10 September 2012

Exercise may improve asthma symptoms

Asthma patients may not have to shun exercise for fear of exacerbating their symptoms, a new study suggests.


Asthma patients may not have to shun exercise for fear of exacerbating their symptoms, a new study suggests. In fact, exercise could improve their symptoms and quality of life, according to research reported at the European Respiratory Society's annual conference in Vienna, Austria.

With attention to self management, increased physical activity did not worsen asthma control and in most cases was associated with improvement, said Dr Carol Mancuso and her team at the Hospital for Special Surgery in New York City, in a presentation at the conference.

How the study was done

The researchers randomised 256 patients to two different exercise regimens for a 12-month period. A control group completed a survey measuring energy expenditure, promised to increase physical activity, received a pedometer and an asthma workbook, and then received bimonthly follow-up phone calls. Intervention patients received this protocol plus small gifts and instructions in fostering positive affect and self-affirmation.

"Participants chose the physical activity they wished - there was no set protocol," Dr Mancuso said. ”The purpose of the study was to foster adoption of lifestyle activities, that is, activities participations (they) could incorporate into their daily routines, and thus have a greater chance of being maintained over a lifetime."

The role of physical activity

"The ability to choose the physical activity probably played a role in maintaining asthma control," she said.

The main outcome of the study - the within-patient change in energy expenditure in kilojoule per week - was reported earlier this year in Archives of Internal Medicine. In fact, both groups of patients showed similar increases in physical activity, so for purposes of the current analysis, the researchers pooled the results from both groups.

At baseline, 38% of the patients reported well-controlled asthma on the Asthma Control Questionnaire. After one year of increased exercise, the number had jumped to 60%.Patients' scores on the Asthma Quality of Life Questionnaire also increased from an average of 5 at baseline to 5.9 by year's end on the seven-point scale.

On mixed effects modeling, variables linked to quality-of-life improvements included male gender, improvement in asthma symptoms, reduction in medications, less depression, and increased physical activity.

Benefits of exercise

It is not clear how much the patients actually increased their physical activity, but the fact that exercise might improve asthma is impressive, said Dr Simon Bacon, an exercise science and asthma specialist at Concordia University in Montreal, Quebec, who was not involved in the study.

"There is a dearth of data in the field, especially using non-supervised exercise programs and clinically relevant asthma measures," Dr Bacon told Reuters Health by email. "However, some caution is needed as there was no control group and the asthma measures used are very subjective, so how much of the effect is purely placebo is unclear to me."

As for a take-home message, Dr Mancuso said, "My recommendations to physicians and patients are that prudently selected increases in physical activity and exercise are very possible for asthma patients. Both should keep in mind that the alternative of a sedentary lifestyle carries many detrimental risks and that for most patients’ asthma should not be a reason to incur these risks over a lifetime."

(Reuters Health, Rob Goodier, September 2012)

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