High-intensity pulmonary rehab program improves outcomes in adults with asthma, obesity

Adults with asthma and obesity who participated in a short-term, high-intensity pulmonary rehabilitation program experienced sustained improvements in asthma outcomes, according to a study published in the European Respiratory Journal.

“This short-term pulmonary rehabilitation program resulted in a clinically relevant improvement of asthma control and marked improvements in body composition, aerobic capacity and lung function in a short period of 3 months,” Yasemin Türk, MD, with the department of pulmonology at Franciscus Gasthuis and Vlietland, Netherlands, and colleagues wrote. “The positive effects on asthma control, BMI, exercise capacity and physical activity persisted during the 12 months of follow-up.”

The researchers conducted a randomized controlled study that enrolled 34 patients with obesity (BMI 30 kg m²) and suboptimal controlled asthma. Patients were randomly assigned to undergo a 3-month pulmonary rehabilitation program (n = 14), pulmonary rehabilitation with an internet-based self-management support program (n = 9) or usual care (n = 11) including advice to exercise and lost weight.

The pulmonary rehabilitation program included high-intensity interval training, nutritional intervention and physiological group sessions.

Primary outcome was change in Asthma Control Questionnaire score between the pulmonary rehabilitation only and pulmonary rehabilitation plus internet-based self-management support after 3 months.

Patients in the pulmonary rehabilitation only group had a significant BMI reduction (–0.986; 95% CI, –1.7 to 0.273; P = .01) and significant improvements in asthma control, exercise capacity and aerobic capacity after 3 months compared with patients assigned usual care.

The patients assigned pulmonary rehabilitation with an internet-based self-management support program had significantly lower weight (–6.23; 95% CI, –11.3 to –1.12; P = .021) and BMI (–2.27; 95% CI, –4.2 to 0.35; P = .025) after 12 months compared with those assigned pulmonary rehabilitation only.

Researchers observed no differences in Asthma Control Questionnaire score between patients assigned pulmonary rehabilitation with an internet-based self-management support program (1.47; 95% CI, –0.4 to 1.74; P = .384) or pulmonary rehabilitation only (0.2; 95% CI, –0.33 to 0.84; P = .758).

Exacerbation rates were higher in the usual care group compared with the pulmonary rehabilitation only group (RR = 2.314; 95% CI, 1.12-4.77; P =.023). There was no significant difference in exacerbation rates between those assigned pulmonary rehabilitation with an internet-based self-management support program or pulmonary rehabilitation only (RR = 1.376; 95% CI, 0.44-4.25; P = .58).

“A short-term multidisciplinary pulmonary rehabilitation program with [high-intensity interval training] and the use of an internet-based self-management program is feasible and effective in both the short- and long-term,” the researchers wrote. “Such well-designed pulmonary rehabilitation programs should be considered in the treatment of obese asthmatics.”