Cochrane for Clinicians
Putting Evidence into Practice
Exercise vs. No Exercise for the Occurrence, Severity, and Duration of Acute Respiratory Tract Infections
Am Fam Physician. 2021 Feb 1;103(3):144-145.
Author disclosure: No relevant financial affiliations.
Does regular exercise reduce the occurrence, severity, or duration of acute respiratory tract infections?
For adults, regular exercise may reduce the overall severity of acute respiratory tract infections and the number of days with symptoms, but there is no evidence that exercise reduces the overall occurrence or duration of these infections.1 (Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence.)
Acute respiratory tract infections (i.e., infections of the respiratory tract lasting less than 30 days) are a common cause of morbidity each year.2 In 2016 in the United States, 9.6% of all medical office visits were for respiratory diseases.3 A 2015 Cochrane review of 11 trials involving 904 adults did not determine whether exercise could affect the occurrence, severity, or duration of acute respiratory tract infections and called for larger, higher-quality studies.4
For this updated review, the authors added three new trials for a total of 1,377 adults; nine trials were from the United States and the remainder were from Brazil, Canada, Portugal, Spain, and Turkey.1 Participants were 18 to 85 years of age. Study duration ranged from seven days to 12 months, and the most common intervention was supervised aerobic exercise for 30 to 45 minutes per session for three to five days each week. All studies compared exercise with no exercise. The review authors relied on the definition of acute respiratory tract infections used by the trial authors. The studies in this review were assessed as being at low risk of reporting bias; low, unclear, or high risk of attrition bias; unclear risk of selection bias; and high risk of performance and detection bias.
Low-certainty evidence demonstrated that aerobic exercise vs. no exercise does not reduce the number of acute respiratory tract infection episodes per year or the proportion of individuals who will experience at least one acute respiratory
Referencesshow all references
1. Grande AJ, Keogh J, Silva V, et al. Exercise versus no exercise for the occurrence, severity, and duration of acute respiratory infections. Cochrane Database Syst Rev. 2020;(4):CD010596....
2. World Health Organization. Programme of Acute Respiratory Infections. Acute respiratory infections in children: case management in small hospitals in developing countries, a manual for doctors and other senior health workers. 1990. Accessed June 17, 2020. https://apps.who.int/iris/handle/10665/61873
3. Rui P, Okeyode T. National Ambulatory Medical Care Survey: 2016 National Summary Tables. Accessed June 17, 2020. https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2016_namcs_web_tables.pdf
4. Grande AJ, Keogh J, Hoffmann TC, et al. Exercise versus no exercise for the occurrence, severity and duration of acute respiratory infections. Cochrane Database Syst Rev. 2015;(6):CD010596.
5. Barrett B, Hayney MS, Muller D, et al. Meditation or exercise for preventing acute respiratory infection: a randomized controlled trial. Ann Fam Med. 2012;10(4):337–346.
6. Barrett B, Hayney MS, Muller D, et al. Meditation or exercise for preventing acute respiratory infection (MEPARI-2): a randomized controlled trial. PLoS One. 2018;13(6):e0197778.
7. Barrett B, Brown R, Mundt M, et al. The Wisconsin Upper Respiratory Symptom Survey is responsive, reliable, and valid. J Clin Epidemiol. 2005;58(6):609–617.
These are summaries of reviews from the Cochrane Library.
This series is coordinated by Corey D. Fogleman, MD, assistant medical editor.
A collection of Cochrane for Clinicians published in AFP is available at https://www.aafp.org/afp/cochrane.
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