Effects of physical therapy on lung function in children with asthma: a systematic review and meta-analysis.

Children with asthma are usually managed with medication, but physical therapy is also used as part of treatment, even though guidelines have been cautious about recommending it. This review and meta-analysis pooled evidence from studies testing physical training, breathing exercises, or inspiratory muscle training to see whether any of these approaches change lung function in children with asthma. Across 18 studies identified, most examined physical training, and when 11 of these were pooled, physical training was linked to a statistically significant improvement in forced vital capacity (a measure of how much air the lungs can hold and exhale). Evidence on breathing exercises and inspiratory muscle training was far too limited, just two studies, to draw conclusions.

The main limitation is that the evidence base for these other approaches remains very small, and the review does not establish how breathing-focused interventions compare to physical training.

If your child has asthma, you may wonder whether exercise-based therapy, not just inhalers or medication, could help their breathing. This review looked at existing studies testing different types of physical therapy, including general physical training and breathing exercises, to see if they improved lung function in children with asthma. The main finding was that physical training was linked to improvement in one lung function measure, forced vital capacity, which reflects how much air the lungs can hold and release.

This comes from pooling results across several studies, which gives more confidence than any single study alone. However, the evidence on breathing exercises and inspiratory muscle training specifically was very limited, based on just two studies, so it is not yet clear whether those approaches help. This research does not tell you to replace or change any current asthma treatment.

It simply points to physical training as an area where lung function benefits have been observed, while acknowledging that more research is still needed, especially on breathing-based techniques.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This review addresses a question that comes up often in paediatric respiratory care: does physical therapy, beyond standard pharmacological asthma management, meaningfully affect lung function in children, and how does that fit with guideline positions that have been cautious about recommending it. The authors pooled 11 studies of physical training and found a statistically significant improvement in forced vital capacity as a percent of predicted value, giving some quantitative support to including exercise-based rehabilitation as an adjunct area worth understanding, though the abstract does not report the specific effect size, confidence interval, or heterogeneity statistics. What this adds to clinical reasoning is modest but notable: it suggests physical training's effect on one spirometric outcome (FVC) rather than overall asthma control, symptom burden, or exacerbation frequency, which were not reported here.

Importantly, the broader systematic review included only 18 studies total, and interventions like breathing exercises or inspiratory muscle training were represented by just two studies, too few to draw any reliable conclusion about their effects. The review does not establish how physical training compares directly to breathing-based approaches, nor does it address study quality, risk of bias, or adverse events, none of which are mentioned in the abstract. Given the relatively small and heterogeneous body of underlying trials, this should be understood as informing an emerging area rather than confirming a clinical pathway.