Despite the uneasiness many people with asthma may feel about putting their lungs through the paces, they can and should exercise regularly, agree most experts. Although physical activity won't "cure or necessarily improve" asthma, reports the American College of Allergy, Asthma and Immunology (ACAAI), it can help patients feel better physically and psychologically.

Most of the nearly 22 million U.S. adults with asthma experience symptoms -- including chest tightness, wheezing, coughing, chest pain and shortness of breath -- from strenuous exercise, according to the American Academy of Allergy, Asthma and Immunology (AAAAI). People with asthma should check with their doctors before beginning an exercise program. Taking preventive measures, such as pre-exercise medications and warm-up and cool-down exercises, can avert asthma attacks, advise both groups.

Here are some other tips adapted from the Web sites of the ACAAI and the AAAAI:

* Choose an asthma-friendly activity. People with asthma generally tolerate activities like swimming, walking, cycling and hiking better than exercises that involve prolonged periods of running. Stop-and-go activities -- such as wrestling, golfing, gymnastics and softball -- usually cause fewer symptoms than sports that involve continuous exercise, such as soccer, field hockey, basketball and long-distance running.

* Pre-medicate as needed. Many people with asthma take an inhaled drug, such as albuterol, pirbuterol or terbutaline, about 15 minutes before exercise. It's also a good idea to keep these medications nearby in case of an attack. Consult with your doctor about what's appropriate for you.

* Breathe through your nose. People with asthma tend to breathe rapidly through their mouths during exercise, bringing cool, dry air -- which can trigger asthma attacks -- directly into the bronchial tubes. The nose has a natural humidifying and filtering process that moderates temperature and humidity while filtering out pollutants, allergens and irritants.

Try to make sure your nose and sinuses are clear; people with allergic asthma should consider taking antihistamines, decongestants, nasal steroid sprays or other medications that might help keep the airways open. (Many such drugs require prescriptions.)

* Pick a good venue. If you have allergies, avoid vigorous exercise around pollen, mold, grass or trees. Car exhaust can be a problem, too. If exercising on carpet, use a mat.

* Limit exercise when symptoms are severe.

* Watch for danger signals. Symptoms that start after less than six to eight minutes of hard exercise or during or after very mild exercise may indicate uncontrolled asthma. Delayed reactions can also occur up to several hours after exercise. If reactions occur, medication to open bronchial tubes may be needed. If you can't control your symptoms this way, consider talking with your doctor about a daily maintenance medication.


* ACAAI:; search for "exercise."

* AAAAI:; search for "exercise."

* American College of Sports Medicine:; scroll down and select "exercise-induced asthma."

* American Thoracic Society:; search for "guidelines for adults with asthma."

-- January W. Payne