A comparison of daily physical activity profiles between adults with severe asthma and healthy controls

Neale, Jill; Orme, Mark; Majd, Sally; Chantrell, Stacey; Singh, Sally; Bradding, Peter; Green, Ruth H.; Evans, Rachael A.

doi:10.1183/13993003.02219-2019

Cited by 19 publications

(20 citation statements)

References 11 publications

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“…This stimulates preosteoclast transformation into mature osteoclasts, which causes osteopenia and osteoporosis, as well as increase the fracture risk [25]. Fourth, adults with asthma are less physically active compared with healthy individuals [26,27] given that exercise and physical activities can trigger bronchoconstriction, which causes exertional dyspnea and other respiratory symptoms. Physical activity is an important factor for bone loss and osteoporosis prevention throughout an individual's life [28].…”

Section: Discussionmentioning

confidence: 99%

The association of asthma and its subgroups with osteoporosis: a cross-sectional study using KoGES HEXA data

Wee

Min

Park

et al. 2020

Allergy Asthma Clin Immunol

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Background A few studies have reported the association between asthma and osteoporosis. We aimed to analyze the association of asthma and its subgroups with osteoporosis in the Korean adult population. Methods We used the health examinee (HEXA) data from the Korean Genome and Epidemiology Study (KoGES) obtained between 2004 and 2016. We included 162,579 participants (n = 3,160 with asthma; n = 159,419 controls) who reported their previous histories of asthma and osteoporosis. The participants were categorized into 3 groups based on asthma management: participants who did not need further treatment due to controlled symptoms (well controlled); participants with ongoing treatment (being treated); participants who were not treated even though they had symptoms (not being treated). Multiple logistic regression analyses were used to calculate the adjusted odds ratios (aORs) with 95% confidence intervals (CIs) for osteoporosis. Subgroup analyses for age and sex were conducted. Results The prevalence of osteoporosis was higher in patients with asthma (13.6%) than in controls (6.8%). In the full-adjusted model, the aORs for osteoporosis were 1.74 (95% CI 1.55–1.94, P < 0.001) in patients with asthma compared to controls. There were consistent findings across the age and sex subgroups. The aORs for osteoporosis were 1.43 (95% CI 1.10–1.86, P = 0.008) in the well-controlled asthma group; 1.55 (95% CI 1.28–1.89, P < 0.001) in the being treated asthma group; and 1.96 (95% CI 1.66–2.31, P < 0.001) in the not being treated asthma group compared to the control group. Conclusion Asthma was associated with osteoporosis in the Korean adult population. Patients with asthma not being treated showed the highest ORs for osteoporosis.

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Section: Discussionmentioning

confidence: 99%

The association of asthma and its subgroups with osteoporosis: a cross-sectional study using KoGES HEXA data

Wee

Min

Park

et al. 2020

Allergy Asthma Clin Immunol

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“…The reduced step count completed by severe asthmatics versus healthy controls was associated with a worse HRQoL, as measured by EuroQoL, Chronic Respiratory Questionnaire, and Asthma QoL Questionnaire [24] Both total time in MVPA and time spent doing sustained bouts of MVPA was positively associated with HRQoL measures [24] Content validity…”

Section: Correlation To Hrqolmentioning

confidence: 99%

“… Most common endpoint used to assess physical activity in patients with asthma  Good indicator of day to day activity in healthy subjects, however pure step count cannot indicate relative effort required to complete steps in subjects with respiratory diseases  Subject to seasonal variation and potentially skewed by occupation [12]  Captures moderate-to-intense activities. Useful endpoint to capture as asthmatics intuitively avoid intense exercise to avoid exercise induced bronchoconstriction [36]  Patients' long-term habits may prevent an improvement in MVPA despite efficacious treatment  Substantial variability in results between subjects and between studies: with averages ranging between 22.3 minutes per day to 125 minutes per day for severe asthmatics [8,22,24]…”

Section: Assessing Physical Activity In Patients With Asthmamentioning

confidence: 99%

“…Conversely, step count can be viewed as a crude representation of physical activity which is impacted by occupation and does not at first glance reflect patient experience. However, recent evidence may suggest otherwise; in 2020, N eale and colleagues [ 24 ] showed that step count in patients with asthma is inversely correlated with HRQoL.…”

Section: Assessing Physical Activity In Patients With Asthmamentioning

confidence: 99%

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Physical activity end-points in trials of chronic respiratory diseases: summary of evidence

et al. 2022

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BackgroundPhysical activity (PA) contributes to improving respiratory symptoms. However, validated endpoints are few and there is limited consensus about what is a clinically meaningful improvement for patients. This review summarises the evidence to date on the range of PA endpoints used in chronic obstructive pulmonary disease (COPD), asthma and idiopathic pulmonary fibrosis (IPF) whilst evaluating their appropriateness as endpoints in trials and their relation to patients’ everyday life.MethodsTrials reporting PA endpoints were collected using Citeline's database Trialtrove; this was supplemented by searches in PubMed.ResultsThe daily-patient-reported outcome (PRO)active and clinical visit-PROactive physical activity (D-PPAC & C-PPAC) composite endpoints appeared superior at capturing the full experience of PA in patients with COPD and were responsive to bronchodilator intervention. Time spent in moderate-to-vigorous PA is a recently validated endpoint for IPF that correlates with exercise capacity and quality of life. Step count (SC) appears the best available PA measure for asthma which consistently declines with worse disease status. However, evidence suggests a time lag before significant improvement in SC is seen which may reflect the impact of human behaviour on PA.ConclusionsPA represents a challenging domain to accurately measure. This is the first review evaluating PA measures used specifically within the respiratory field. Whilst PA can be effectively captured using PROactive in patients with COPD, this review highlights the unmet need for novel patient-focused endpoints in asthma and IPF which would offer opportunities to develop efficacious medicines with impact on patients’ therapeutic care and quality of life.

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“…This highlights the potential benefit of using smartphone technology in patients recognised to avoid moderate to vigorous intensity physical activity (e.g. people with airways disease) [28] or in cohorts with impaired mobility (i.e. elderly individuals +/-those with underlying musculoskeletal disorders) [29].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Smartphone pedometers in adults with asthma: a practical approach to physical activity assessment? A pilot validation study

Reilly

Stavropoulos‐Kalinoglou

Clifton

et al. 2021

Journal of Asthma

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The aim of this pilot validation study was to determine the accuracy of a smartphone (iPhone®) pedometer in adults with and without asthma. Methods: Ten adults with asthma and ten healthy controls underwent clinical assessment prior to completing two separate trials. Phase 1.standardised treadmill and self-paced walking tests. Total steps were recorded via: (i) Yamax Digiwalker™ SW800 pedometer positioned on the waistband, (ii) iPhone® pedometer positioned on the upper body, (iii) iPhone® pedometer positioned on the lower body and evaluated against a videoverified manual step-count. Phase 2. step-count was evaluated over seven-days during habitual freeliving conditions via Yamax Digiwalker™ SW800 and iPhone® pedometers. Results: During treadmill walking, the iPhone® positioned on the lower body correlated strongly (r = 0.96) and produced the highest level of agreement (mean bias: -11 steps, LOA: -43 to 21 steps) in comparison to videoverified manual step-count. During self-paced walking, all devices provided an excellent step-count estimate. During free-living conditions, no difference was observed between the Yamax Digiwalker™ SW800 pedometer and iPhone® (P = 0.10) and a strong correlation (r = 0.94) and acceptable agreement (mean bias: -343, LOA: -1963 to 1276 steps) was observed. Conclusion: Our findings indicate that an in-built iPhone® pedometer offers a practical approach to physical activity assessment in adults with and without asthma. Future research is now required to further validate the precision of this approach and evaluate the efficacy and effectiveness of smartphone pedometers to monitor and promote physical activity when employed during medical consultation and/or clinical research trials.

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A comparison of daily physical activity profiles between adults with severe asthma and healthy controls

Cited by 19 publications

References 11 publications

The association of asthma and its subgroups with osteoporosis: a cross-sectional study using KoGES HEXA data

The association of asthma and its subgroups with osteoporosis: a cross-sectional study using KoGES HEXA data

Physical activity end-points in trials of chronic respiratory diseases: summary of evidence

Smartphone pedometers in adults with asthma: a practical approach to physical activity assessment? A pilot validation study

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