توان بخشي ورزشي بيماران آسمي بسمه تعالی آشنايي با تكنيك هاي توان بخشي ورزشي بيماران آسمي دكتر احمد ابراهيمي عطري عضو هيات علمي دانشكده تربيت بدني و علوم ورزشي دانشگاه فردوسي مشهد

مقدمه: آسم انسداد برگشت پذير راههاي هوايي است و التهاب مزمن و پاسخ دهي بيش از حد راههاي هوايي نيز وجود دارد. آسم يكي از شايع ترين و قديمي ترين بيماري ها مي باشد. بر اساس گزارش سازمان بهداشت جهاني بيش از 150 ميليون نفر در سطح جهان به آسم مبتلا مي باشند. ميزان مرگ و مير ناشي از حمله حاد آسم را تا 38 درصد گزارش كرده اند. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

مقدمه: راندولف (2002) ميزان شيوع آسم ناشي از ورزش ( EIA ) در بين ورزشكاران المپيك را بين 10 تا 20 درصد اعلام كرد. در مسابقات سئول (1988) از 255 عضو تيم المپيك استراليا , 21 نفر آسماتيك بودند. شيوع آسم در ايران بين 10 تا 15 درصد مي باشد. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

اهداف درمان آسم : اهداف درمان آسم شامل حفظ سطح فعاليت فرد در حد طبيعي, حفظ عملكرد سيستم تنفسي در حد طبيعي, پيشگيري از حملات آسم و علائم مزمن آزار دهنده, استفاده از حداقل دارو با حداقل عارضه دارويي و افزايش كارايي و كيفيت زندگي بيمار آسمي مي باشد. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

اهداف توان بخشي ورزشي بيماران آسمي شامل پيشگيري از پيشرفت بيماري كاهش شدت بيماري تنفسي كاهش نياز به مصرف دارو كاهش اضطراب و افسردگي كاهش سرفه و تنگي نفس در طول زندگي روزمره و در هنگام تمرين بهبود حالت تندرستي و تركيب بدن بهبود ظرفيت عملكردي ريه بهبود ظرفيت عملكردي روزانه از طريق بهبود استقامت قلبي تنفسي بهبود كيفيت زندگي و بهبود حالات رواني بيمار افزايش اعتماد به نفس VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

حركات ورزشي, تنها عامل طبيعي است كه باعث تند ايمني (Tachyphylaxis) (كاهش عكس العمل نسبت به يك تحريك در نتيجه تحريكات مكرر و ملايم) مي شود. وقتي دوره هايي از حركات ورزشي با فاصله كوتاه از يكديگر انجام مي شود , پيش از آغاز حركات ورزشي اصلي و شديد , تنگي راههاي تنفسي را به حداقل مي رساندكه به اين پديده دوره تحريك ناپذيري مي گويند. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

پياده روي بسيار ساده و راحت است. يكي از بهترين ورزشهاي هوازي براي بيماران مبتلا به بيماريهاي تنفسي, پياده روي مي باشد. زيرا: پياده روي بسيار ساده و راحت است. نياز به مهارت خاص و مكان مخصوص و امكانات ويژه اي ندارد. احتمال بروز آسيب هاي اسكلتي , عضلاني در اين نوع فعاليت كم است و بيماران براحتي مي توانند پياده روي را انجام داده و از اثرات سودمند آن بهره مند شوند. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

آسم و فعاليت هاي ورزشي فعاليت هاي ورزشي كوتاه يك تا دو دقيقه اي همراه با استراحت براي افراد آسمي مناسب است زيرا فعاليت هاي شديد ادامه دار مانند دويدن طولاني مدت باعث حمله آسم مي شود. فعاليت هايي كه داراي شروع و توقف است مثل بدمينتون مي تواند مفيد باشد. دوچرخه سواري چنانچه فاصله استراحت ميان آن باشد مي تواند مفيد باشد, شنا كردن و قدم زدن بسيار مطلوب است به شرط آنكه خود را گرم نگاه داريد. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

آسم كنترل نشده آسم كنترل نشده مي تواند منجر به: افسردگي كاهش اعتماد به نفس ناراحتي هاي روحي افت تحصيلي شود. نوجوانان مبتلا به آسم به خاطر خجالت از بروز حمله آسم در بين همسالان خود در بازيهاي دسته جمعي شركت نمي كنند و از ورزش، بازي و فوايد آن محروم مي شوند. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

انجمن آمريكايي توان بخشي ريوي و قلبي عروقي , برنامه كامل توان بخشي ريوي را كه ورزش جزء مهمي از آن است را كليد دستيابي به بهبود عملكرد رواني بيماران مي داند. استفاده از درمان هاي دارويي براي بيماران آسمي , داراي عوارض جانبي مي باشد در حالي كه استفاده از روشهاي درمان غير دارويي مثل ورزش و فعاليت بدني علاوه بر تاثير مثبت بر عملكرد ريوي بيماران آسمي, داراي عوارض جانبي نمي باشد. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

اثرات آمادگي جسماني بر جريان هوا بازدمي در افراد آسمي پيشنيه تحقيقات : فرانكويس هاس تحقيقي تحت عنوان: اثرات آمادگي جسماني بر جريان هوا بازدمي در افراد آسمي آماده و غير آماده انجام داد. گروه آماده به طور معني داري نسبت به گروه غير آماده زمان بيشتري روي نوار گردان دويدند و به سطح بالايي از نظر ميزان حداكثر اكسيژن مصرفي رسيدند. در گروه آماده, كاهش علايم آسم و كاهش در مصرف دارو مشاهده شد. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

پيشنيه تحقيقات : جان بي وست در تحقيق خود نشان ميدهد كه: در اثر اجراي فعاليت ورزشي سبك توسط بيماران ريوي, ظرفيت حياتي با فشار 18 درصد, حداكثر تهويه ارادي 10 درصد و ظرفيت حياتي به مقدار 23 درصد بهبود يافته است. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

پيشنيه تحقيقات : بوندگارد و همكارانش به مدت دو ماه بيماران آسمي را تحت تمرينات ورزشي قرار دادند و به ميزان 10 درصد افزايش در ظرفيت ريوي مشاهده كردند . VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

پيشنيه تحقيقات : كلارك و كوچران گزارش كردند: بيماران آسمي پس از انجام فعاليت هاي هوازي به مدت چهار هفته سه جلسه اي و مدت 6 دقيقه در هر جلسه به ميزان 23 درصد بهبود در ظرفيت حياتي اجباري مشاهده كردند. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

پيشنيه تحقيقات : نايدرمن و همكارانش در تحقيق خود برنامه تمرين شامل 9 هفته سه جلسه اي و هر جلسه 20 دقيقه تمرين با چرخ كارسنج و نوار گردان بود. تمرينات توان بخشي ورزشي با 50 درصد حداكثر سطح توانايي بيماران شروع شد و به تدريج هر هفته بر شدت تمرينات افزوده مي شد. نتايج تحقيق نشان مي دهد كه استقامت با چرخ كارسنج از 5 دقيقه به 12 دقيقه افزايش يافت و از نظر رواني و اجتماعي, كاهش افسردگي و كاهش ناتواني در بيماران مشاهده شد. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

پيشنيه تحقيقات : نتايج تحقيق فرانك و يرانت نشان مي دهد كه آمادگي هوازي در بيماران با آسم ملايم باعث بهبود ظرفيت تهويه اي و كاهش تنگي نفس در هنگام ورزش مي شود. در اين تحقيق بيماران آسمي پس از اجراي 10 هفته تمرين هوازي به طور معني داري حداكثر اكسيژن مصرفي آنها افزايش يافت و مقدار حداكثر تهويه ارادي از 96 ليتر در دقيقه به 2/108 ليتر در دقيقه افزايش يافت. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

پيشنيه تحقيقات : نتايج تحقيق مكنزي نشان مي دهد كه: 15 دقيقه گرم كردن تداومي با 60 درصد حداكثر اكسيژن مصرفي مي تواند بطور معني داري برونكواسپاسم بعد از تمرين در ورزشكاران آسمي را كاهش دهد. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

پيشنيه تحقيقات : تحقيقات امتنر در دپارتمان طب ريه سوئد نشان مي دهد كه: 10 هفته برنامه تمرينات توان بخشي ورزشي در آب باعث بهبود آمادگي قلبي عروقي , كاهش ضربان قلب استراحتي , افزايش معني داري در حجم بازدمي با فشار در يك ثانيه (FEV1) و جريان بازدمي با فشار (FEF) و كاهش اضطراب و تنگي نفس در بيماران شد. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

پيشنيه تحقيقات : كاتز بيان مي كند كه با توجه به تئوري كاهش آب و گرما, مشكل آسم ناشي از ورزش (EIA) بروز مي كند. بنابراين، يادگيري اصولي چون، تنفس هواي گرم و مرطوب نسبت به هواي سرد و خشك در طول برنامه تمرين ورزشي ضروري است . تنفس هواي تميز و تنفس از طريق بيني نسبت به تنفس دهاني برتري دارد. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

پيشنيه تحقيقات : ويليام استدرمز تعداد 35 بيمار آسمي را به مدت سه ماه تحت تمرينات منظم ورزشي قرار داد و بهبود معني داري در حداكثر اكسيژن مصرفي, تهويه دقيقه اي, آستانه هوازي و تنگي نفس مشاهده شد. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

پيشنيه تحقيقات : در تحقيق احمد ابراهيمي عطري (1382) تحت عنوان: تاثير برنامه تمرين هوازي بر عملكرد ريه و تحمل به فعاليت در بيماران آسمي تعداد 36 بيمار آسمي انتخاب شدند. گروه تجربي (18 نفر) در برنامه تمرين هوازي هشت هفته سه جلسه اي شركت كردند در حالي كه گروه شاهد (18 نفر) هيچگونه تمرين ورزشي انجام ندادند. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

نتایج: نتايج اين تحقيق نشان مي دهد كه تغييرات ميانگين حجم بازدمي با فشار در يك ثانيه (FEV1) , ظرفيت حياني با فشار (FVC) , جريان بازدمي حداكثر(PEF) , متوسط جريان بازدمي با فشار (75%-FEF25) , حداكثر تهويه ارادي (MVV), تعداد تنفس در دقيقه (RF) و تحمل به فعاليت با آزمون شش دقيقه راه رفتن (6MWT) در پس آزمون در بين بيماران آسمي گروه تجربي و شاهد تفاوت معني داري وجود داشت . VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

ميانگين تغييرات در FEv1 , FVC , PEF , (75%-FEF25) , MVV , RF , 6MWT , به ترتيب 56/25 ـ , 19/17 - , 09/32 ـ , 93/27 ـ , 18/22 ـ , 63/5 , 5/307 ـ در گروه تجربي در حالي كه اين شاخص ها در گروه شاهد به ترتيب 2/6, 67/4, 96/1 , 65/6 , 56/15 , 87/2 ـ و 78/18 بود. (0.05  P) نتايج تحقيق حاضر نشان مي دهد كه بيماران آسمي كه در برنامه تمرين هوازي شركت كرده اند نسبت به گروه شاهد عملكرد ريوي و تحمل به فعاليت بهتري داشتند. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

بحث و نتیجه گیری: نتايج تحقيقات نشان مي دهد كه: اجراي يك دوره تمرينات توان بخشي ورزشي ويژه بيماران آسمي , فوايد ارزشمندي براي اين گروه از بيماران دارد. بنابراين… برنامه توان بخشي ورزشي در كنار برنامه دارو و درماني مي تواند در درمان بيماران آسمي به عنوان تكميل كننده فرايند درمان مد نظر متخصصين قرار گيرد. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

بحث و نتیجه گیری: محقيقن نتيجه گرفتند كه: تمرينات ورزشي با شدت هاي كنترل شده سبب بهبود آمادگي جسماني و عملكرد قلبي ريوي بيماران آسمي مي شود و اين بيماران مي توانند با انجام فعاليت هاي بدني منظم به طور معني داري وضعيت قلبي ريوي خود را بهبود بخشند و در نهايت توانايي شركت در ورزش هاي مختلف را خواهند داشت. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

بحث و نتیجه گیری: بهبود استقامت عضلات تهويه اي ناشي از افزايش سطوح آنزيم هاي هوازي عضلات تهويه مي باشد. تمرين هاي ورزشي مي تواند در بهبود توانايي تحمل سطوح بالاي تهويه زير بيشينه موثر باشد. فرايند تمرين مي تواند جريان هواي ذخيره ريوي بيماران ‌آسمي را افزايش دهد و بيمار قادر به تحمل فعاليت زير بيشينه خواهد بود. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

به طور کلی: تمرينات ورزشي بايد به عنوان نقطه اتكاء در توان بخشي ريوي مورد توجه قرار گيرد و فعاليت هاي بدني باعث بهبود كيفيت زندگي بيماران ريوي مي شود. VRIs, also called “the common cold” or rhinosinusitis, are recognized as the most common infectious illness in humans and a major cause of acute morbidity in individuals of all ages worldwide.1 Viral pathogens associated with these infections include the picornaviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), adenoviruses, and coronaviruses. The ability to detect these viruses with advanced techniques such as reverse-transcription polymerase chain reaction (RT-PCR) assays has allowed the laboratory identification of specific viruses that cause various respiratory syndromes. Rhinoviruses (RVs, one of the genera of the picornavirus family) are the most common cause of VRI symptoms. Picornaviruses have been isolated in up to 82% of persons with self-reported cold symptoms during the peak fall season.2 Most picornaviruses identified were RVs; some were enteroviruses. Those not identified were assumed to be RV. In this study, picornavirus RNA was detected in 46% of the culture-negative nasal wash specimens. From 70% to 88% of human RV infections result in symptomatic respiratory episodes characterized by rhinorrhea, nasal obstruction, sore throat, cough, and hoarseness, without systemic symptoms such as fever.1,3 1. Monto AS, Fendrick AM, Sarnes MW. Respiratory illness caused by picornavirus infection: a review of clinical outcomes. Clin Ther. 2001;23:1615-1627. 2. Arruda E, Pitkäranta A, Witek T Jr, Doyle CA, Hayden FG. Frequency and natural history of rhinovirus infections in adults during autumn. J Clin Microbiol. 1997;35:2864-2868. 3. Gwaltney JM Jr. Rhinovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000:1940- 1948.

پیشنهاد: بنابراين توصيه مي شود برنامه تمرينات ورزشي به عنوان يكي از روشهاي درمان غير دارويي و بخشي از برنامه توان بخشي ريوي براي بيماران آسمي مورد استفاده متخصصين قرار گيرد تا علاوه بر كاهش هزينه هاي درماني و صرفه جويي اقتصادي, از طريق ورزش و فعاليت بدني به نشاط و شادابي جسمي و وراني در بيماران آسمي رسيده و ميزان اميد به زندگي اين بيماران نيز از طريق توان بخشي ورزشي افزايش يابد. It is well established that certain viruses such as RSV and influenza virus infect the lower airways and cause tissue inflammation and lower airway obstruction.1 Studies have also reported the finding of RV in bronchoalveolar lavage specimens.2 It has also been shown that RVs can replicate at the higher temperatures of the lower airways, and in situ hybridization localized RV infection to the lower airways of human volunteers with experimentally induced nasal infection.3 Experimental infections with RVs have also provided evidence to support the association of RV infection and asthma exacerbations, which result from lower airway inflammation.1,4 Experimental RV infection increases lower airway inflammation, as indicated by increased submucosal lymphocytes and epithelial eosinophils in bronchial biopsy specimens,4 and increases the number of neutrophils in bronchial lavage fluid.5 1. Gern JE, Busse WW. The role of viral infections in the natural history of asthma. J Allergy Clin Immunol. 2000;106:201-212. 2. Gern JE, Galagan DM, Jarjour NN, Dick EC, Busse WW. Detection of rhinovirus RNA in lower airway cells during experimentally induced infection. Am J Respir Crit Care Med. 1997;155:1159-1161. 3. Papadopoulos NG, Bates PJ, Bardin PG, et al. Rhinoviruses infect the lower airways. J Infect Dis. 2000;181:1875-1884. 4. Fraenkel DJ, Bardin PG, Sanderson G, Lampe F, Johnston SL, Holgate ST. Lower airways inflammation during rhinovirus colds in normal and in asthmatic subjects. Am J Respir Crit Care Med. 1995;151:879-886. 5. Jarjour NN, Gern JE, Kelly EAB, Swenson CA, Dick CR, Busse WW. The effect of an experimental rhinovirus 16 infection on bronchial lavage neutrophils. J Allergy Clin Immunol. 2000;105:1169-1177.

منابع فارسی: 1- جرن جيمزاي, باس ويليام, دبليو . تشخيص و درمان آلرژي و آسم , ترجمه دكتر رضا فريد حسيني , دكتر ليدا عطارد , انتشارات آستان قدس رضوي 1380 2- معين مصطفي و همكاران, آسم , علوم پايه و باليني , انتشارات مركز نشر دانشگاه تهران 1382 3- ليوتلتنر برايان سي , ورزش و درمان بيماريها , ترجمه دكتر فرزين حلبچي , دكتر مهران عسگري خانقاه , ناشي اميد دانش 1380 4- گوردون نيلي اف , اختلالات تنفسي راهنماي كامل تمرينات ورزشي , ترجمه دكتر نادر طوسي , نشر علم و حركت 1381 5- ملويل آربلا, جانسون كولين , تندرستي بدون دارد, ترجمه: دكتر رضا عليجانيان , انتشارات ماني 1378 6- عليزاده بهزاد, رجصتي حقي محسن , آلرژي و آسم در كودكان , نشر همدل 1380 7- دست , جان بي , اصول فيزيولوژي تنفس , ترجمه , دكتر فرخ شادان , انتشارات مهر 1368 8- ابراهيمي عطري احمد, فريد حسيني رضا , خالدان اصغر , تاثير تمرينات ورزشي هوازي بر عملكرد ريوي و تحمل به فعاليت بيماران آسمي 1382 It is well established that certain viruses such as RSV and influenza virus infect the lower airways and cause tissue inflammation and lower airway obstruction.1 Studies have also reported the finding of RV in bronchoalveolar lavage specimens.2 It has also been shown that RVs can replicate at the higher temperatures of the lower airways, and in situ hybridization localized RV infection to the lower airways of human volunteers with experimentally induced nasal infection.3 Experimental infections with RVs have also provided evidence to support the association of RV infection and asthma exacerbations, which result from lower airway inflammation.1,4 Experimental RV infection increases lower airway inflammation, as indicated by increased submucosal lymphocytes and epithelial eosinophils in bronchial biopsy specimens,4 and increases the number of neutrophils in bronchial lavage fluid.5 1. Gern JE, Busse WW. The role of viral infections in the natural history of asthma. J Allergy Clin Immunol. 2000;106:201-212. 2. Gern JE, Galagan DM, Jarjour NN, Dick EC, Busse WW. Detection of rhinovirus RNA in lower airway cells during experimentally induced infection. Am J Respir Crit Care Med. 1997;155:1159-1161. 3. Papadopoulos NG, Bates PJ, Bardin PG, et al. Rhinoviruses infect the lower airways. J Infect Dis. 2000;181:1875-1884. 4. Fraenkel DJ, Bardin PG, Sanderson G, Lampe F, Johnston SL, Holgate ST. Lower airways inflammation during rhinovirus colds in normal and in asthmatic subjects. Am J Respir Crit Care Med. 1995;151:879-886. 5. Jarjour NN, Gern JE, Kelly EAB, Swenson CA, Dick CR, Busse WW. The effect of an experimental rhinovirus 16 infection on bronchial lavage neutrophils. J Allergy Clin Immunol. 2000;105:1169-1177.

منابع لاتین: 9- Bendstrup: Patient rehabilitation improves activities of daily living, quality of life and Exercise tolerance in pulmonary disease Eur – Respir , j Dec 10(12) pp , 2801 – 6 (1997) 10- Randolph . christopheri exercise induced asthma. How to make the diagnosis ; Journal of Respiratory Disense , July (2002) 11- American Thoracic Society : Pulmonarty Rehobilitation . Am,j Respir. Crit . care med vol : 159 , NO : 5 , May (1999) 12- Boskabady : Prevalence of Asthma Symptoms amony Secondary School Students in The city of Mashhad . J.med . Sci (1999) 13- Hass . Francoise ; EFFects of physical fithess on expiratory airflow exercising asthmatic people : Med,sci , Sports , Exercis , Vol;17 , NO: 5 , pp 585 – 592 (1985) 14- Bundgaard : Effect of physical Training on peak oxygen consumption rate and Exercise – indu-ced asthma in adult asthmatics ; Scand J.clin lab invest , Feb , 42 (1) . pp. 9-13(1988) 15- Clark and cochrane : Benefit and problems of a physical Training program for asthmatic patients . 16- Niederman : Benefits of a multidisciplinary pulmonary rehabilitation program . chest 99 , pp, 768 – 804 (1991) 17- Frank . virant : Exercise – indnced Bronchospam : med,sci: sports Exercise vol: 24, NO, 8pp 851- 855 (1992) It is well established that certain viruses such as RSV and influenza virus infect the lower airways and cause tissue inflammation and lower airway obstruction.1 Studies have also reported the finding of RV in bronchoalveolar lavage specimens.2 It has also been shown that RVs can replicate at the higher temperatures of the lower airways, and in situ hybridization localized RV infection to the lower airways of human volunteers with experimentally induced nasal infection.3 Experimental infections with RVs have also provided evidence to support the association of RV infection and asthma exacerbations, which result from lower airway inflammation.1,4 Experimental RV infection increases lower airway inflammation, as indicated by increased submucosal lymphocytes and epithelial eosinophils in bronchial biopsy specimens,4 and increases the number of neutrophils in bronchial lavage fluid.5 1. Gern JE, Busse WW. The role of viral infections in the natural history of asthma. J Allergy Clin Immunol. 2000;106:201-212. 2. Gern JE, Galagan DM, Jarjour NN, Dick EC, Busse WW. Detection of rhinovirus RNA in lower airway cells during experimentally induced infection. Am J Respir Crit Care Med. 1997;155:1159-1161. 3. Papadopoulos NG, Bates PJ, Bardin PG, et al. Rhinoviruses infect the lower airways. J Infect Dis. 2000;181:1875-1884. 4. Fraenkel DJ, Bardin PG, Sanderson G, Lampe F, Johnston SL, Holgate ST. Lower airways inflammation during rhinovirus colds in normal and in asthmatic subjects. Am J Respir Crit Care Med. 1995;151:879-886. 5. Jarjour NN, Gern JE, Kelly EAB, Swenson CA, Dick CR, Busse WW. The effect of an experimental rhinovirus 16 infection on bronchial lavage neutrophils. J Allergy Clin Immunol. 2000;105:1169-1177.

منابع لاتین: 18- Mckenzie : The protective effects of continuous and interval exercise in athletes with Exercise - induced asthma ; Med sci sport Exer , Aug , 26 (8) pp 951-6 (1994) 19- Emtner : High Intensity physical training in adults with asthmai chest , 109 , pp , 323 – 330 (1996) 20- Kats : Prevention with and without the use of medication for exercise - induced asthma : med,sci – sports Exercise . Vol: 18,NO :3 (2000) 21- Stdrms williamm : Can a regular exercise program improve your patients asthma ? journal of Respiratory diseases . June (2002) 22- Moore , Gollnick : Response of Ventilatory Muscles of the rate to endurance training pfluger arch (1982 ) 23- Robinson , E, P : Improvement in ventilatory muscle function with running . J.Apple physiol , 52 (1982 ) 24- Martin , B.J : ventilation endurance in Athletes and non- athletes : med,sci , sports exercise 13: 21 (1981) 25- Bender , P.R Maximal ventilation for exhausting exercise , med , sci , sports Exerc , 17 , pp: 164 (1985 ) 26- Patessi . A , : The role of exercise training in pulmonary rehabilition: European Respiratory Review , Vol , 5.Noi 25 febury (2002) 27- Mcardel William , frank katch , victor katch : Essentials of exercise physiology , William & wilins (2000) It is well established that certain viruses such as RSV and influenza virus infect the lower airways and cause tissue inflammation and lower airway obstruction.1 Studies have also reported the finding of RV in bronchoalveolar lavage specimens.2 It has also been shown that RVs can replicate at the higher temperatures of the lower airways, and in situ hybridization localized RV infection to the lower airways of human volunteers with experimentally induced nasal infection.3 Experimental infections with RVs have also provided evidence to support the association of RV infection and asthma exacerbations, which result from lower airway inflammation.1,4 Experimental RV infection increases lower airway inflammation, as indicated by increased submucosal lymphocytes and epithelial eosinophils in bronchial biopsy specimens,4 and increases the number of neutrophils in bronchial lavage fluid.5 1. Gern JE, Busse WW. The role of viral infections in the natural history of asthma. J Allergy Clin Immunol. 2000;106:201-212. 2. Gern JE, Galagan DM, Jarjour NN, Dick EC, Busse WW. Detection of rhinovirus RNA in lower airway cells during experimentally induced infection. Am J Respir Crit Care Med. 1997;155:1159-1161. 3. Papadopoulos NG, Bates PJ, Bardin PG, et al. Rhinoviruses infect the lower airways. J Infect Dis. 2000;181:1875-1884. 4. Fraenkel DJ, Bardin PG, Sanderson G, Lampe F, Johnston SL, Holgate ST. Lower airways inflammation during rhinovirus colds in normal and in asthmatic subjects. Am J Respir Crit Care Med. 1995;151:879-886. 5. Jarjour NN, Gern JE, Kelly EAB, Swenson CA, Dick CR, Busse WW. The effect of an experimental rhinovirus 16 infection on bronchial lavage neutrophils. J Allergy Clin Immunol. 2000;105:1169-1177.

مرداد 1385-دانشگاه شهید باهنر کرمان It is well established that certain viruses such as RSV and influenza virus infect the lower airways and cause tissue inflammation and lower airway obstruction.1 Studies have also reported the finding of RV in bronchoalveolar lavage specimens.2 It has also been shown that RVs can replicate at the higher temperatures of the lower airways, and in situ hybridization localized RV infection to the lower airways of human volunteers with experimentally induced nasal infection.3 Experimental infections with RVs have also provided evidence to support the association of RV infection and asthma exacerbations, which result from lower airway inflammation.1,4 Experimental RV infection increases lower airway inflammation, as indicated by increased submucosal lymphocytes and epithelial eosinophils in bronchial biopsy specimens,4 and increases the number of neutrophils in bronchial lavage fluid.5 1. Gern JE, Busse WW. The role of viral infections in the natural history of asthma. J Allergy Clin Immunol. 2000;106:201-212. 2. Gern JE, Galagan DM, Jarjour NN, Dick EC, Busse WW. Detection of rhinovirus RNA in lower airway cells during experimentally induced infection. Am J Respir Crit Care Med. 1997;155:1159-1161. 3. Papadopoulos NG, Bates PJ, Bardin PG, et al. Rhinoviruses infect the lower airways. J Infect Dis. 2000;181:1875-1884. 4. Fraenkel DJ, Bardin PG, Sanderson G, Lampe F, Johnston SL, Holgate ST. Lower airways inflammation during rhinovirus colds in normal and in asthmatic subjects. Am J Respir Crit Care Med. 1995;151:879-886. 5. Jarjour NN, Gern JE, Kelly EAB, Swenson CA, Dick CR, Busse WW. The effect of an experimental rhinovirus 16 infection on bronchial lavage neutrophils. J Allergy Clin Immunol. 2000;105:1169-1177. با تشکر از توجه شما مرداد 1385-دانشگاه شهید باهنر کرمان