A Behavior Change Intervention Aimed at Increasing Physical Activity Improves Clinical Control in Adults With Asthma

The Management of Extrapulmonary Comorbidities and Treatable Traits; Obesity, Physical Inactivity, Anxiety, and Depression, in Adults With Asthma

“…Physical inactivity is also a well-known risk factor for obesity, which has also been shown to negatively impact asthma outcomes (25). Conversely, higher levels of physical activity in asthma have been associated with better asthma control, lung function and exercise capacity and decreased markers of systemic inflammation (15,18,26). In one study, compared to individuals with asthma who were inactive (defined as an energy expenditure <1.5 kcal/kg body weight (BW) per day) or moderately active (1.5 kcal/kg BW per day), individuals with asthma who were active (>3.0 kcal/kg BW per day), were reported to have greater overall health, less mental health impairments, fewer activity limitations and better perceived mental health (27).…”

More Movement for Better Control

“…There is likely to be a complex interplay of biological mechanisms underpinning asthma control, but the growing interest in research to evaluate the effects of exercise on the immune system may play an important role in defining the disease-modifying potential of physical activity. 12 Further studies across the range of clinical phenotypes and endotypes of asthma will help to clarify whether the impact of physical activity interventions on clinical control is mediated by direct and/or indirect (eg, via weight loss) effects on immune pathways, or occur via changes in other outcomes such as sleep quality and anxiety as observed by Freitas et al 5 In summary, the study by Freitas et al 5 provides important new evidence that a multicomponent behavior change intervention targeted at increasing physical activity can lead to short-term improvements in asthma control. Given its potential for wide clinical implementation, the importance of enhancing physical activity deserves further recognition in asthma treatment pathways.…”

“…The assessor-blinded randomized controlled trial by Freitas et al 5 in this issue of CHEST tested a behavior change intervention aimed at improving physical activity in adults with asthma who were physically inactive. The 8-week intervention comprised a weekly 40-min face-to-face counseling session, supported by a workbook and a commercially available activity monitor.…”

“…9 Despite optimal pharmacologic treatment, many adults with asthma continue to be burdened with frequent exacerbations and high health-care use. 10 All but one of the participants in the study by Freitas et al 5 were prescribed inhaled corticosteroids (average daily dose, approximately 1,900 mg) and long-acting b-agonists.…”

“…This goes some way in helping to understand the potential mechanisms underpinning the change in asthma control. The authors of the current trial 5 have previously reported the relationships between improvements in asthma control and both weight loss and reduction in (airway and systemic) inflammation achieved through exercise training. 11 The current study did not measure any inflammatory biomarkers but did report a reduction in body weight, albeit of a smaller magnitude than their previous exercise training study.…”