Can physical exercise improve allergic rhinitis symptoms in adults? A systematic review of randomized controlled trials

This systematic review aimed to evaluate the effectiveness of structured physical exercise in reducing symptoms and improving clinical outcomes in adults with allergic rhinitis. Electronic databases including MEDLINE, CINAHL, Web of Science, and the Cochrane Library were systematically searched. This review included randomized controlled trials (RCTs) involving adults with clinically diagnosed allergic rhinitis or objective evidence of allergic sensitization. The quality of the included articles was appraised by the Risk of Bias 2 Tool. Searches were conducted from database inception to 4 March 2026. The protocol was registered in PROSPERO (CRD420261283259). A total of 3,811 records were identified, with seven RCTs involving 395 participants included in the review. Exercise interventions were generally associated with improvements in allergic rhinitis symptoms, nasal function, and inflammatory biomarkers. Pooled data from two studies demonstrated a significant improvement in peak nasal inspiratory flow favouring exercise interventions over control (SMD 0.99, 95% CI 0.41 to 1.56; p < 0.01; I² = 0%). This systematic review summarized the available RCTs showing that exercise may improve allergic rhinitis symptoms and clinical indicators. However, the current evidence remains limited by small sample sizes and heterogeneity across studies, and the findings should be interpreted with caution.