Physical activity, physical capacity and sedentary behavior among asthma patients

Abstract

BACKGROUND : Although exercise and daily physical activity (PA) have long been known to benefit patients with chronic disorders, knowledge is limited regarding asthma. OBJECTIVE : In a Danish setting, our aim was to measure physical activity, sedentary behavior, and physical capacity among patients with asthma. We hypothesized that people with severe asthma would be less active and more sedentary than their mild-moderate counterparts. METHODS : Adults with asthma were recruited through respiratory outpatient clinics and subsequently examined twice, 4 weeks apart. At each visit, participants underwent a series of lung function tests, questionnaires, and maximum oxygen uptake testing (VO 2 max). Between the visits, participants wore an accelerometer continuously for 4 weeks, measuring sedentary time and daily steps. Sixty patients, 27 with mild-moderate asthma (GINA 1–3) and 33 with severe asthma (GINA 4–5), completed both visits and had valid accelerometer measurements. RESULTS : No significant differences between the two groups were found in sedentary time, number of steps or VO 2 max. VO 2 max was significantly correlated with FeNO (r = −0.30, p < 0.05), Short Form-12 Mental Health (r = 0.37, p < 0.05), Asthma Control Questionnaire (r = −0.35, p < 0.05), and Mini Asthma Quality of Life Questionnaire (r = 0.36, p < 0.05). CONCLUSION : No differences were observed between patients with mild-moderate and severe asthma regarding sedentary behavior, daily steps or level of cardiopulmonary fitness. Furthermore, patients with the highest VO 2 max had the higher quality of life scores. Abbreviations : VO 2 max: Maximal Oxygen Uptake; CPET: Cardiopulmonary Exercise Testing; BMI: Body Mass Index; FEV1: Forced Expired Volume in the First Second; FVC: Forced Vital Capacity; PEF: Peak Expiratory Flow; EIB: Exercise-Induced Bronchoconstriction; COPD: Chronic Obstructive Pulmonary Disease; ACQ: Asthma Control Questionnaire; Mini-AQLQ: Mini Asthma Quality of Life Questionnaire; SF-12: Short Form 12 Health Survey; SNOT-22: Sino-Nasal Outcome Test 22; GINA: The Global Initiative for Asthma; CRP: C-reactive Protein; Hgb:Hemoglobin count; EOS: Eosinophil count; EVH: Eucapnic Voluntary Hyperventilation; FeNO: Fractional Exhaled Nitric Oxide; PA: Physical Activity ERS: European Respiratory Society; ATS: American Thoracic Society; CRS: Chronic Rhinosinusitis; AHR: Airway Hyperresponsiveness

Key Considerations When Addressing Physical Inactivity and Sedentary Behaviour in People with Asthma

“…A total of 17 studies explored correlates (k = 13) [ 19 , 39 , 40 , 42 , 43 , 44 , 45 , 46 , 47 , 49 , 51 , 52 , 53 ] or determinants (k = 6) [ 22 , 41 , 43 , 46 , 47 , 48 , 50 ] of physical activity or sedentary behaviour; most (82%) were of cross-sectional design ( Table 2 ). Of the 17 studies, 10 (59%) assessed physical activity or sedentary behaviour with pedometers or accelerometer devices ( Table 2 ).…”

“…Two studies [ 51 , 53 ] reported correlations between health-related variables and sedentary behaviour, and no study sought to identify sedentary behaviour determinants. Both of the abovementioned studies reported correlations between sedentary behaviour and asthma control, pulmonary function, eosinophilic inflammation, airway inflammation or QoL [ 51 , 53 ]. Ricketts et al [ 53 ] reported correlations between sedentary behaviour and exercise capacity, dyspnoea, body mass, psychological health, and medication usage.…”

“…Only one of four studies found a statistically significant correlation between physical activity and QoL [ 53 ]. Studies that assessed the correlation between physical activity and eosinophils [ 22 , 48 , 51 , 53 ], Immunoglobulin E (IgE) [ 51 ], and markers of oxidative stress [ 45 ] did not find statistically significant results. However, associations with physical activity were found for high-sensitivity C-reactive protein (r 2 = 0.15) [ 22 , 48 ] and fractional concentration of exhaled nitric oxide (FeNo) (r = −0.37, p = 0.005) [ 53 ].…”

Exercise and asthma – trigger or treatment?

“…However, no association was observed between VO 2peak and pulmonary function. In adults with mild-to-moderate and severe asthma, Hansen et al [17] observed comparable fitness (39.3 ± 1.5 ml kg − 1 min − 1 and 36.7 ± 1.3 ml kg − 1 min − 1 , respectively). However, significant associations were observed between VO 2 max , body mass index (BMI), airway inflammation and asthma control.…”

“…Since 2020, six observational studies have evaluated functional and/ or exercise capacity in people with asthma [12][13][14][15][16][17] (Table 1). Gianfrancesco et al [12] assessed functional capacity via the 6-min walk test and Glittre ADL-test (TGlittre) in a large cohort of children and adolescents (aged 7-17 years).…”