Objective:

To evaluate the effects of physical activity on pulmonary function and quality of life in patients with asthma across a broad age range and multiple exercise modalities, including structured interventions.

Key Findings:

• Twenty-two RCTs (n = 1,280) were included. Physical activity significantly improved FEV1% predicted (MD = 5.79, 95% CI: 1.89–9.69; I2 = 89.16%).
• Improvements were also noted in PEF (L/s) (MD = 0.47, 95% CI: 0.08–0.85) and FVC (L) (MD = 0.55, 95% CI: 0.25–0.84).
• Quality of life as measured by PAQLQ improved (MD = 1.13, 95% CI: 0.45–1.81).
• No significant moderators identified for FEV1% predicted or FVC% predicted.
• Certainty of evidence was low for FEV1% predicted and very low for other outcomes, impacting the reliability of findings.

Interpretation:

Physical activity is associated with improved lung function and quality of life in asthma patients; however, the overall certainty of evidence is low due to risk of bias and heterogeneity, which limits the applicability of these findings.

Limitations:

• Risk of bias and heterogeneity in included studies may affect the reliability of results.
• Inconsistent operationalization of pulmonary function outcomes complicates comparisons.
• Low certainty of evidence for several outcomes necessitates cautious interpretation.

Conclusion:

The systematic discordance between predicted-value and absolute-unit scales across pulmonary function outcomes underscores the urgent need for standardized outcome reporting in future trials to enhance comparability and reliability.