Abstract
BACKGROUND: Exercise is an effective treatment for asthma, but there is still ongoing debate regarding the most beneficial form of exercise. This study used data from randomized controlled trials to compare and rank the types of exercise that improve asthma-related quality of life (QOL) in patients [total score and four subdomain scores (symptoms, activity limitations, emotional functions, and environmental stimulants)]. METHOD: This study was meticulously conducted using a rigorous methodology. We included randomized controlled trials of 10 types (two major categories: single-mode exercise and comprehensive-mode exercise) of exercise for the interventional treatment of asthmatics (≥16 years old). The effect size measures were standardized mean differences (SMDs) with 95% credible intervals (CrIs). The confidence of evidence was examined using Confidence in network meta-analysis. The study protocol has been registered with PROSPERO under registration number CRD420251110553. RESULT: We identified 1,237 citations based on 35 studies involving 3,946 participants. Compared with the control group, all comprehensive-mode exercises (yoga, aerobic combined with breathing or resistance exercise) significantly improved the total score of asthma-related QOL (and four subdomain scores) among participants, and the SMDs [95% Credible Interval (CrI)] ranged between 2.26 (1.63 to 2.90) for Yoga to 1.06 (0.01 to 2.11) for high-intensity interval training (HIIT). Notably, HIIT demonstrated promising trends in improving asthma-related QOL compared to moderate-intensity aerobic exercises (P-score = 0.58). While Buteyko (P-score = 0.48) ranked first among various breathing exercises, the differences in efficacy between these methods were mostly small or uncertain. exercise prescription were significant factors affecting the network meta-analysis results. CONCLUSION: Various comprehensive exercise modes are the best way to improve asthma-related QOL in patients. The exercise period will affect the effectiveness of the rehabilitation program. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251110553, PROSPERO CRD420251110553.