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Management of Asthma at School: Physical Education

Last updated on November 21st, 2021

Guidelines for Sports for Students with Asthma

1. The student should use pre-exercise medication if exercise regularly causes asthma. An inhaled bronchodilator should be taken10-30 minutes before significant exercise. If cromoglycate or nedocromil is used, this should be taken at this time also.

2. If a student has obvious wheeze or breathing difficulty in spite of premedication, exercise will be hazardous and should be avoided. A recent cold or sore throat or a recent asthma attack increases the risk of exercise induced asthma.

3. Warm-up prior to vigorous activity should be progressive, for example walking and other low level activities, and flexibility exercises. Students should then run rapidly on the spot for 30 seconds, followed by a 60 second rest. Repeat 2 or 3 times. Subsequent exercise should then be less wheeze provoking than usual.

4. Following an initial warm-up, a work load should be chosen that can be tolerated for 10-15 minutes. This could be swimming, running or games depending on the nature of the physical education lesson. With improved tolerance to exercise the stress should be gradually increased and pro-longed to approximately 60 minutes or the length of the lesson. Interval training consisting of short periods of exercise for five to seven minutes, as in gymnastics or games for example, with intervening periods of relaxation or rest (but without complete recovery) is usually preferred to endurance training.

5. Exercising in cold temperatures can be a significant trigger for asthma. Exercise in a warm, humid climate, e.g. swimming is preferred to running outdoors in winter.

6. Students should exercise for as long as the rest of the class, or until coughing, wheezing or chest tightness develops, which may range from a few minutes to the full lesson.

7. The frequency of exercise should be the same as for the rest of the class.

8. The intensity of exercise should start at a low level and gradually increase to develop exercise tolerance. This will vary greatly among students with asthma, and from day to day in the same student.

9. Should a student become wheezy during exercise and develop asthma, stop the activity and treat if necessary with a bronchodilator (reliever) inhaler.

10. Warm down. Avoid stopping exercise abruptly. Follow the usual “warm down” procedure.


Physical Education Programs for Students with Asthma

Physical exertion should be ENJOYABLE! A student should not be discouraged because an activity may induce asthma. However, this should not be forced, if the student knows that some distress is likely to occur. Certain physical activities are more suitable than others.

Fitness activities.

Intermittent high anaerobic activity is preferred to sustained long duration aerobic activity. Circuit training is suitable but prolonged aerobicd activity is less appropriate. Exercycles, rebounders or other similar equipment for students with asthma are preferable to exercising outdoors in cold temperatures. Cold induces asthma.


Swimming is very good exercise for everyone, including students with asthma. Research shows that warm, moist conditions lessen the degree of exercise induced asthma occurring. Warm-ups are needed both out of the pool and in. Students with severe asthma may be able to build up aerobic fitness through swimming and progress to other activities previously beyond them. However, avoid having students with asthma swim in cold pools, especially in cold air temperatures. Some students with asthma may be affected by treated swimming pools.

Aquatic team activities such as water polo and relay races provide fun peer interaction between students with asthma and others. Snorkeling is acceptable for students with asthma, but because of pressure changes scuba diving is potentially very hazardous and should NOT be undertaken, even when well. Breath holding activities such as retrieving objects at the bottom of a pool should also be avoided.


Athletic activities that are intermittent and related to interval training are less likely to produce asthma than prolonged activity such as distance running. Cross country running can be made easier by alternately walking and running.

Ball activities.

These are appropriate because of their intermittent nature and provide good social interaction. As with all students, emphasis should be placed in physical education on skill development leading into modified games.

Gymnastics include trampolining.

These are most suitable because they may provide opportunity for extensive anaerobic exercise and social interaction with peers.

Movement and Dance.

Care is needed as some dance sequences are vigorous and prolonged. However, movement and dance provide extensive potential for a student to build security through expression, both individually and within a group.

Education outside the classroom.

Aquatic sports such as canoeing, sailing, rafting and cycling are stimulating activities for all students including those with asthma. A wealth of opportunities exists for the student with asthma to develop physical and social skills. Almost all of these outside activities can be modified to involve them. Always ensure that a bronchodilator inhaler is available with all activities outside the classroom.

Many other activities are suitable – the important point is that the student with asthma must feel comfortable with the activity. Students with asthma should also be taught to recognize and apply relaxation techniques – physical, mental and emotional.

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