sensible to limit the type of aerobic exercise for asthmatic patients .
it was shown that effects of rebound exercise not only are equivalent but even better than traditional aerobic exercises .
it is the fact that the participants of the study were volunteers , and it might have intensified the results .
however , it is just the point : exercise demands a lot of effort and , therefore , needs interest and should be accompanied with fun and enjoyment .
we suggest for unskilled exercises such as rebound training , a period of supervised exercise is attempted before independence .
supervisors need to address the skill acquisition as well as the volume ( frequency , intensity , and time ) of training . how effects of rebound therapy are justified ?
we noted that rebound exercises are fun and they encourage a longer period of workout .
we also noted that keeping balance and position on trampoline burden a lot of pressure on anti - gravity muscles and increases the blood flow to active muscles , and subsequently improves the functional capacity.[2527 ] movement on trampoline has a vibration effect on muscle spindles that fine tune the muscle tension . in another words , any hop or jump on a hard surface such as land activates the stretch reflex and increase the muscle tension .
but , hop and jumps on trampoline are anticipated and flexibility of the surface cushions the contact and increases its time . it in turn controls the stretch reflex and leads to less muscle tone .
it is why at a certain level of oxygen intake , the pulse rate is lower on trampoline compared to running on treadmill and oxygen efficiency is higher in trampoline exercises .
last but not least , sedentary life style is one of the major disadvantages of the modern life .
chronic diseases , including asthma , complicate and worsen the situation . in today 's iran ,
subsequently , the general fitness and specially the aerobic fitness fall lower than average of the society . on the other hand ,
when no supervised exercise is practiced , patients would find no opportunity to raise their awareness for preventing symptoms and asthma attacks .
further to these disadvantages , lack of physical activity lowers the quality of psychosocial life as well .
present study demonstrated that both aerobic and rebound exercises were worthwhile for mild to moderate male asthmatic patients .
we demonstrated that the use of rebound exercises resulted in some advantages in vo2peak and respiratory indices , provided patients would be interested and enjoy the exercises .
thus , the use of different exercise modalities in accordance to patients ' interests seems advisable .
present study demonstrated that both aerobic and rebound exercises were worthwhile for mild to moderate male asthmatic patients .
we demonstrated that the use of rebound exercises resulted in some advantages in vo2peak and respiratory indices , provided patients would be interested and enjoy the exercises .
thus , the use of different exercise modalities in accordance to patients ' interests seems advisable .
 background : there are some auspicious records on applying aerobic exercise for asthmatic patients . 
 recently , it is suggested that rebound exercise might even increase the gains . 
 this study was designed to compare the effects of rebound therapy to aerobic training in male asthmatic patients.methods:sample included 37 male asthmatic patients ( 20 - 40 years ) from the same respiratory clinic . 
 after signing the informed consent , subjects volunteered to take part in control , rebound , or aerobic groups . 
 there was no change in the routine medical treatment of patients . 
 supervised exercise programs continued for 8 weeks , consisting of two sessions of 45 to 60 minutes per week . 
 criteria measures were assessed pre- and post exercise program . 
 peak exercise capacity ( vo2peak ) was estimated by modified bruce protocol , forced vital capacity ( fvc ) , forced expiratory volume in 1 second ( fev1 ) , and fev1% were measured by spirometer . 
 data were analyzed by repeated measure analysis of variance ( anova).results : significant interactions were observed for all 4 criteria measures ( p < 0.01 ) , meaning that both the exercise programs were effective in improving fvc , fev1 , fev1% , and vo2peak . 
 rebound exercise produced more improvement in fev1 , fev1% , and vo2peak.conclusions:regular exercise strengthens the respiratory muscles and improves the cellular respiration . 
 at the same time , it improves the muscular , respiratory , and cardio - vascular systems . 
 effects of rebound exercise seem to be promising . 
 findings suggest that rebound exercise is a useful complementary means for asthmatic male patients . 
INTRODUCTION
METHODS
Study design
Selection criteria
Exercise training
Measurements
Data analysis
RESULTS
CONCLUSION
DISCUSSION
Practical applications