Effect of lower torso training on asthma patients





lower-torso muscles, 6-min walk distance, asthma


Purpose: the researchers see that this project is significant for asthma patients to help them improve. Therefore, this study hypothesizes that lower torso muscle endurance may affect 6MWT in asthma patients. To test this hypothesis, we examined the effect of decreased thoracic muscular endurance on asthma patients' 6-minute walk test (6MWT).

Material & Methods: this study included two groups (experimental and control), and they used a quantitative descriptive technique and achieved Pre – Post tests research design. The researcher began by administering a pre-test to the two groups. Researchers then carried out the therapy to experiment group, whereas the control group used the hospital protocol. Following the conclusion of the treatment, the researcher conducted a post-test for both groups. The program of the treatment's impact may be determined precisely by comparing the pre-and post-test findings. The trial lasted 24 meetings, with training occurring three times a week. On many occasions, twenty asthmatic patients from Imam Sadiq Hospital who had been hospitalized at a pulmonary rehabilitation center were assessed. Patients were included if they met the global effort for asthma recommendations for asthma diagnosis. The current study employed an experimental design. This study evaluated the maximal inspiratory pressure (PI, max), the pulmonary function test, the baseline dyspnea index (BDI), and the six-minute walk test (6MWT). Each exercise (leg extension and leg press) on gymnasium equipment was assigned a one-minute repetition. Additionally, the St. George Respiratory Questionnaire (SGRQ) was used to determine a person's quality of life. The researchers discovered that a training program had statistically significant favorable impacts on the 6MWT and body weight.

Conclusion: this study's findings demonstrated the critical role of lower torso training in achieving submaximal exercise tolerance. Additionally, they may pave the way for new avenues for training programs aimed at increasing functional activity in asthma patients.


Abdelbasset, W.K., Elsayed, S.H., Nambi, G., Alqahtani, B.A., Osailan, A.M., Azab, A.R., Moawd, S.A., Ali, Z.A., Verma, A., Hussein, R.S., & Eid, M.M. (2022). Optimization of pulmonary function, functional capacity, and quality of life in adolescents with thoracic burns after a 2-month arm cycling exercise programme: A randomized controlled study, Burns, 48(1), 78-84. https://doi.org/10.1016/j.burns.2021.03.010

Ahmadizad, S., Ghorbani, S., Ghasemikaram, M., & Bahmanzadeh, M. (2014). Effects of short-term nonperiodized, linear periodized and daily undulating periodized resistance training on plasma adiponectin, leptin and insulin resistance. Clinical biochemistry, 47(6), 417-422. https://doi.org/10.1016/j.clinbiochem.2013.12.019

American Thoracic Society, & European Respiratory Society (2002a). International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001. Am J Respir Crit Care Med., 165(2), 277-304. https://doi.org/10.1164/ajrccm.165.2.ats01

Amin, R., Maiya, G.A., Mohapatra, A.K., Acharya, V. Alison, J.A., Dale M., & Vaishali, K. (2022). Effect of a home-based pulmonary rehabilitation program on functional capacity and health-related quality of life in people with interstitial lung disease – A randomized controlled trial protocol. Respiratory Medicine, 201, 106927. https://doi.org/10.1016/j.rmed.2022.106927

ATS, & ERS (2002b). ATS/ERS Statement on Respiratory Muscle Testing. American journal of respiratory and Critical Care Medicine, 166(4), 518-624. https://doi.org/10.1164/rccm.166.4.518

Boutou, A.K., Daniil, Z., Pitsiou, G., Papakosta, D., Kioumis, I., & Stanopoulos, I. (2020). Cardiopulmonary exercise testing in patients with asthma: What is its clinical value? Respiratory medicine, 167, 105953. https://doi.org/10.1016/j.rmed.2020.105953

Capodaglio, P., Maestri, R., & Bazzini, G. (1997). Reliability of a hand gripping endurance test. Ergonomics, 40(4), 428-434. https://doi.org/10.1080/001401397188062

Chung, Y., Huang, T.-Y., Liao, Y.-H., & Kuo, Y.-C. (2021). 12-week inspiratory muscle training improves respiratory muscle strength in adult patients with stable asthma: a randomized controlled trial. International Journal of Environmental Research and Public Health, 18(6), 3267. https://doi.org/10.3390/ijerph18063267

Corlateanu, A., Plahotniuc, A., Corlateanu, O., Botnaru, V. Bikov, A., Mathioudakis, A.G., Covantev, S., & Siafakas, N. (2021). Multidimensional indices in the assessment of chronic obstructive pulmonary disease, Respiratory Medicine, 185, 106519. https://doi.org/10.1016/j.rmed.2021.106519

Elliott-Button, H.L., Johnson, M.J., Nwulu, U., & Clark, J. (2020). Identification and assessment of breathlessness in clinical practice: a systematic review and narrative synthesis. Journal of pain and symptom management, 59(3), 724-733.e19. https://doi.org/10.1016/j.jpainsymman.2019.10.014

Enright, P.L., McBurnie, M.A., Bittner, V., Tracy, R.P., McNamara, R., Arnold, A., & Newman, A.B. (2003). The 6-min walk test: a quick measure of functional status in elderly adults. Chest, 123(2), 387-398. https://doi.org/10.1378/chest.123.2.387

Esteban, C., Arostegui, I., Aramburu, A. Moraza, J., Najera-Zuloaga, J., Aburto, M., Aizpiri, S., Chasco, L., & Quintana, J.M. (2020). Predictive factors over time of health-related quality of life in COPD patients. Respir Res, 21, 138. https://doi.org/10.1186/s12931-020-01395-z

Hussien, J., Brunet, J., Romain, A.J., Lemelin, L., & Baillot, A. (2022). Living with severe obesity: adults’ physical activity preferences, self-efficacy to overcome barriers and motives. Disability and Rehabilitation, 44(4), 590-599. https://doi.org/10.1080/09638288.2020.1773944

Huzmeli, I., Ozer, A., Akkus, O., & Yalcin, F. (2022). The results of inspiratory muscle training on cardiac, respiratory, musculoskeletal, and psychological status in patients with stable angina: a randomized controlled trial. Disability and Rehabilitation, 1-12. https://doi.org/10.1080/09638288.2022.2146767

Jones, P.W., Quirk, F.H., Baveystock, C.M., & Littlejohns P. (1992). A self-complete measure of health status for chronic airflow limitation. American review of respiratory disase, 145(6), 1321-1327. https://doi.org/10.1164/ajrccm/145.6.1321

Kubincová, A., Takáč, P., Kendrová, L., Joppa, P., & Mikuľáková, W. (2018). The effect of pulmonary rehabilitation in mountain environment on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD) and chronic bronchitis. Medical science monitor: international medical journal of experimental and clinical research, 24, 6375. https://doi.org/10.12659/MSM.909777

Kyle, U., Pichard, C., Rochat, T., Slosman, D., Fitting, J., & Thiebaud, D. (1998). New bioelectrical impedance formula for patients with respiratory insufficiency: comparison to dual-energy X-ray absorptiometry. European Respiratory Journal, 12(4), 960-966. https://doi.org/10.1183/09031936.98.12040960

Lee, J., Gutierrez, N.L., & McKay C. (2020). A Shoulder Strength Program for Wheelchair Basketball Players. Palaestra, 34(3). https://doi.org/10.1123/jsr.2017-0011

Li, N., Li, P., Lu, Y., & Wu, W. (2020). Effects of resistance training on exercise capacity in elderly patients with chronic obstructive pulmonary disease: a meta-analysis and systematic review. Aging Clin Exp Res. 32, 1911-1922. https://doi.org/10.1007/s40520-019-01339-8

Mahler, D.A., Weinberg, D.H., Wells, C.K., & Feinstein, A.R. (1984). The measurement of dyspnea: contents, interobserver agreement, and physiologic correlates of two new clinical indexes. Chest, 85(6), 751-758. https://doi.org/10.1378/chest.85.6.751

Mizrahi, D., Fardell, J.E., Cohn, R.J., Partin, R.E., Howell, C.R., Hudson, M.M., Robison, L.L., Ness, K.K., McBride, J., Field, P., Wakefield, C.E., & Simar, D. (2020). The 6-minute walk test is a good predictor of cardiorespiratory fitness in childhood cancer survivors when access to comprehensive testing is limited. International journal of cancer, 147(3), 847-855. https://doi.org/10.1002/ijc.32819

Ng, S.S., & Hui-Chan, C.W. (2012). Contribution of ankle dorsiflexor strength to walking endurance in people with spastic hemiplegia after stroke. Archives of physical medicine and rehabilitation, 93(6), 1046-1051. https://doi.org/10.1016/j.apmr.2011.12.016

Nici, L., Donner, C., Wouters, E., Zuwallack, R., Ambrosino, N., Bourbeau, J., Carone, M., Celli, B., Engelen, M., Fahy, B., Garvey, C., Goldstein, R., Gosselink, R., Lareau, S., MacIntyre, N., Maltais, F., Morgan, M., O’Donnell, D., Prefault, C. … Troosters, T. (2006). American thoracic society/European respiratory society statement on pulmonary rehabilitation. American journal of respiratory and critical care medicine, 173(12), 1390-1413. https://doi.org/10.1164/rccm.200508-1211ST

Nyberg A., Törnberg A., & Wadell, K. (2016). Correlation between limb muscle endurance, strength, and functional capacity in people with chronic obstructive pulmonary disease, Physiotherapy Canada, 68(1), 46-53. https://doi.org/10.3138/ptc.2014-93

Oczkowski, S., Ergan, B., Bos, L., Chatwin, M., Ferrer, M., Gregoretti, C., Heunks, L., Frat, J.-P., Longhini, F., Nava, S., Navalesi, P., Ozsancak Uğurlu, A., Pisani, L., Renda, T., Thille, A.W., Winck, J.C., Windisch, W., Tonia, T., Boyd, J., … Scala, R. (2022). ERS Clinical Practice Guidelines: High-flow nasal cannula in acute respiratory failure. European respiratory journal, 59(4), 2101574. https://doi.org/10.1183/13993003.01574-2021

Roldán, A., Forte, A., Monteagudo, P., Cordellat, A., Monferrer-Marín, J., & Blasco-Lafarga, C. (2021). Determinants of dynamic inspiratory muscle strength in healthy trained elderly, Postgraduate medicine, 133(7), 807-816. https://doi.org/10.1080/00325481.2021.1945761

Russell, A.M., & Saketkoo, L.A. (2021). Patient-Centredness and Patient-Reported Measures (PRMs) in Palliation of Lung Disease. In Lindell, K.O., & Danoff, S.K. (Eds), Palliative Care in Lung Disease. Respiratory Medicine. Humana, Cham. https://doi.org/10.1007/978-3-030-81788-6_4

Sami, R., Zohal, M., & Mohammadi, N. (2020). Clinical Determinants of the Six-Minute Walk Test (6MWT) in Stable Non-Cystic Fibrosis Bronchiectasis Patients. Tanaffos, 19(4), 385-391. https://pubmed.ncbi.nlm.nih.gov/33959177/

Severin, R., Franz, C.K., Farr, E., Meirelles, C., Arena, R., Phillips, S.A., Bond, S., Ferraro, F., & Faghy, M. (2022). The effects of COVID-19 on respiratory muscle performance: making the case for respiratory muscle testing and training. European Respiratory Review, 31(166). https://doi.org/10.1183/16000617.0006-2022

Silva, C.M.d.S.e., Gomes Neto, M., Saquetto, M.B., Conceição, C.S.d., & Souza-Machado, A. (2018). Effects of upper limb resistance exercise on aerobic capacity, muscle strength, and quality of life in COPD patients: a randomized controlled trial. Clinical rehabilitation, 32(12), 1636-1644. https://doi.org/10.1177/0269215518787338

Society, A.T. (2002). ATS/ERS Statement on respiratory muscle testing, Am J Respir Crit Care Med, 166(4), 518-624. https://doi.org/10.1164/rccm.166.4.518

Tamulevičiūtė-Prascienė, E., Beigienė, A., Thompson, M.J., Balnė, K., Kubilius, R., & Bjarnason-Wehrens, B. (2021). The impact of additional resistance and balance training in exercise-based cardiac rehabilitation in older patients after valve surgery or intervention: randomized control trial. BMC geriatrics, 21(1), 1-12. https://doi.org/10.1186/s12877-020-01964-3

Trudelle-Jackson, E., Hines, E., Medley, A., & Thompson, M. (2020). Exploration of habitual walking behavior and home-based muscle power training in individuals with total knee arthroplasty. Journal of Physical Activity and Health, 17(3), 331-338. https://doi.org/10.1123/jpah.2019-0233

Van Weel, C., Bateman, E.D., Bousquet, J., Reid, J., Grouse, L., Schermer, T., Valovirta, E., & Zhong, N. (2008). Asthma management pocket reference 2008, Allergy, 63(8), 997-1004. https://doi.org/10.1111/j.1398-9995.2008.01643.x

Vermeulen, F., Garcia, G., Ninane, V., & Laveneziana, P. (2016). Activity limitation and exertional dyspnea in adult asthmatic patients: what do we know? Respiratory medicine, 117, 122-130. https://doi.org/10.1016/j.rmed.2016.06.003

Volianitis, S., McConnell, A.K., & Jones, D.A. (2001). Assessment of maximum inspiratory pressure. Respiration, 68(1), 22-27. https://doi.org/10.1159/000050458




How to Cite

Shimal H. Hamad, Ammar Hamza Hadi, & Bestoon Akram Ahmad. (2023). Effect of lower torso training on asthma patients. Physical Rehabilitation and Recreational Health Technologies, 8(1), 13–21. https://doi.org/10.15391/prrht.2023-8(1).02



Original research article