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



Asthma is a common chronic respiratory disease in children. In addition to medications, physical therapy is considered as a treatment strategy for asthma. We conducted this study to investigate the effects of physical therapy on lung function in children with asthma.


Three databases were searched. We conducted the meta-analysis for the forced expiratory volume in the first second in percent predicted values [FEV1(%pred)], the forced vital capacity in percent predicted values [FVC(%pred)], and the peak expiratory flow in percent predicted values [PEF(%pred)] by using a random effect model.


Of the 6474 identified studies, 18 studies (16 in physical training, 2 in breathing exercise or inspiratory muscle training) were included in the systematic review and 11 studies (all in physical training) were included in the meta-analysis. The meta-analysis showed a significantly improved FVC(%pred) in the experimental group.


Physical training improved FVC(%pred) significantly in children with asthma. Further study is needed, especially on the effects of breathing exercise and inspiratory muscle training in children with asthma.


  • Our study reviewed the physical therapies for children with asthma and clarified whether and how these therapies affect them.

  • Our study found that physical training improved the forced vital capacity in percent predicted values [FVC(%pred)] significantly in asthmatic children.

  • Our study provided evidence that physical training could improve lung function in children with asthma, which is not identical to the Global Initiative for Asthma (GINA) guidelines.

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Fig. 1: Results of study selection summarized in a PRISMA flow diagram.
Fig. 2: Risk of bias summary.
Fig. 3: Risk of bias graph.
Fig. 4: Forest plot of comparison.
Fig. 5: Funnel plot with pseudo 95% confidence limits.
Fig. 6: Result of Egger’s test.


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This study is supported by the Sichuan Provincial Department of Science and Technology (No. 2013sz0040). The funders had no role in the design, execution, or writing of this protocol.

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Q.W. put forward the concept of this study. W.Z., W.Y., and L.L. were engaged in the study search, study selection, data extraction, risk of bias assessment, and data analysis. H.L. was responsible for project administration. W.Z. drafted the preliminary version of this manuscript. All authors critically reviewed, revised, and approved this final manuscript.

Corresponding author

Correspondence to Hanmin Liu.

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Zhang, W., Wang, Q., Liu, L. et al. Effects of physical therapy on lung function in children with asthma: a systematic review and meta-analysis. Pediatr Res 89, 1343–1351 (2021).

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