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Xu C, Jia J, Zhao B, Yuan M, Luo N, Zhang F, Wang H. Objectively measured daily steps and health outcomes: an umbrella review of the systematic review and meta-analysis of observational studies. BMJ Open 2024; 14:e088524. [PMID: 39384238 PMCID: PMC11474941 DOI: 10.1136/bmjopen-2024-088524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 09/25/2024] [Indexed: 10/11/2024] Open
Abstract
OBJECTIVES The purpose of this review is to summarise the evidence from a systematic review and meta-analysis of observational studies that objectively measure daily steps and health outcomes. DESIGN This is an umbrella review. DATA SOURCES PubMed, Embase, Scopus, the Cochrane Library and Web of Science databases were searched through 31 January 2024. ELIGIBILITY We included systematic reviews of observational studies (with or without meta-analysis) that assessed the association of objectively measured daily steps with human health-related outcomes. Methodological quality was assessed using 'A MeaSurement Tool to Assess systematic Reviews 2'. RESULTS A total of 10 systematic reviews and 6 health outcomes were included after excluding irrelevant and duplicate studies. Higher daily steps were associated with more benefits than harms for a range of health-related outcomes, including all-cause mortality, cardiovascular event, skeletal muscle lesions, metabolic diseases and respiratory disease. A dose-response analysis showed that an increase of 500-1000 steps per day was associated with lower all-cause mortality and cardiovascular events. Beneficial associations were also found in patients with asthma and acutely hospitalised older adults. Conversely, one study within a systematic review suggested that higher daily steps (≥10 000) might be associated with an increased 52% risk of meniscal pathologies in individuals without knee osteoarthritis. However, one study within a systematic review suggested a potential increased risk of meniscal pathologies in individuals without knee osteoarthritis. Specifically, those exceeding 10 000 steps per day showed a 52% increase in risk. CONCLUSION The results of this study suggest that daily steps are associated with a lower risk of all-cause mortality and cardiovascular events. Future research could focus on identifying specific populations that may benefit most from increased daily steps and exploring potential mechanisms to enhance our understanding of how daily steps contribute to improved health outcomes. PROSPERO REGISTRATION NUMBER CRD42022347055.
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Affiliation(s)
- Chunlan Xu
- Department of Nursing, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jinli Jia
- Department of Nursing, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Binbin Zhao
- Department of Nursing, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Man Yuan
- Department of Nursing, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Nan Luo
- Department of Nursing, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fan Zhang
- Department of Nephrology A, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui Wang
- Department of Nursing, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Valkenborghs SR, Wood LG, Callister R, Upham JW, Grainge CL, Anderson S, Williams LM, McLoughlin RF, Williams EJ, Scott HA. Effects of Moderate- Versus Vigorous-Intensity Exercise Training on Asthma Outcomes in Adults. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:2744-2753.e8. [PMID: 38901614 DOI: 10.1016/j.jaip.2024.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 05/20/2024] [Accepted: 06/09/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND The therapeutic effects of exercise have prompted calls for it to be embedded into standard asthma care, but evidence informing the optimal exercise intensity is lacking. OBJECTIVE This study aimed to compare the effects of moderate- and vigorous-intensity aerobic exercise training on asthma outcomes and inflammation. METHODS This was a 12-week randomized controlled trial in 46 adults with asthma randomized to either (1) 45-minute moderate-intensity exercise training 3 times/wk, (2) 30-minute vigorous-intensity exercise training 3 times/wk, or (3) the control group. Asthma-related quality of life (AQLQ), asthma control (ACQ), cardiorespiratory fitness, body composition, and airway and systemic inflammation were assessed before and after the intervention. RESULTS Forty-one participants completed the study (89% retention). The moderate-intensity group had a statistically and clinically significant improvement in AQLQ (0.63 [0.33-0.93], P < .001) and ACQ (-0.51 [-0.83 to -0.19], P = .003) relative to control. The vigorous-intensity group had a statistically, but not clinically, significant improvement in AQLQ (0.46 [0.14-0.80], P = .007) and ACQ (-0.36 [-0.69 to -0.02], P = .040) relative to control. After moderate-intensity training, there was a reduction in sputum macrophage (-1341 [-2491 to -191] × 104/mL, P = .024) and lymphocyte (-114 [-220 to -8] × 104/mL, P = .036) counts relative to control. A reduction in android fat mass, but not a change in fitness, was associated with improved AQLQ (rs = -0.341, P = .030) and reduced sputum IL-6 (rs = 0.422, P = .013). CONCLUSIONS Our findings suggest that both moderate-intensity and vigorous-intensity aerobic exercise training are associated with improvements in clinical asthma outcomes and, therefore, both intensities could be recommended as an adjuvant asthma therapy.
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Affiliation(s)
- Sarah R Valkenborghs
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia; Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Lisa G Wood
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia; Immune Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Robin Callister
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia; Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - John W Upham
- Translational Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Christopher L Grainge
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| | - Sophie Anderson
- School of Environmental and Life Sciences, The University of Newcastle, Ourimbah, NSW, Australia
| | - Lily M Williams
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia; Immune Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Rebecca F McLoughlin
- School of Nursing and Midwifery, The University of Newcastle, Callaghan, NSW, Australia; Asthma and Breathing Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia; National Health and Medical Research Council, Centre of Excellence in Treatable Traits, New Lambton Heights, NSW, Australia
| | - Evan J Williams
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia; Immune Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Hayley A Scott
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia; Immune Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
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Maden T, Polat H, Cengiz EK, Kahraman T. Validity and reliability of the Six-Minute Pegboard Ring Test for assessing functional capacity and upper limb function in persons with multiple sclerosis. Mult Scler Relat Disord 2024; 90:105836. [PMID: 39197349 DOI: 10.1016/j.msard.2024.105836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 07/24/2024] [Accepted: 08/19/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND The timed walk test is essential for assessing the functional capacity of persons with multiple sclerosis (MS). When a decline in ambulation ability and loss of function in the later stages of MS is observed, it is imperative to utilize alternative methods for measuring functional capacity. OBJECTIVE To investigate the validity and reliability of the Six-Minute Pegboard Ring Test (6PBRT) in persons with MS. METHODS Forty-three persons with MS were included in this study. Disease severity was quantified using the Expanded Disability Status Scale (EDSS). The 6PBRT was employed to assess upper extremity function during exercise stress, and vital signs were monitored pre- and post-test. Muscle strength was measured using a digital dynamometer for shoulder flexor, shoulder abductor, and grip strength, in addition to a hand dynamometer. Manual dexterity was evaluated through the 9-Hole Peg Test (9HPT), and walking endurance was assessed using the 2-Minute Walk Test (2MWT). Test-retest reliability was computed using the intraclass correlation coefficient (ICC). RESULTS The ICC value for the 6PBRT was 0.96 (95% CI 0.92-0.97), indicating excellent test-retest reliability. Significant differences in vital signs were observed before and after conducting the 6PBRT (p < 0.05). A strong negative correlation was found between the 6PBRT score and EDSS (r = -0.650, p < 0.001). The 9HPT of the dominant side demonstrated a moderate correlation with the 6PBRT score (r = -0.502, p = 0.001), whereas no significant correlation was shown between the non-dominant side 9HPT and the 6PBRT score (p > 0.05). Moreover, a positive moderate correlation was shown between the performance on the 2MWT and the 6PBRT score (r = 0.413, p = 0.006). However, no significant correlation was detected between the proximal muscle strength of the upper extremity, handgrip strength, and the 6PBRT score in individuals with multiple sclerosis (p > 0.05). CONCLUSION The 6PBRT is a reliable and valid tool to evaluate upper extremity function and exercise capacity in persons with MS.
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Affiliation(s)
- Tuba Maden
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gaziantep University, Gaziantep, Turkey.
| | - Hakan Polat
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, SANKO University, Gaziantep, Turkey.
| | | | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Turkey.
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Drummond D, Mazenq J, Lezmi G, Cros P, Coutier L, Desse B, Divaret-Chauveau A, Dubus JC, Girodet PO, Kiefer S, Llerena C, Pouessel G, Troussier F, Werner A, Schweitzer C, Lejeune S, Giovannini-Chami L. [Therapeutic management and adjustment of long-term treatment]. Rev Mal Respir 2024; 41 Suppl 1:e35-e54. [PMID: 39181752 DOI: 10.1016/j.rmr.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Affiliation(s)
- D Drummond
- Service de pneumologie et d'allergologie pédiatrique, hôpital Necker, AP-HP, université Paris Cité, Paris, France
| | - J Mazenq
- Service de pneumologie pédiatrique, hôpital la Timone, AP-HM, université Aix-Marseille, Marseille, France
| | - G Lezmi
- Service de pneumologie et d'allergologie pédiatrique, hôpital Necker, AP-HP, université Paris Cité, Paris, France
| | - P Cros
- Service de pédiatrie, CHU Morvan, Brest, France
| | - L Coutier
- Unité Inserm U1028, CNRS, UMR 5292, université de Lyon 1, Lyon, France; Service de pneumologie pédiatrique, hospices civils de Lyon, hôpital Femme-Mère-Enfant, Bron, France
| | - B Desse
- Service de pédiatrie-néonatalogie, CH de Grasse, Grasse, France
| | - A Divaret-Chauveau
- Service de médecine infantile et explorations fonctionnelles pédiatriques, DeVAH EA 3450, hôpital d'enfants, faculté de médecine de Nancy, CHRU de Nancy, université de Lorraine, Vandœuvre-Lès-Nancy, France
| | - J-C Dubus
- Service de pneumologie pédiatrique, hôpital la Timone, AP-HM, université Aix-Marseille, Marseille, France
| | - P-O Girodet
- CIC1401, service de pharmacologie médicale, CHU de Bordeaux, université de Bordeaux, Bordeaux, France
| | - S Kiefer
- Service de médecine infantile et explorations fonctionnelles pédiatriques, DeVAH EA 3450, hôpital d'enfants, faculté de médecine de Nancy, CHRU de Nancy, université de Lorraine, Vandœuvre-Lès-Nancy, France
| | - C Llerena
- UTEP 38, hôpital Couple-Enfant, CHU de Grenoble Alpes, Grenoble, France
| | - G Pouessel
- ULR 2694 : METRICS, université de Lille, Lille, France; Service de pédiatrie, CH de Roubaix, Roubaix, France; Univ. Lille, Service de pneumologie et d'allergologie pédiatrique, hôpital Jeanne de Flandre, CHU de Lille, F-59000 Lille, France
| | - F Troussier
- Service de pédiatrie, CHU d'Angers, Angers, France
| | - A Werner
- Pôle pédiatrique, Association française de pédiatrie ambulatoire (AFPA) Ancenis Saint-Géreon, Villeneuve-lès-Avignon, France
| | - C Schweitzer
- Service de médecine infantile et explorations fonctionnelles pédiatriques, DeVAH EA 3450, hôpital d'enfants, faculté de médecine de Nancy, CHRU de Nancy, université de Lorraine, Vandœuvre-Lès-Nancy, France
| | - S Lejeune
- Univ. Lille, Service de pneumologie et d'allergologie pédiatrique, hôpital Jeanne de Flandre, CHU de Lille, F-59000 Lille, France..
| | - L Giovannini-Chami
- Service de pneumologie et d'allergologie pédiatrique, hôpitaux pédiatriques de Nice CHU-Lenval, université Côte d'Azur, Nice, France
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Narendra DK, Khurana S. Asthma and Hyperglycemia: Exploring the Interconnected Pathways. Diagnostics (Basel) 2024; 14:1869. [PMID: 39272654 PMCID: PMC11393853 DOI: 10.3390/diagnostics14171869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 08/19/2024] [Accepted: 08/21/2024] [Indexed: 09/15/2024] Open
Abstract
The interplay between asthma and glucose metabolism disorders, such as hyperglycemia, has gained increasing attention due to the potential exacerbation of asthma symptoms and severity. This review explores the complex relationship between hyperglycemia and asthma, emphasizing the pathophysiological links, the impact of glucose metabolism disorders on asthma, and the effects of asthma medications on glucose levels. Hyperglycemia, often induced by asthma treatments like corticosteroids, has been associated with an increased risk of asthma exacerbations. This review delves into the pathophysiology underlying this association, highlighting the role of insulin resistance, metabolic syndrome, and obesity in both the development and management of asthma. Metabolic syndrome, characterized by abdominal obesity and hyperglycemia, independently increases the risk of worsening respiratory symptoms and asthma. Furthermore, this review examines the influence of various antidiabetic medications on asthma outcomes. Biguanides, like metformin, have shown promise in improving asthma outcomes in patients with type 2 diabetes mellitus and asthma. However, other medications have mixed results regarding their impact on asthma control and lung function. Considering these findings, this review advocates for further research into the role of metabolic pathways in asthma management. It calls for comparative studies and the inclusion of asthma-related outcomes in clinical trials of antidiabetic drugs to better understand their potential benefits for individuals with obesity and concurrent asthma.
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Affiliation(s)
| | - Sandhya Khurana
- University of Rochester Medical Center, Rochester, NY 14620, USA
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6
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Eijkemans M, Mommers M, Harskamp-van Ginkel MW, Vrijkotte TGM, Ludvigsson J, Faresjö Å, Bergström A, Ekström S, Grote V, Koletzko B, Bønnelykke K, Eliasen AU, Bager P, Melbye M, Annesi-Maesano I, Baïz N, Barros H, Santos AC, Duijts L, Mensink-Bout SM, Flexeder C, Koletzko S, Schikowski T, Eggesbø MÅ, Lenters V, Fernández-Tardón G, Subiza-Perez M, Garcia-Aymerich J, López-Vicente M, Sunyer J, Torrent M, Ballester F, Kelleher C, Mehegan J, von Berg A, Herberth G, Standl M, Kuehni CE, Pedersen ESL, Jansen M, Gehring U, Boer JMA, Devereux G, Turner S, Peltola V, Lagström H, Inskip HM, Pike KC, Dalmeijer GW, van der Ent CK, Thijs C. Physical activity, sedentary behaviour, and childhood asthma: a European collaborative analysis. BMJ Open Respir Res 2024; 11:e001630. [PMID: 39147399 PMCID: PMC11331876 DOI: 10.1136/bmjresp-2023-001630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/28/2024] [Indexed: 08/17/2024] Open
Abstract
OBJECTIVES To investigate the associations of physical activity (PA) and sedentary behaviour in early childhood with asthma and reduced lung function in later childhood within a large collaborative study. DESIGN Pooling of longitudinal data from collaborating birth cohorts using meta-analysis of separate cohort-specific estimates and analysis of individual participant data of all cohorts combined. SETTING Children aged 0-18 years from 26 European birth cohorts. PARTICIPANTS 136 071 individual children from 26 cohorts, with information on PA and/or sedentary behaviour in early childhood and asthma assessment in later childhood. MAIN OUTCOME MEASURE Questionnaire-based current asthma and lung function measured by spirometry (forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity) at age 6-18 years. RESULTS Questionnaire-based and accelerometry-based PA and sedentary behaviour at age 3-5 years was not associated with asthma at age 6-18 years (PA in hours/day adjusted OR 1.01, 95% CI 0.98 to 1.04; sedentary behaviour in hours/day adjusted OR 1.03, 95% CI 0.99 to 1.07). PA was not associated with lung function at any age. Analyses of sedentary behaviour and lung function showed inconsistent results. CONCLUSIONS Reduced PA and increased sedentary behaviour before 6 years of age were not associated with the presence of asthma later in childhood.
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Affiliation(s)
- Marianne Eijkemans
- Maastricht University Care and Public Health Research Institute, Maastricht, Netherlands
- Department of Pediatrics, Catharina Ziekenhuis, Eindhoven, Netherlands
| | - Monique Mommers
- Maastricht University Care and Public Health Research Institute, Maastricht, Netherlands
| | - Margreet W Harskamp-van Ginkel
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Locatie Meibergdreef, Amsterdam, Netherlands
| | - Tanja G M Vrijkotte
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Locatie Meibergdreef, Amsterdam, Netherlands
| | - Johnny Ludvigsson
- Division of Pediatrics, Department of Biomedical and Clinical Sciences (BKV), Medical Faculty, Crown Princess Victoria Children's Hospital, Linköping University Hospital, Linköping, Sweden
| | - Åshild Faresjö
- Department of Health, Medicine and Caring Sciences; Public Health, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Veit Grote
- Department of Pediatrics, Munich University Hospital Dr von Hauner Children's Hospital, Munchen, Germany
| | - Berthold Koletzko
- Department of Pediatrics, Munich University Hospital Dr von Hauner Children's Hospital, Munchen, Germany
| | - Klaus Bønnelykke
- Copenhagen University Hospital, Gentofte, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen, Denmark
| | - Anders Ulrik Eliasen
- Copenhagen University Hospital, Gentofte, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen, Denmark
- Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | - Peter Bager
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Mads Melbye
- K.G. Jebsen Center for Genetic Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian Institute of Public Health Centre for Fertility and Health, Oslo, Norway
- Department of Genetics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Isabella Annesi-Maesano
- Institute Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM, Montpellier, France
| | - Nour Baïz
- Institute Desbrest of Epidemiology and Public Health, University of Montpellier and INSERM, Montpellier, France
| | - Henrique Barros
- Instituto de Saúde Pública da Universidade do Porto, UP EPIUnit, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Ana Cristina Santos
- Instituto de Saúde Pública da Universidade do Porto, UP EPIUnit, Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Pediatrics, Division of Neonatology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Sara M Mensink-Bout
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Claudia Flexeder
- German Research Center for Environmental Health, Institute of Epidemiology Helmholtz Zentrum München, Neuherberg, Germany
- Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research, Munchen, Germany
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Sibylle Koletzko
- Department of Pediatrics, Munich University Hospital Dr von Hauner Children's Hospital, Munchen, Germany
- Department of Pediatrics, Gastroenterology and Nutrition, University of Warmia and Mazury in Olsztyn School of Medicine, Olsztyn, Poland
| | - Tamara Schikowski
- Department of Epidemiology, IUF Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Merete Åse Eggesbø
- Department of Environmental Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Virissa Lenters
- Department of Environmental Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
- Julius Center for Health Sciences and Primary Care, Utrecht, Netherlands
| | - Guillermo Fernández-Tardón
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), University of Oviedo, CIBERESP, Madrid, Spain
| | - Mikel Subiza-Perez
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, Donostia-san Sebastian, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Judith Garcia-Aymerich
- Non-Communicable Diseases and Environment Research Programme, Barcelona Institute for Global Health, Barcelona, Spain
| | - Mónica López-Vicente
- ISGlobal, Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Jordi Sunyer
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Ferran Ballester
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO, Universitat Jaume I, Valencia, Spain
- Nursing School, Universitat de València, Valencia, Spain
| | - Cecily Kelleher
- UCD School of Public Health, Physiotherapy and Sports Science, College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - John Mehegan
- UCD School of Public Health, Physiotherapy and Sports Science, College of Health and Agricultural Sciences, University College Dublin, Dublin, Ireland
| | - Andrea von Berg
- Research Institute, Department of Pediatrics, Marien-Hospital Wesel gGmbH, Wesel, Germany
| | - Gunda Herberth
- Department of Environmental Immunology, Helmholtz-Centre for Environmental Research - UFZ, Leipzig, Germany
| | - Marie Standl
- German Research Center for Environmental Health, Institute of Epidemiology Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Lung Research, Giessen, Germany
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital University Hospital Bern, Bern, Switzerland
| | - Eva S L Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Maria Jansen
- Public Health Services, Academic Collaborative Centre for Public Health Limburg, Heerlen, Netherlands
- Department of Health Services Research, Maastricht University Care and Public Health Research Institute, Maastricht, Netherlands
| | - Ulrike Gehring
- Utrecht University Institute for Risk Assessment Sciences, Utrecht, Netherlands
| | - Jolanda M A Boer
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Graham Devereux
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Steve Turner
- Women and Children’s Division, NHS Grampian, Aberdeen, UK
- Child Health, University of Aberdeen, Aberdeen, UK
| | - Ville Peltola
- Department of Paediatrics and Adolescent Medicine, TYKS Turku University Hospital, Turku, Finland
| | - Hanna Lagström
- Department of Public Health and Centre for Population Health Research, University of Turku, Turku, Finland
- TYKS Turku University Hospital, Turku, Finland
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NHS Foundation Trust, NIHR Southampton Biomedical Research Centre, Southampton, UK
| | | | | | - Cornelis K van der Ent
- Department of Paediatric Pulmonology, Wilhelmina Children's Hospital University Medical Centre, Utrecht, Netherlands
| | - Carel Thijs
- Maastricht University Care and Public Health Research Institute, Maastricht, Netherlands
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7
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de Lima FF, Dos Santos JMB, Lunardi AC, de Oliveira JM, Freitas PD, Kim FS, Agondi RC, Carvalho-Pinto RM, Furlanetto KC, Carvalho CRF. Physical Activity and Sedentary Behavior as Treatable Traits for Clinical Control in Moderate-to-Severe Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:2047-2055. [PMID: 38492665 DOI: 10.1016/j.jaip.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/21/2024] [Accepted: 03/06/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Physical activity and sedentary behavior are treatable traits that may impact asthma control in distinct manners, but this impact remains poorly understood. OBJECTIVE To evaluate the influence of physical activity and sedentary behavior on clinical control in adults with moderate-to-severe asthma. METHODS This cross-sectional, multicentric study included 426 individuals with moderate-to-severe asthma. Assessments included physical activity and sedentary time (actigraphy), clinical asthma control (Asthma Control Questionnaire [ACQ]), quality of life (Asthma Quality of Life Questionnaire), anxiety and depression symptoms (Hospital Anxiety and Depression Scale), anthropometric data, and lung function. Participants were grouped according to physical activity levels and sedentary behavior. RESULTS Participants who walked ≥7500 steps/day presented better ACQ scores than those who walked <7500 steps/day (P < .05), independent of sedentary status. The percentage of patients with controlled asthma was higher in the active/sedentary (43.9%) and active/nonsedentary (43.8%) groups than in the inactive/sedentary (25.4%) and inactive/nonsedentary (23.9%) groups (P < .02). The likelihood of having uncontrolled asthma according to the treatable traits of physical inactivity (odds ratio [95% confidence interval]: 2.36 [1.55-3.59]), higher anxiety (2.26 [1.49-3.42]), and depression symptoms (1.95 [1.28-2.95]) was significant (P ≤ .002). Obesity and sedentary time were not associated with asthma control. CONCLUSIONS Our results show that ≥7500 steps/day is associated with better asthma control independent of sedentary time in adults with moderate-to-severe asthma. Physical inactivity, anxiety, and depression symptoms are associated with higher odds of uncontrolled asthma. These results suggest that interventions should mainly focus on increasing physical activity rather than reducing sedentary time.
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Affiliation(s)
- Fabiano F de Lima
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Juliana M B Dos Santos
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Adriana C Lunardi
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Joice M de Oliveira
- Biological and Health Sciences Center, UNOPAR Pitágoras University, Londrina, Brazil; Laboratory of Research in Pulmonary Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
| | - Patrícia D Freitas
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Fabiana S Kim
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Rosana Câmara Agondi
- Clinical Immunology and Allergy Division, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Regina M Carvalho-Pinto
- Pulmonary Division, Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Karina C Furlanetto
- Biological and Health Sciences Center, UNOPAR Pitágoras University, Londrina, Brazil; Laboratory of Research in Pulmonary Physiotherapy, State University of Londrina (UEL), Londrina, Brazil
| | - Celso R F Carvalho
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.
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8
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Burge AT, Lee AL. Get a move on: physical (in)activity in people with obstructive airway disease. ERJ Open Res 2024; 10:00305-2024. [PMID: 39040589 PMCID: PMC11261376 DOI: 10.1183/23120541.00305-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 04/03/2024] [Indexed: 07/24/2024] Open
Abstract
A study extended the "can do, do do" concept in people with obstructive airways disease to demonstrate different clinical and movement behaviour characteristics based on quadrant classification, and proposed a treatable traits approach to management https://bit.ly/4cOGlN5.
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Affiliation(s)
- Angela T. Burge
- Respiratory Research@Alfred, School of Translational Medicine, Monash University, Melbourne, VIC, Australia
- Institute for Breathing and Sleep, Heidelberg, VIC, Australia
| | - Annemarie L. Lee
- Institute for Breathing and Sleep, Heidelberg, VIC, Australia
- Department of Physiotherapy, Monash University, Frankston, VIC, Australia
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9
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Oliva FM, Tarasconi M, Malovini A, Zappa M, Visca D, Zampogna E. Evaluation of physical activity before and after respiratory rehabilitation in normal weight individuals with asthma: a feasibility study. Front Sports Act Living 2024; 6:1372048. [PMID: 38783863 PMCID: PMC11111960 DOI: 10.3389/fspor.2024.1372048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/12/2024] [Indexed: 05/25/2024] Open
Abstract
Background Individuals with asthma spend less time engaging in physical activity compared to the general population. Increasing physical activity has become a patient-centered goal for the treatment of treatable traits of individuals with asthma. There are data showing the possible effects of a pulmonary rehabilitation program on physical activity in obese individuals with asthma but not in normal-weight asthmatics. The objective of this feasibility study is to estimate the number of daily steps and time spent on activity in normal-weight individuals with asthma, measured before and after a pulmonary rehabilitation program. Methods Normal-weight individuals with moderate to severe asthma were evaluated. The individuals measured their daily steps with an accelerometer for 5 days before and after a pulmonary rehabilitation program. The study was registered on ClinicalTrials.gov: NCT05486689. Results In total, 17 participants were enrolled; one dropout and data on the time in activity of two individuals are missing due to a software error during the download. Data from 16 patients were analyzed. The median number of steps/day at baseline was 5,578 (25th, 75th percentiles = 4,874, 9,685) while the median activity time was 214 min (25th, 75th percentiles = 165, 239). After the rehabilitation program, the number of daily steps increased by a median value of 472 (p-value = 0.561) and the time in activity reduced by 17 min (p-value = 0.357). We also found a significant difference in quality of life, muscle strength, and exercise capacity. Conclusions The results of this study make it possible to calculate the sample size of future studies whose main outcome is daily steps in normal-weight individuals with asthma. The difficulties encountered in downloading time in activity data do not allow the same for this outcome. Clinical Trial Registration ClinicalTrials.gov, identifier NCT05486689.
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Affiliation(s)
- Federico Mattia Oliva
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Matteo Tarasconi
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - Alberto Malovini
- Laboratory of Informatics and Systems Engineering for Clinical Research, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Martina Zappa
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Dina Visca
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Elisabetta Zampogna
- Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
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10
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Laurence R, Ancel J, Devilliers MA, Carre S, Dury S, Dormoy V, Deslée G, Perotin JM. Patient education needs in severe asthma, a pilot study. BMC Pulm Med 2024; 24:134. [PMID: 38491533 PMCID: PMC10943831 DOI: 10.1186/s12890-024-02960-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/09/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Severe asthma is characterized by frequent exacerbations, altered lung function, and impaired quality of life. Tailored patient education allows for the improvement of both asthma management and quality of life. Our study aimed to assess the needs of severe asthma patient in therapeutic education, according to previous therapeutic patient education background and asthma phenotype. METHODS Consecutive patients monitored for severe asthma in a tertiary referral center were considered for inclusion and answered a questionnaire detailing their patient education needs and the topics they would like to discuss. Asthma history, clinical and biological data, and lung function results were recorded. RESULTS Fifty-three patients were included and 47 (88.7%) expressed at least one need. The most frequently selected topics were "life with asthma" (83%), "treatment use" (68%), and "exacerbation management" (60%), independent of previous participation in a patient education program dedicated to asthma. Patients of older age at inclusion, uncontrolled asthma, and T2-high phenotypes were associated with different profiles of patient education needs. CONCLUSION Our study identified frequent and various patient educational needs among severe asthmatics, highlighting the importance of an in-depth assessment of severe asthmatics expectations and the crucial need for the development of dedicated educational tools.
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Affiliation(s)
- Rodolphe Laurence
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
| | - Julien Ancel
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
| | - Maëva A Devilliers
- University of Reims Champagne-Ardenne (URCA), Inserm UMR-S 1250, SFR Cap-Santé, Reims, France
| | - Sophie Carre
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
- Transversal Unit of Patient Education (UTEP), University Hospital of Reims, Reims, France
| | - Sandra Dury
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
| | - Valérian Dormoy
- University of Reims Champagne-Ardenne (URCA), Inserm UMR-S 1250, SFR Cap-Santé, Reims, France
| | - Gaëtan Deslée
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France
- University of Reims Champagne-Ardenne (URCA), Inserm UMR-S 1250, SFR Cap-Santé, Reims, France
| | - Jeanne-Marie Perotin
- Department of Respiratory Diseases, University Hospital of Reims, Reims, France.
- University of Reims Champagne-Ardenne (URCA), Inserm UMR-S 1250, SFR Cap-Santé, Reims, France.
- CRISALIS/F-CRIN INSERM Network, Service des Maladies Respiratoires, CHU Maison Blanche, Inserm UMR-S, 45 rue Cognacq-Jay, 1250, 51092, Reims cedex, France.
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11
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Kowalik S, O'reilly M, Niedźwiedź A, Kędzierski W. Equine Asthma Does Not Affect Circulating Myostatin Concentrations in Horses. Animals (Basel) 2024; 14:799. [PMID: 38473184 DOI: 10.3390/ani14050799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
(1) Background: The number of horses suffering from chronic respiratory diseases, resembling human asthma, is increasing but there is still a lack of reliable and accurate methods to detect these disorders. Numerous studies have found elevated plasma concentrations of one of the myokines, namely, myostatin (MSTN), in people suffering from severe asthma. MSTN normally inhibits myoblast proliferation and differentiation through autocrine or paracrine signals. Therefore, given the pathogenesis of asthma, we hypothesize that MSTN could be a useful biomarker of equine asthma. Thus, this study aimed to compare the concentration of MSTN in the blood plasma of fully healthy and asthmatic horses. (2) Methods: A total of 61 horses were clinically examined to confirm or exclude the occurrence of equine asthma, including bronchoalveolar lavage (BAL) fluid cytology performed on 49 horses. This study included three groups of horses, two of which were clinically healthy, and one of which was asthmatic. (3) Results: The mean circulatory MSTN concentration determined using the ELISA method in asthmatic horses was significantly higher than that in clinically healthy young Thoroughbred racehorses (p < 0.05), but it did not differ as compared to the group of healthy, adult leisure horses. (4) Conclusions: The obtained results did not unambiguously support our original hypothesis that MSTM may be a reliable marker for the early diagnosis of equine asthma. To the best of the authors' knowledge, this is the first study to analyze the plasma MSTN concentration in equine asthma patients, and therefore further studies are needed to confirm our novel findings.
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Affiliation(s)
- Sylwester Kowalik
- Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, ul. Akademicka 12, 20-033 Lublin, Poland
| | - Maisie O'reilly
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Grunwaldzki Sq. 47, 50-366 Wrocław, Poland
| | - Artur Niedźwiedź
- Department of Internal Medicine and Clinic of Diseases of Horses, Dogs and Cats, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Grunwaldzki Sq. 47, 50-366 Wrocław, Poland
| | - Witold Kędzierski
- Department of Biochemistry, Faculty of Veterinary Medicine, University of Life Sciences in Lublin, ul. Akademicka 12, 20-033 Lublin, Poland
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12
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Rockette-Wagner B, Wisnivesky JP, Holguin F, Ankam J, Arora A, Federmann E, Smith V, Federman AD, Conroy MB. The relationships between Physical activity and asthma control and Body Mass Index (BMI) in patients with asthma. J Asthma 2024; 61:194-202. [PMID: 37847059 DOI: 10.1080/02770903.2023.2260868] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/05/2023] [Accepted: 09/14/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVE Asthma is one of the most common chronic conditions in developed countries. We examined whether physical activity (PA) is related to asthma control and body mass index (BMI) in asthma patients. METHODS Cross-sectional data collected on PA (ActiGraph GT3X-BT), asthma control (the Asthma Control Questionnaire; ACQ), and BMI were examined in 206 adults (mean[sd] age 47.2[13.8] years; 49.5% had an obese BMI) with clinically diagnosed asthma. Relationships between PA and continuous BMI and asthma control were assessed using linear regression. Differences in PA across obesity (non-obese: <30 Kg/m2/obese: ≥30 Kg/m2) and asthma control categories (controlled: ≤0.75/uncontrolled: >0.75 ACQ score) were also examined. RESULTS Median (p25, p75) steps counts and peak cadence were 6035 (4248, 8461) steps/day and 123 (115, 133) steps in a minute, respectively. There were nearly 2000 fewer steps/day among those with uncontrolled asthma versus controlled and among those with obese BMI versus nonobese, respectively (both p < 0.05). In regression models adjusted for relevant covariates each 1-unit increase in ACQ score was associated with -686 [95%CI -997, -13] (p ≤ 0.05) average steps/day. The statistical significance of these findings was attenuated (p ≥ 0.05) when BMI was added to the model. However, the point estimate was not reduced (-766 [95%CI -1060, 34]. CONCLUSIONS Overall step counts were low in this population despite peak cadence values suggesting that most participants could perform moderate intensity activity. Increasing step counts should be considered an important lifestyle intervention goal in obese and non-obese asthma patients with low PA levels.
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Affiliation(s)
| | - Juan P Wisnivesky
- Icahn School of Medicine, Mount Sinai Beth Israel Hospital, New York, NY, USA
| | - Fernando Holguin
- Anschutz School of Medicine, University of Colorado, Denver, CO, USA
| | - Jyoti Ankam
- Icahn School of Medicine, Mount Sinai Beth Israel Hospital, New York, NY, USA
| | - Arushi Arora
- Icahn School of Medicine, Mount Sinai Beth Israel Hospital, New York, NY, USA
| | - Emily Federmann
- Icahn School of Medicine, Mount Sinai Beth Israel Hospital, New York, NY, USA
| | - Vongphone Smith
- Anschutz School of Medicine, University of Colorado, Denver, CO, USA
| | - Alex D Federman
- Icahn School of Medicine, Mount Sinai Beth Israel Hospital, New York, NY, USA
| | - Molly B Conroy
- School of Medicine, University of Utah, Salt Lake City, UT, USA
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13
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De-Miguel-Diez J, Llamas-Saez C, Vaquero TS, Jiménez-García R, López-de-Andrés A, Carabantes-Alarcón D, Carricondo F, Romero-Gómez B, Pérez-Farinos N. Association between Asthma and Lower Levels of Physical Activity: Results of a Population-Based Case-Control Study in Spain. J Clin Med 2024; 13:591. [PMID: 38276097 PMCID: PMC10816609 DOI: 10.3390/jcm13020591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
(1) Background: Our aim was to determine changes in the prevalence of physical activity (PA) in adults with asthma between 2014 and 2020 in Spain, investigate sex differences and the effect of other variables on adherence to PA, and compare the prevalence of PA between individuals with and without asthma. (2) Methods: This study was a cross-sectional, population-based, matched, case-control study using European Health Interview Surveys for Spain (EHISS) for 2014 and 2020. (3) Results: We identified 1262 and 1103 patients with asthma in the 2014 and 2020 EHISS, respectively. The prevalence of PA remained stable (57.2% vs. 55.7%, respectively), while the percentage of persons who reported walking continuously for at least 2 days a week increased from 73.9% to 82.2% (p < 0.001). Male sex, younger age, better self-rated health, and lower body mass index (BMI) were significantly associated with greater PA. From 2014 to 2020, the number of walking days ≥2 increased by 64% (OR1.64 95%CI 1.34-2.00). Asthma was associated with less PA (OR0.87 95%CI 0.47-0.72) and a lower number of walking days ≥2 (OR0.84 95%0.72-0.97). (4) Conclusions: Walking frequency improved over time among people with asthma. Differences in PA were detected by age, sex, self-rated health status, and BMI. Asthma was associated with less LTPA and a lower number of walking days ≥2.
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Affiliation(s)
- Javier De-Miguel-Diez
- Respiratory Care Department, Gregorio Marañón General University Hospital, 28007 Madrid, Spain;
| | - Carlos Llamas-Saez
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (C.L.-S.); (A.L.-d.-A.); (D.C.-A.)
| | | | - Rodrigo Jiménez-García
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (C.L.-S.); (A.L.-d.-A.); (D.C.-A.)
| | - Ana López-de-Andrés
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (C.L.-S.); (A.L.-d.-A.); (D.C.-A.)
| | - David Carabantes-Alarcón
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (C.L.-S.); (A.L.-d.-A.); (D.C.-A.)
| | - Francisco Carricondo
- Department of Immunology, Laboratory of Neurobiology of Hearing (UCM 910915), Ophthalmology and Otorhinolaryngology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (F.C.); (B.R.-G.)
| | - Barbara Romero-Gómez
- Department of Immunology, Laboratory of Neurobiology of Hearing (UCM 910915), Ophthalmology and Otorhinolaryngology, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (F.C.); (B.R.-G.)
| | - Napoleón Pérez-Farinos
- Epi-PHAAN Research Group, School of Medicine, Universidad de Malaga, 29071 Malaga, Spain;
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14
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Mantoani LC, Furlanetto KC, Camillo CA, de Oliveira JM, Polastri C, Schneider LP, Zamboti CL, Hernandes NA, Pitta F. Comparison of Physical Activity Patterns among Three Major Chronic Respiratory Diseases. J Clin Med 2023; 12:6832. [PMID: 37959297 PMCID: PMC10650693 DOI: 10.3390/jcm12216832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
Although the level of physical activity in daily life (PADL) plays a vital role concerning the health of subjects with chronic lung diseases, it remains uncertain how PADL patterns compare among different conditions. This study's objective was to compare the PADL levels of subjects with COPD, asthma and idiopathic pulmonary fibrosis (IPF); and to investigate PADL behaviour in different diseases' severity. Stable subjects who had not undergone pulmonary rehabilitation in the previous year were included. Subjects were divided into two subgroups according to disease severity: mild/moderate and severe/very severe. The primary outcome was time spent in moderate-to-vigorous physical activities (MVPA) (Actigraph GT3x) measured during one week over 12 h/day; other assessments included pulmonary function, peripheral muscle strength and exercise capacity. Comparisons among subgroups were corrected for age, BMI and sex. The analysis involved 119 subjects (47 asthma, 48 COPD and 24 IPF). Subjects with asthma had higher PADL levels than those with COPD and IPF (MVPA 18(14-22) vs. 8(4-12) vs. 7(1-12) min/day, respectively; p ancova = 0.002). Subjects with severe/very severe IPF had the lowest PADL level among all subgroups. Adult subjects with asthma have higher PADL levels than those with COPD and IPF, whereas patients with severe and very severe IPF are the most physically inactive subjects.
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Affiliation(s)
- Leandro Cruz Mantoani
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
- Department of Physiotherapy, Faculty of Science and Technology, São Paulo State University (UNESP), Presidente Prudente 19060-080, Brazil
- Graduate Associated Program in Rehabilitation Sciences, University Pitagoras UNOPAR / UEL, Londrina 86041-140, Brazil
| | - Karina Couto Furlanetto
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
- Graduate Associated Program in Rehabilitation Sciences, University Pitagoras UNOPAR / UEL, Londrina 86041-140, Brazil
| | - Carlos Augusto Camillo
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
- Department of Physiotherapy, Faculty of Science and Technology, São Paulo State University (UNESP), Presidente Prudente 19060-080, Brazil
- Graduate Associated Program in Rehabilitation Sciences, University Pitagoras UNOPAR / UEL, Londrina 86041-140, Brazil
| | - Joice Mara de Oliveira
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
| | - Cláudia Polastri
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
| | - Lorena Paltanin Schneider
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
| | - Camile Ludovico Zamboti
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
- Department of Physiotherapy, Faculty of Science and Technology, São Paulo State University (UNESP), Presidente Prudente 19060-080, Brazil
| | - Nidia Aparecida Hernandes
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
| | - Fabio Pitta
- Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, Londrina State University (UEL), Londrina 86047-970, Brazil; (K.C.F.); (C.A.C.); (J.M.d.O.); (C.P.); (L.P.S.); (C.L.Z.); (N.A.H.)
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15
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Urroz Guerrero PD, Oliveira JM, Lewthwaite H, Gibson PG, McDonald VM. Key Considerations When Addressing Physical Inactivity and Sedentary Behaviour in People with Asthma. J Clin Med 2023; 12:5998. [PMID: 37762938 PMCID: PMC10531510 DOI: 10.3390/jcm12185998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/06/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
People with asthma tend to be less physically active and more sedentary than people without asthma. This narrative review aimed to present key considerations when addressing physical inactivity and sedentary behaviour in people with asthma by identifying barriers and facilitators, determinants and correlates, and intervention approaches. Using a search strategy, electronic databases were searched for relevant studies. Data extracted from studies were qualitatively synthesised. A total of 26 studies were included in the review. Six studies reported asthma symptoms as a barrier to physical activity, while four studies reported having a supportive network as a physical activity facilitator. Across studies, physical activity correlates/determinants were pulmonary function, exercise capacity, body mass index, dyspnoea, psychological health, and asthma control. Interventions that effectively improved physical activity in the short term were a step-based prescription programme, a weight loss programme incorporating aerobic and resistance training, and a weight loss lifestyle intervention, while a high-intensity interval training pulmonary rehabilitation program was effective in the long term. The collective findings suggest that a personalised physical activity programme incorporating different strategies is needed. There was minimal evidence to provide recommendations to optimise sedentary behaviour in asthma, and more research is needed on the topic.
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Affiliation(s)
- Paola D. Urroz Guerrero
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, NSW 2305, Australia; (P.D.U.G.); (H.L.); (P.G.G.)
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Joice M. Oliveira
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW 2308, Australia
- Graduate Program in Rehabilitation Sciences, Pitagoras Unopar University, Londrina 86041-140, PR, Brazil
- Laboratory of Research in Respiratory Physiotherapy, Department of Physiotherapy, State University of Londrina, Londrina 86038-350, PR, Brazil
| | - Hayley Lewthwaite
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, NSW 2305, Australia; (P.D.U.G.); (H.L.); (P.G.G.)
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Peter G. Gibson
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, NSW 2305, Australia; (P.D.U.G.); (H.L.); (P.G.G.)
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW 2305, Australia
| | - Vanessa M. McDonald
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, NSW 2305, Australia; (P.D.U.G.); (H.L.); (P.G.G.)
- Asthma and Breathing Program, Hunter Medical Research Institute, Newcastle, NSW 2305, Australia;
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW 2308, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW 2305, Australia
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16
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Iwamoto H, Hirano T, Amano Y, Murakawa K, Fukatsu-Chikumoto A, Yamaji Y, Yamane M, Anabuki K, Otani T, Higaki N, Miyamoto S, Isobe T, Yokoyama A, Matsunaga K, Hattori N. Prospective Real-World Analysis of Asthma Patients With Preserved and Reduced Physical Activity. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2792-2800.e2. [PMID: 37178763 DOI: 10.1016/j.jaip.2023.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/18/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Asthma is a highly heterogeneous airway disease, and the clinical characteristics of patients with asthma with preserved and reduced physical activity are poorly understood. OBJECTIVE We aimed to investigate the risk factors and clinical phenotypes associated with reduced physical activity in a wide range of patients with asthma. METHODS We conducted a prospective observational study of 138 patients with asthma, including patients with asthma without chronic obstructive pulmonary disease (COPD) (n = 104) and asthma-COPD overlap (n = 34), and 42 healthy controls. Physical activity levels were measured for 2 weeks using a triaxial accelerometer at baseline and 1 year later. RESULTS Higher eosinophils and body mass index (BMI) were associated with reduced physical activity in patients with asthma without COPD. Cluster analysis of asthma without COPD revealed 4 asthma phenotypes. We identified a cluster with preserved physical activity (n = 43) that was characterized by good symptom control and lung function and included a high proportion of biologics users (34.9%). Multivariate regression analysis revealed that patients with late-onset eosinophilic (n = 21), high-BMI noneosinophilic (n = 14), and symptom-predominant asthma phenotypes (n = 26) had lower levels of physical activity than controls. Patients with asthma-COPD overlap also had significantly lower physical activity levels than controls. Similar trends in physical activity levels were observed in each asthma group at 1-year follow-up. CONCLUSION This study showed the clinical features of patients with asthma with preserved and reduced physical activity. Reduced physical activity was observed in various asthma phenotypes and in asthma-COPD overlap.
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Affiliation(s)
- Hiroshi Iwamoto
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Tsunahiko Hirano
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Yoshihiro Amano
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Shimane, Japan
| | - Keita Murakawa
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Ayumi Fukatsu-Chikumoto
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Yoshikazu Yamaji
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Mayuka Yamane
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kazuki Anabuki
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Toshihito Otani
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoko Higaki
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Miyamoto
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takeshi Isobe
- Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Shimane, Japan
| | - Akihito Yokoyama
- Department of Respiratory Medicine and Allergology, Kochi Medical School, Kochi University, Kochi, Japan
| | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Noboru Hattori
- Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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17
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de Lima FF, Lunardi AC, Pinheiro DHA, Carvalho-Pinto RM, Stelmach R, Giavina-Bianchi P, Agondi RC, Carvalho CR. Identifying the Characteristics of Responders and Nonresponders in a Behavioral Intervention to Increase Physical Activity Among Patients With Moderate to Severe Asthma: Protocol for a Prospective Pragmatic Study. JMIR Res Protoc 2023; 12:e49032. [PMID: 37651174 PMCID: PMC10502597 DOI: 10.2196/49032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Previous research has suggested that most adults improve their asthma control after a short-term behavioral intervention program to increase physical activity in daily life (PADL). However, the characteristics of individuals who respond and do not respond to this intervention and the medium-term response remain unknown. OBJECTIVE This study aims to (1) identify the characteristics of adult responders and nonresponders with asthma to a behavioral intervention to increase physical activity and (2) evaluate the functional and clinical benefits in the medium term. METHODS This prospective pragmatic study will include adults with moderate to severe asthma who enroll in a behavioral intervention. All individuals will receive an educational program and an 8-week intervention to increase PADL (1 time/wk; up to 90 min/session). The educational program will be conducted in a class setting through group discussions and video presentations. Behavioral interventions will be based on the transtheoretical model using counseling, incentives, and individual feedback aiming to increase participation in physical activity. Motivational interviewing and guidelines for overcoming barriers will be used to stimulate individuals to reach their goals. Pre- and postintervention assessments will include the following: PADL (triaxial accelerometry), body composition (octopolar bioimpedance), barriers to PADL (questionnaire), clinical asthma control (Asthma Control Questionnaire), quality of life (Asthma Quality of Life Questionnaire), anxiety and depression levels (Hospital Anxiety and Depression Scale), and exacerbations. "Responders" to the intervention will be defined as those who demonstrate an increase in the number of daily steps (≥2500). RESULTS In December 2021, the clinical trial registration was approved. Recruitment and data collection for the trial is ongoing, and the results of this study are likely to be published in late 2024. CONCLUSIONS The intervention will likely promote different effects according to the clinical characteristics of the individuals, including asthma control, age, anxiety and depression levels, obesity, and several comorbidities. Identifying individuals who respond or do not respond to behavioral interventions to increase PADL will help clinicians prescribe specific interventions to adults with asthma. TRIAL REGISTRATION ClinicalTrials.gov NCT05159076; https://clinicaltrials.gov/ct2/show/NCT05159076. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49032.
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Affiliation(s)
| | - Adriana Claudia Lunardi
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | - Rafael Stelmach
- Pulmonary Division, Instituto do Coração, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Pedro Giavina-Bianchi
- Department of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Rosana Câmara Agondi
- Department of Clinical Immunology and Allergy, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Celso Rf Carvalho
- Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil
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18
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Pitzner-Fabricius A, Dall CH, Henriksen M, Hansen ESH, Toennesen LL, Hostrup M, Backer V. Effect of High-Intensity Interval Training on Inhaled Corticosteroid Dose in Asthma Patients: A Randomized Controlled Trial. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2133-2143.e8. [PMID: 37256238 DOI: 10.1016/j.jaip.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Inhaled corticosteroids (ICS) are the cornerstone of asthma treatment. However, ICS has side effects, and dose reduction is recommended when possible. Physical exercise improves asthma control, but it is unknown whether it reduces the reliance on ICS. OBJECTIVE To assess whether supervised high-intensity interval training reduces the need for ICS in untrained asthma patients. METHODS An assessor-blinded single-center randomized controlled trial, Copenhagen, Denmark. One hundred fifty untrained ICS-treated adults with symptomatic asthma were randomly assigned (2:1) to 6 months of supervised exercise 3 times weekly or a lifestyle as usual control group. Every second month, a clinical algorithm based on symptom control was applied in both groups to adjust ICS dose. Primary outcome was the proportion who had their ICS dose reduced by 25% or more after 6 months. Secondary outcomes included actual ICS dosage in micrograms per day. RESULTS Between October 2017 and December 2019, 102 patients were allocated to exercise intervention (86% completed) and 48 to the control (85% completed). At the 6-month visit, 63% versus 50% met the primary outcome in the exercise and control groups, respectively (adjusted risk difference 9.6% [95% CI -3.8 to 18.8]; P = .15). Daily ICS dose was reduced in favor of the exercise group, with a mean difference of -234 μg (95% CI -391 to -77; P = .0037), corresponding to a 24% reduction from baseline. This effect was sustained at 12 months. The intervention was safe and well tolerated. CONCLUSIONS Six months of regular exercise results in reduction in daily ICS dose without compromising asthma control.
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Affiliation(s)
- Anders Pitzner-Fabricius
- Centre for Physical Activity Research, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; The Parker Institute, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Christian H Dall
- The Parker Institute, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Physio- and Occupational Therapy, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Marius Henriksen
- The Parker Institute, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Erik S H Hansen
- Centre for Physical Activity Research, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Louise L Toennesen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Respiratory Medicine, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Morten Hostrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke Backer
- Centre for Physical Activity Research, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Otorhinolaryngology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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19
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Price OJ, Paixão C, Poddighe D, Miranda S, Silva R, Silva L, Volpato E, Sylvester K, Nyberg A, Šajnić A, Cruz J. ERS International Congress 2022: highlights from the Allied Respiratory Professionals Assembly. ERJ Open Res 2023; 9:00013-2023. [PMID: 37228263 PMCID: PMC10204849 DOI: 10.1183/23120541.00013-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/14/2023] [Indexed: 05/27/2023] Open
Abstract
In this article, we provide a brief overview of some of the outstanding sessions that were (co)organised by the Allied Respiratory Professionals Assembly during the 2022 European Respiratory Society International Congress, which was held in a hybrid format. Early Career Members from Assembly 9 summarised the content of the sessions, with the support of the Officers from the four Assembly groups: Respiratory Function Technologists and Scientists (Group 9.01); Physiotherapists (Group 9.02); Nurses (Group 9.03); and Psychologists and Behavioural Scientists (Group 9.04). The sessions covered the following topics: recent advances in cardiopulmonary exercise and challenge testing; the role and new trends in physiotherapy, exercise and physical activity promotion interventions in chronic respiratory diseases; development of the international curriculum for respiratory nurses and nursing aspects in disease management; and treatment adherence, e-health interventions and post-coronavirus disease 2019 challenges. This Highlights article targets delegates who attended the Congress sessions, as well as those who were unable to attend, and provides valuable insight into the latest scientific data and emerging areas affecting the clinical practice of Allied Respiratory Professionals.
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Affiliation(s)
- Oliver J. Price
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, UK
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
- Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- The authors contributed equally
| | - Cátia Paixão
- Lab3R – Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal
- iBiMED – Institute of Biomedicine, University of Aveiro, Aveiro, Portugal
- Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
- The authors contributed equally
| | - Diego Poddighe
- Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, KU Leuven, Leuven, Belgium
- The authors contributed equally
| | - Sabina Miranda
- Pneumology Dept, HUNSC Hospital, Tenerife, Spain
- The authors contributed equally
| | - Rui Silva
- Unidade de Cuidados na Comunidade Vallis Longus, ACeS Maia/Valongo, Porto, Portugal
- The authors contributed equally
| | - Liliana Silva
- Matosinhos Local Health Unit, Porto, Portugal
- CINTESIS – Centre for Health Technology and Services Research, Porto, Portugal
- The authors contributed equally
| | - Eleonora Volpato
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
- The authors contributed equally
| | - Karl Sylvester
- Respiratory Physiology, Royal Papworth and Cambridge University Hospitals NHS Foundation Trusts, Cambridge, UK
| | - André Nyberg
- Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
| | - Andreja Šajnić
- Department for Respiratory Diseases Jordanovac, University Hospital Center, Zagreb, Croatia
| | - Joana Cruz
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences (ESSLei), Polytechnic of Leiria, Leiria, Portugal
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20
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Price OJ, Simpson AJ. Exercise and asthma - Trigger or treatment? Respir Med 2023; 213:107247. [PMID: 37086818 DOI: 10.1016/j.rmed.2023.107247] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/16/2023] [Accepted: 04/03/2023] [Indexed: 04/24/2023]
Abstract
Exercise is one of the most commonly reported symptom triggers for people with asthma. However, a growing body of evidence indicates that regular exercise and physical activity are associated with improved clinical and patient reported outcomes. In this article, we summarise and consolidate recent original studies evaluating exercise and physical activity profiles in people with asthma and provide an up-to-date perspective concerning the role of exercise training and physical activity promotion in the context of asthma management. To conclude, we identify key unmet needs and provide directions for future research.
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Affiliation(s)
- Oliver J Price
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, UK; Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK; Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
| | - Andrew J Simpson
- School of Sport, Exercise and Rehabilitation Sciences, University of Hull, Hull, UK
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21
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Ricketts HC, Buchan DS, Steffensen F, Chaudhuri R, Baker JS, Cowan DC. Physical activity levels in asthma: relationship with disease severity, body mass index and novel accelerometer-derived metrics. J Asthma 2023; 60:824-834. [PMID: 35876843 DOI: 10.1080/02770903.2022.2102037] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVES Patients with asthma may feel limited in physical activity (PA). Reduced PA has been demonstrated in asthmatics versus healthy controls, and increasing PA associated with improved asthma outcomes. Obesity is commonly found with difficult-to-control asthma and worsens outcomes. We compared PA levels in participants with difficult-to-control asthma and elevated body mass index (BMI) (DOW group) and two mild-moderate asthma groups: one with BMI <25 kg/m2 (MHW) and one with BMI ≥25 (MOW). METHODS This cross-sectional study used 7-day recordings from wrist-worn accelerometers to compare PA between groups. Inactive time, light (LPA), moderate-vigorous PA (MVPA) were measured, along with two novel metrics: intensity gradient (IG) reflecting PA intensity, and average acceleration (AA) reflecting PA volume. PA parameters were compared using ANOVA or Kruskall-Wallis testing. Correlation and linear regression analyses explored associations between PA parameters and asthma outcomes. As AA was the PA parameter correlated most closely with asthma-related outcomes, an exploratory analysis compared outcomes in highest and lowest AA quartiles. RESULTS 75 participants were recruited; 57 accelerometer readings were valid and included in analysis. Inactive time was significantly higher (p < 0.001), and LPA (p < 0.007), MVPA (p < 0.001), IG (p < 0.001) and AA (p < 0.001) all significantly lower in DOW versus MHW and MOW groups, even after adjusting for age and BMI. Quartiles based on AA had significantly different asthma profiles. CONCLUSIONS Overweight/obese participants with difficult-to-control asthma performed less PA, and activity of reduced intensity and volume. Increased AA is associated with improvement in several asthma-related outcomes. Increased PA should be recommended to relevant patients.
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Affiliation(s)
- Helen Clare Ricketts
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Duncan S Buchan
- Division of Sports and Exercise, University of the West of Scotland, Lanarkshire, UK
| | - Femke Steffensen
- Glasgow Clinical Research Facility, Glasgow Royal Infirmary, Glasgow, UK
| | - Rekha Chaudhuri
- Institute of Infection, Inflammation and Immunity, University of Glasgow, Glasgow, UK
| | - Julien S Baker
- Centre for Health and Exercise Research, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Douglas C Cowan
- Respiratory Department, Glasgow Royal Infirmary, Glasgow, UK
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22
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Vilanova-Pereira M, Jácome C, Rial Prado MJ, Barral-Fernández M, Blanco Aparicio M, Fontán García-Boente L, Lista-Paz A. Effectiveness of nordic walking in patients with asthma: A study protocol of a randomized controlled trial. PLoS One 2023; 18:e0281007. [PMID: 36893205 PMCID: PMC9997906 DOI: 10.1371/journal.pone.0281007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 01/05/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Patients with asthma often consider their symptomatology a barrier to exercise, leading to a reduced physical activity level. This study aims to determine whether the effect of a Nordic walking (NW) training program plus education and usual care is superior to educational and usual care only, in terms of exercise tolerance and other health-related outcomes in patients with asthma. The second aim is to explore the patients' experience with the NW program. METHODS A randomized controlled trial will be conducted with 114 adults with asthma recruited in sanitary area of A Coruña, Spain. Participants will be randomized to NW or control groups in blocks of six and in the same proportion in each group. Participants in the NW group will enrol in supervised sessions during eight weeks, three times/week. All participants will receive three educational sessions on asthma self-management plus usual care (S1 Appendix). Outcomes such as exercise tolerance (primary outcome), physical activity level, asthma-related symptoms and asthma control, dyspnea, lung function, handgrip strength, health related quality of life, quality of sleep, treatment adherence and healthcare resources use will be measured pre and postintervention, and at three and six months of follow-up. Participants in the NW group will additionally participate in focus groups. DISCUSSION This is the first study analysing the effect of NW in patients with asthma. NW combined with education and usual care is expected to improve exercise tolerance, but also asthma-related outcomes. If this hypothesis is confirmed, a new community-based therapeutic approach will be available for patients with asthma. TRIAL REGISTRATION Study registered in ClinicalTrials.gov with number of register NCT05482620.
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Affiliation(s)
| | - Cristina Jácome
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | | | | | - Marina Blanco Aparicio
- Department of Respiratory Medicine, University Hospital of A Coruña, A Coruña, Galicia, Spain
| | | | - Ana Lista-Paz
- The Faculty of Physiotherapy, The University of A Coruña, A Coruña, Galicia, Spain
- Psychosocial and Functional Rehabilitation Intervention Research Group, The University of A Coruña, A Coruña, Galicia, Spain
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23
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Oliveira JM, Spositon T, Rugila DF, Pitta F, Furlanetto KC. Validity of the International Physical Activity Questionnaire (short form) in adults with asthma. PLoS One 2023; 18:e0282137. [PMID: 36827240 PMCID: PMC9956041 DOI: 10.1371/journal.pone.0282137] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND The short form of the International Physical Activity Questionnaire (IPAQ) is widely used to assess PA and has already been used in adults with asthma; however, its validity has not been yet studied in this population. Therefore, the aim of this study was to verify the convergent and discriminative validity of the IPAQ short form in adults with asthma. METHODS Fifty-three adults with asthma (36 females; 48±15 years; 29±6 kg/m²) wore the triaxial activity monitor Actigraph for eight days to objectively measure steps/day, time in light physical activity (PA), moderate-to-vigorous PA (MVPA), and sedentary behaviour. Participants filled out the IPAQ matching with the same week they wore the Actigraph, with measures of: time of MVPA and total PA/week; categorization of low, moderate or high PA level; time in seated position. RESULTS IPAQ self-reported total time of PA/week was weakly correlated with steps/day. The IPAQ categorization correlated moderately with time in light, MVPA and steps/day. Self-reported time in seated position on weekdays was moderately correlated with objective percentage/day of time in sedentary behaviour in the same period. IPAQ categorization in PA levels was able to differentiate between low to moderate and low to high PA levels. CONCLUSIONS These results cannot confidently infer the convergent validity of the IPAQ to quantify number of steps/day and time spent in PA of adults with asthma. However, this instrument may be useful to categorize patients into three levels of PA.
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Affiliation(s)
- Joice Mara Oliveira
- Research and Postgraduate Center, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil
- Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina, Londrina, Paraná, Brazil
| | - Thamyres Spositon
- Research and Postgraduate Center, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil
- Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina, Londrina, Paraná, Brazil
| | - Diery Fernandes Rugila
- Research and Postgraduate Center, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil
- Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina, Londrina, Paraná, Brazil
| | - Fabio Pitta
- Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina, Londrina, Paraná, Brazil
| | - Karina Couto Furlanetto
- Research and Postgraduate Center, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil
- Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina, Londrina, Paraná, Brazil
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24
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Nanda A, Siles R, Park H, Louisias M, Ariue B, Castillo M, Anand MP, Nguyen AP, Jean T, Lopez M, Altisheh R, Pappalardo AA. Ensuring equitable access to guideline-based asthma care across the lifespan: Tips and future directions to the successful implementation of the new NAEPP 2020 guidelines, a Work Group Report of the AAAAI Asthma, Cough, Diagnosis, and Treatment Committee. J Allergy Clin Immunol 2023; 151:869-880. [PMID: 36720288 DOI: 10.1016/j.jaci.2023.01.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/08/2023] [Accepted: 01/19/2023] [Indexed: 01/29/2023]
Abstract
The most recent recommendations from the 2020 National Asthma Education and Prevention Program Update and Global Initiative for Asthma 2021 guide evidence-based clinical decision making. However, given the present state of health disparities by age, income, and race, the equitable implementation and dissemination of these guidelines will be unlikely without further guidance. This work group report reviews the current state of the new asthma guideline implementation; presents updated evidence-based therapeutic options with attention to specific patient populations; and addresses barriers to the implementation of these guidelines in minoritized, historically marginalized, and underresourced communities. Allergists and immunologists can use practical ways to accomplish the goals of improved asthma care access and advanced asthma care across the life span, with specific considerations to historically marginalized populations. Modifiable barriers to guideline implementation include financial barriers, environmental factors, and allergy subspecialty access and care coordination. Various programs to improve access to guideline-based asthma care include community programs, school-based asthma programs, and digital health solutions, with an emphasis on reducing disparities by race.
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Affiliation(s)
- Anil Nanda
- Asthma and Allergy Center, Lewisville-Flower Mound; Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas
| | - Roxana Siles
- Department of Allergy and Clinical Immunology, Respiratory Institute, Cleveland Clinic Foundation, Cleveland
| | - Henna Park
- Department of Pediatrics, University of Illinois Hospital, Chicago
| | - Margee Louisias
- Department of Medicine, Division of Allergy and Clinical Immunology, Brigham and Women's Hospital, Cleveland; Department of Immunology, Boston Children's Hospital, Boston; Harvard Medical School, Boston
| | - Barbara Ariue
- Department of Pediatrics, Division of Allergy/Immunology, Loma Linda Children's Hospital, Loma Linda
| | - Maria Castillo
- Department of Medical Education at Driscoll Children's Hospital, Corpus Christi
| | - Mahesh Padukudru Anand
- Department of Respiratory Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore
| | - Anh P Nguyen
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, School of Medicine, University of California Davis, Sacramento
| | - Tiffany Jean
- Division of Basic and Clinical Immunology, Department of Medicine, University of California Irvine, Orange
| | - Michael Lopez
- Division of Basic and Clinical Immunology, Department of Medicine, University of California Irvine, Orange
| | - Roula Altisheh
- Department of Allergy and Clinical Immunology, Respiratory Institute, Cleveland Clinic Foundation, Cleveland
| | - Andrea A Pappalardo
- Department of Pediatrics, Department of Medicine, University of Illinois at Chicago, Chicago
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Passos NF, Freitas PD, Carvalho-Pinto RM, Cukier A, Carvalho CRF. Increased physical activity reduces sleep disturbances in asthma: A randomized controlled trial. Respirology 2023; 28:20-28. [PMID: 36068181 DOI: 10.1111/resp.14359] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 08/08/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND OBJECTIVE Individuals with asthma are more likely to develop sleep-disordered breathing. Exercise training improves sleep; however, the effect of physical activity (PA) on improving sleep quality remains unknown. This study had two objectives: (i) to evaluate the effect of a behavioural intervention to increase physical activity in daily living (PADL) on sleep quality in adults with asthma; (ii) to verify the association between a change in sleep quality, quality of life, anxiety, depression and asthma symptoms. METHODS This randomized controlled clinical trial included adults physically inactive with asthma. Participants were randomized into the control (CG; n = 25) and intervention groups (IG; n = 24). IG was submitted to a behavioural intervention to increase PADL, and CG received the usual care. Pre- and post-intervention assessments of sleep quality (by actigraphy and questionnaire), PADL level (by accelerometry), asthma control, health-related quality of life and anxiety and depression levels were conducted. RESULTS Both groups were similar at baseline. After the intervention, IG increased daily steps and moderate to vigorous PA levels. IG also improved sleep efficiency and latency as well as increased asthma-symptom-free days compared to CG. In addition, a greater proportion of participants in the IG had improved sleep quality after the intervention. Lastly, IG presented clinical improvement in the asthma-related quality of life questionnaire and a reduction in anxiety symptoms. CONCLUSION Our results demonstrate that a behavioural intervention can increase PA, enhance behavioural sleep quality, efficiency and quality of life and reduce asthma and anxiety symptoms.
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Affiliation(s)
- Natalia Febrini Passos
- Department of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Patricia D Freitas
- Department of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Regina Maria Carvalho-Pinto
- Pulmonary Division, Heart Institute (InCor), Clinics Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Alberto Cukier
- Pulmonary Division, Heart Institute (InCor), Clinics Hospital, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Celso R F Carvalho
- Department of Physical Therapy, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
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Role of Environment on Physical Activity Patterns of Older Adults Living With HIV in New York City. J Assoc Nurses AIDS Care 2023; 34:31-44. [PMID: 35622464 DOI: 10.1097/jnc.0000000000000340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
ABSTRACT The purpose of this study was to survey the physical activity (PA) patterns of older adults with HIV and investigate the relationship between environmental factors and PA in this population. This study was a secondary data analysis from 100 adults, ages 50 years and older, living with HIV in New York City. Descriptive statistics assessed PA patterns. Linear regression assessed the association between environmental factors and time spent in PA. All participants had been living with HIV for 21 years on average, were on antiretroviral therapy, ranged in age from 50 to 71 years, and were 50% female. Participants performed at 75% of their functional capacity ( p < .0001), and females walked less than males ( p < .05). Traffic hazards were the sole environmental predictor of PA participation. Targeted interventions are needed to increase PA in this growing population. Interventions at the policy level should reduce traffic hazards to support PA.
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Hansen NB, Henriksen M, Dall CH, Vest S, Larsen L, Suppli Ulrik C, Backer V. Physical activity, physical capacity and sedentary behavior among asthma patients. Eur Clin Respir J 2022; 9:2101599. [PMID: 36105719 PMCID: PMC9467604 DOI: 10.1080/20018525.2022.2101599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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 (VO2max). 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 VO2max. VO2max 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 VO2max had the higher quality of life scores. Abbreviations: VO2max: 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
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Affiliation(s)
- Nikolaj Brix Hansen
- Center for Physical Activity Research (CFAS), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Marius Henriksen
- The Parker Institute, Copenhagen University Hospital - Bispebjerg-Frederiksberg, Copenhagen, Denmark
| | - Christian Have Dall
- The Parker Institute, Copenhagen University Hospital - Bispebjerg-Frederiksberg, Copenhagen, Denmark
| | - Susanne Vest
- Department of Respiratory and Infection Medicine, North Zealand Hospital, Hilleroed, Denmark
| | - Lotte Larsen
- Center for Physical Activity Research (CFAS), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital - Hvidovre, Hvidovre, Denmark
| | - Vibeke Backer
- Center for Physical Activity Research (CFAS), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
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de Oliveira JM, Karloh M, Matias TS, Barbosa GB, Freitas PD, Carvalho CRF, Furlanetto KC. An online behavior change intervention to promote physical activity in adults with asthma: study protocol for a multicenter randomized controlled trial. Trials 2022; 23:983. [PMID: 36476386 PMCID: PMC9727857 DOI: 10.1186/s13063-022-06881-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Behavior change interventions have been the focus of recent studies, and the COVID-19 pandemic highlighted the importance of online interventions. However, no previous studies have investigated behavior change techniques to improve physical activity in adults with asthma through online intervention. METHODS This double-blind clinical trial will investigate the effectiveness of an online behavior change intervention in increasing physical activity and reducing sedentary behavior in adults with asthma, as well as in improving other clinical outcomes in short and medium terms. Patients with clinically stable moderate to severe asthma, who are physically inactive and do not have cardiovascular and/or osteoneuromuscular impairments will be randomized into control or intervention groups (23 in each). Both groups will carry out an online educational program (1 h). Additionally, the intervention group will receive weekly individual online sessions for 12 weeks of motivation-based behavior change intervention to promote an increase in physical activity and reduce sedentary behavior based on both self-determination theory and transtheoretical model. The intervention group will also receive an activity monitor with specific strategies related to it. Both groups will be reassessed immediately after the intervention and 6 months after that. The primary outcomes are physical activity and sedentary behavior, which will be objectively assessed by a triaxial accelerometer (Actigraph wGT3X-BT). Secondary outcomes are Asthma Control Questionnaire, Incremental Step Test, Sit-To-Stand, Timed Up-and-Go, 4-Metre Gait Speed, Asthma Quality of Life Questionnaire, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Actiwatch 2, and the Hospital Anxiety and Depression Scale. DISCUSSION The intervention is unprecedented and was carefully developed to joint most characteristics and techniques of both behavioral strategies (transtheoretical model and self-determination theory). Therefore, this intervention has the potential to improve physical activity levels and asthma management and reduce sedentary behavior. As a consequence, this novel intervention will improve global health in this population and support its use in clinical practice. The intervention will be carried out online with direct weekly contact with the therapist. Consequently, it has low implementation costs, might improve patient's attendance, and has the potential to be largely offered elsewhere. TRIAL REGISTRATION ClinicalTrials.gov NCT05241223 . Registered on January 22, 2022.
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Affiliation(s)
- Joice Mara de Oliveira
- grid.441851.d0000 0004 0635 1143Graduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), 591 Marselha St., Londrina, PR 86041-14 Brazil ,grid.411400.00000 0001 2193 3537Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), 60 Robert Kock Ave., Londrina, PR 86038-350 Brazil
| | - Manuela Karloh
- grid.412287.a0000 0001 2150 7271Department of Physiotherapy, Center for Health Sciences and Sport, Santa Catarina State University (UDESC), 358 Paschoal Simone St., Florianópolis, SC 88080-700 Brazil
| | - Thiago Sousa Matias
- grid.411237.20000 0001 2188 7235Department of Physical Education, Scool of Sports, Graduate Program in Physical Education, Graduate Program in Public Health, Federal University of Santa Catarina (UFSC), Eng. Agronômico Andrei Cristian Ferreira, s/n - Trindade, Florianópolis, SC 88040-900 Brazil
| | - Graziele Besen Barbosa
- grid.412287.a0000 0001 2150 7271Department of Physiotherapy, Center for Health Sciences and Sport, Santa Catarina State University (UDESC), 358 Paschoal Simone St., Florianópolis, SC 88080-700 Brazil
| | - Patricia Duarte Freitas
- grid.11899.380000 0004 1937 0722Department of Physical Therapy, School of Medicine, University of Sao Paulo (USP), 455 Dr Arnaldo Ave., São Paulo, SP 01246-903 Brazil
| | - Celso R. F. Carvalho
- grid.11899.380000 0004 1937 0722Department of Physical Therapy, School of Medicine, University of Sao Paulo (USP), 455 Dr Arnaldo Ave., São Paulo, SP 01246-903 Brazil
| | - Karina Couto Furlanetto
- grid.441851.d0000 0004 0635 1143Graduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), 591 Marselha St., Londrina, PR 86041-14 Brazil ,grid.411400.00000 0001 2193 3537Laboratory of Research in Respiratory Physiotherapy (LFIP), Department of Physiotherapy, State University of Londrina (UEL), 60 Robert Kock Ave., Londrina, PR 86038-350 Brazil
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Denche-Zamorano Á, Urbano-Mairena J, Pastor-Cisneros R, Muñoz-Bermejo L, Barrios-Fernandez S, Garcia-Gordillo MÁ, Colmenarez-Mendoza A, Guerra-Bustamante J, Mendoza-Muñoz M. A Cross-Sectional Study on Physical Activity and Psychological Distress in Adults with Asthma. Healthcare (Basel) 2022; 10:healthcare10122469. [PMID: 36553992 PMCID: PMC9778577 DOI: 10.3390/healthcare10122469] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/01/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
Abstract
Physical Activity (PA) could contribute to decreasing psychological distress and improving Self-Perceived Health (SPH) in adults with Asthma. The main objective of this study was to analyse the associations between the Physical Activity Level (PAL) Perceived Social Support (PSS) and Mental Health, using the Goldberg General Health Questionnaire (GHQ-12), and SPH in the adult population with Asthma. This descriptive cross-sectional study is based on data from the 2017 Spanish National Health Survey, including 1040 participants with Asthma in the study. The Kruskal-Wallis test was performed to study the hypothetical differences between the PAL and the different variables derived from the GHQ-12. In addition, correlations between the variables generated and the items of the GHQ-12, together with the PAL and the Duke-UNC-11, were analysed using Spearman's rho correlation coefficients. Inverse correlations were found between Mental Health and PSS (rho: -0.351) and between Mental Health and PAL (rho: -0.209), as well as in the rest of the GHQ-12 items: successful coping (rho: -0.197), self-esteem (rho: -0.193) and stress (rho: -0.145). The more active subjects had better SPH. Therefore, the research showed how higher PAL and positive SPH are related to lower psychological distress in adults with Asthma.
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Affiliation(s)
- Ángel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Javier Urbano-Mairena
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
| | - Raquel Pastor-Cisneros
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Caceres, Spain
- Correspondence:
| | - Laura Muñoz-Bermejo
- Social Impact and Innovation in Health (InHEALTH), University of Extremadura, 10003 Caceres, Spain
| | - Sabina Barrios-Fernandez
- Occupation, Participation, Sustainability and Quality of Life (Ability Research Group), Nursing and Occupational Therapy College, University of Extremadura, 10003 Caceres, Spain
| | | | | | - Joan Guerra-Bustamante
- Area of Personality, Evaluation and Psychological Treatment, Department of Psychology and Anthropology, Faculty of Nursing and Occupational Therapy, University of Extremadura, 10003 Caceres, Spain
| | - María Mendoza-Muñoz
- Research Group on Physical and Health Literacy and Health-Related Quality of Life (PHYQOL), Faculty of Sport Sciences, University of Extremadura, 10003 Caceres, Spain
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
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McLoughlin RF, Clark VL, Urroz PD, Gibson PG, McDonald VM. Increasing physical activity in severe asthma: a systematic review and meta-analysis. Eur Respir J 2022; 60:2200546. [PMID: 35896208 PMCID: PMC9753478 DOI: 10.1183/13993003.00546-2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/23/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Physical inactivity is common in asthma and is recognised as an important modifiable risk for poor clinical outcomes such as impaired asthma control and health-related quality of life (HRQoL). Despite evidence supporting the role of physical activity in reducing the risk of these outcomes, little is known about optimal interventions for increasing physical activity in those with severe disease. This systematic review and meta-analysis evaluates the effectiveness of interventions in increasing physical activity in severe asthma. METHODS MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, Embase, PubMed, Informit, SPORTDiscus and Cochrane databases were searched up to September 2021 for physical activity-based intervention studies that assessed physical activity outcomes (e.g. steps per day, time spent undertaking physical activity) in adults with severe asthma. Data on asthma-related (e.g. asthma control) and health-related outcomes (e.g. HRQoL) were assessed as secondary outcomes. The revised Cochrane Risk of Bias tool was used to assess risk of bias. Random-effects meta-analyses synthesised data where possible. RESULTS Four randomised controlled trials (all 12 weeks in duration) including 176 adults with moderate-to-severe asthma were included. An increase in physical activity was reported with a moderate-vigorous intensity aerobic and resistance training intervention (steps per day and time spent undertaking physical activity), and an unsupervised pedometer-based intervention (steps per day). Meta-analyses showed that physical activity interventions had an overall positive effect on steps per day (mean difference (MD) 1588, 95% CI 399-2778; p=0.009, I2=23), asthma control (MD -0.65, 95% CI -0.95--0.35; p<0.0001, I2=0%) and HRQoL (MD 0.56, 95% CI 0.10-1.01; p=0.02, I2=16%) compared to control. CONCLUSION While there is some evidence supporting the effectiveness of interventions in improving physical activity in adults with severe asthma, higher-quality, large-scale studies of longer duration are needed to determine the optimal intervention.
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Affiliation(s)
- Rebecca F McLoughlin
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
- School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia
| | - Vanessa L Clark
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
- School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia
| | - Paola D Urroz
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
- School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia
| | - Peter G Gibson
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
- Dept of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia
| | - Vanessa M McDonald
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, Newcastle, Australia
- Hunter Medical Research Institute, Newcastle, Australia
- School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia
- Dept of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, Australia
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Pitzner‐Fabricius A, Clark VL, Backer V, Gibson PG, McDonald VM. Factors associated with 6-min walk distance in severe asthma: A cross-sectional study. Respirology 2022; 27:1025-1033. [PMID: 35811337 PMCID: PMC9796104 DOI: 10.1111/resp.14323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/16/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Exercise capacity is associated with health-related quality of life and symptom control in severe asthma. Thus, interventions targeting exercise capacity are likely to be beneficial. However, clinical and biological factors impacting exercise capacity in severe asthma are sparsely investigated. We aimed to describe the association of selected clinical and biological factors with 6-min walk distance (6MWD) in adults with severe asthma and investigate the impact of sex on these outcomes. METHODS A cross-sectional study in adults with severe asthma was conducted. Exercise capacity was measured by 6-min walk test, and association between 6MWD and predictors were evaluated using multiple linear regression. RESULTS A total of 137 patients (females, 85; median age, 59 years) were recruited. Overall, asthma control (-15.2 m, 95% CI -22.6 to -7.7; p = 0.0001) and BMI (-3.2 m, 95% CI -5.1 to -1.3; p = 0.001) were significantly associated with exercise capacity (adjusted variance, adj. R2 = 0.425). In females, 5-item Asthma Control Questionnaire (ACQ-5; p = 0.005) and BMI (p < 0.001) were significantly associated with 6MWD (adj. R2 = 0.423). In males, a 0.5-point increase in ACQ-5 was associated with a decrease in 6MWD by 10.2 m (95% CI -22.8 to 2.4; p = 0.11), but no clinical nor biological factors reached statistical significance (adj. R2 = 0.393). CONCLUSION Asthma symptoms and BMI were associated with exercise capacity in the overall population. Optimizing these factors may enhance the ability of patients to improve their exercise capacity and gain the associated positive health outcomes, but further studies are warranted.
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Affiliation(s)
- Anders Pitzner‐Fabricius
- Centre for Physical Activity ResearchCopenhagen University Hospital—RigshospitaletCopenhagenDenmark
| | - Vanessa L. Clark
- Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy LungsHunter Medical Research Institute, College of Health Medicine and Wellbeing, The University of NewcastleNewcastleNew South WalesAustralia
| | - Vibeke Backer
- Centre for Physical Activity ResearchCopenhagen University Hospital—RigshospitaletCopenhagenDenmark,Department of OtorhinolaryngologyRigshospitalet, University of CopenhagenCopenhagenDenmark
| | - Peter G. Gibson
- Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy LungsHunter Medical Research Institute, College of Health Medicine and Wellbeing, The University of NewcastleNewcastleNew South WalesAustralia,Department of Respiratory and Sleep MedicineJohn Hunter HospitalNewcastleNew South WalesAustralia
| | - Vanessa M. McDonald
- Centre of Excellence in Severe Asthma and Priority Research Centre for Healthy LungsHunter Medical Research Institute, College of Health Medicine and Wellbeing, The University of NewcastleNewcastleNew South WalesAustralia,Department of Respiratory and Sleep MedicineJohn Hunter HospitalNewcastleNew South WalesAustralia
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Tooba R, Wu TD. Obesity and asthma: A focused review. Respir Med 2022; 204:107012. [PMID: 36279813 PMCID: PMC9671155 DOI: 10.1016/j.rmed.2022.107012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Rubabin Tooba
- Department of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, USA.
| | - Tianshi David Wu
- Department of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, USA; Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
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Daily Physical Activity in Asthma and the Effect of Mepolizumab Therapy. J Pers Med 2022; 12:jpm12101692. [PMID: 36294831 PMCID: PMC9605576 DOI: 10.3390/jpm12101692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/15/2022] [Accepted: 10/08/2022] [Indexed: 01/24/2023] Open
Abstract
For the various asthma-specific beneficial effects of physical activity, daily physical activity (DPA) and the potential of asthma therapies on DPA require better characterization. Hence, we aimed to determine (a) the DPA of asthma patients, and (b) the effect of add-on mepolizumab on the DPA of severe asthma patients. Methods: Adult outpatients with mild-to-moderate or severe asthma had accelerometer assessment of DPA. Severe asthma patients who were commenced on mepolizumab had their DPA reassessed after 12 months. Results: For the total cohort (n = 36), daily step count, time in moderate-to-vigorous physical activity (MVPA), MVPA volume and Movement Intensity (MI) were 7806 ± 3823 steps, 123 (interquartile range, 63) min, 657 ± 255 MET·min and 1.96 (0.45) m/s2, respectively. All patients met at least one recommendation for DPA but less than half met recommendations for vigorous DPA. Patients on mepolizumab therapy increased daily step count (646 steps; 9%), time in MVPA (20 min; 21%), MVPA volume (87 MET·min; 17%) and MI (0.11 m/s2; 6%) for the same amount of moving time; lung function, asthma control and health-related quality of life also improved. Conclusions: Analysis of the first national data on DPA in asthma and novel comparison against current applicable guidelines and identified beneficial thresholds showed borderline levels of DPA with room for improvement especially for severe asthma patients. In a non-sedentary cohort of severe asthma patients, mepolizumab conferred significant and meaningful improvements in DPA.
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Satar S, Sahin ME, Ergun P. Factors Affecting the Success of Pulmonary Rehabilitation in Asthma. J Asthma 2022; 60:912-919. [PMID: 35930532 DOI: 10.1080/02770903.2022.2109163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Objective: The majority of patients with asthma limit their physical activity due to the fear of exercise dyspnea. Regular exercise, on the other hand, is currently suggested as one of the non-pharmaceutical treatment alternatives for patients with asthma since it improves their quality of life and symptom control. This study aimed to investigate the indicators of success in patients with asthma receiving pulmonary rehabilitation (PR). Methods: A total of 131 patients with the diagnosis of asthma were included in the study. All patients attended an 8-week comprehensive, multidisciplinary, outpatient and individualized PR program. Results: The factors related to the gains in dyspnea perception, exercise capacity, peripheral muscle strength, respiratory muscle strength and quality of life were evaluated. In the multivariate linear regression analysis, the gain in dyspnea perception is related to baseline dyspnea. The gain in exercise capacity is related to baseline exercise capacity and the amount of smoking. The gain in peripheral muscle strength is related to gender. The gain in respiratory muscle strength is related to age, and finally the gain in quality of life is related to baseline dyspnea and anxiety levels. Conclusion: Especially men, young people, heavy smokers, and those with low initial exercise capacity, high perception of dyspnea, and high anxiety are more likely to benefit from PR.
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Affiliation(s)
- Seher Satar
- Health Sciences University Ankara Atatürk Sanatorium Training and Research Hospital, Chronic Respiratory Disease Clinic - Pulmonary Rehabilitation Center, Ankara, TURKEY
| | - Mustafa Engin Sahin
- Health Sciences University Ankara Atatürk Sanatorium Training and Research Hospital, Chronic Respiratory Disease Clinic - Pulmonary Rehabilitation Center, Ankara, TURKEY
| | - Pinar Ergun
- Health Sciences University Ankara Atatürk Sanatorium Training and Research Hospital, Chronic Respiratory Disease Clinic - Pulmonary Rehabilitation Center, Ankara, TURKEY
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Exercise Training Programs Improve Cardiorespiratory and Functional Fitness in Adults With Asthma: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Cardiopulm Rehabil Prev 2022; 42:423-433. [PMID: 35703265 DOI: 10.1097/hcr.0000000000000698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This systematic review aimed to identify the characteristics and determine the effects of exercise interventions on improving health-related physical fitness in adults with asthma. REVIEW METHODS A systematic search was completed in MEDLINE, CINAHL, Embase, and SPORTDiscus for peer-reviewed publications of experimental studies that investigated the effects of an exercise training intervention on performance-based health-related physical fitness outcomes in adults with asthma. Two reviewers independently screened studies for inclusion according to predetermined criteria and performed data extraction and quality assessment of included studies. SUMMARY Forty-five articles were included, in which results for 39 unique studies were reported. Subjects (n = 2135) were aged 22 ± 4 to 71 ± 11 yr with mild-severe asthma. Most exercise programs used aerobic exercise, either alone or in combination with resistance or breathing/stretching exercises. The most common exercise program characteristics were supervised moderate-to-vigorous intensity aerobic exercise performed for 30-45 min 3 d/wk. Meta-analyses revealed significant improvements in cardiorespiratory fitness (V˙o2peak: unstandardized mean difference [MD] 3.1 mL/kg/min, 95% CI, 1.9-4.3), functional fitness (walking distance: MD 41 m, 95% CI, 27-54), and overall health-related physical fitness (standardized mean difference [SMD] 0.67, 95% CI, 0.46-0.89) in favor of groups who underwent experimental exercise training interventions. Aerobic exercise elicited superior improvements in health-related physical fitness compared with breathing/stretching exercise (SMD 0.47, 95% CI, 0.14-0.81).Supervised exercise training programs, particularly those aerobic in nature, are effective in eliciting clinically meaningful improvements in cardiorespiratory and functional fitness in adults with asthma.PROSPERO registration ID number = CRD42018092828.
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Cao Z, Xu C, Zhang P, Wang Y. Associations of sedentary time and physical activity with adverse health conditions: Outcome-wide analyses using isotemporal substitution model. EClinicalMedicine 2022; 48:101424. [PMID: 35516443 PMCID: PMC9065298 DOI: 10.1016/j.eclinm.2022.101424] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background As one of the most common lifestyles today, sedentary behaviour is a risk factor for many health conditions. To inform potential behavioural guideline development, we aimed to estimate the theoretical effects of replacing sedentary behaviour with different intensity of physical activity on risks of 45 common non-communicable diseases (NCDs). Methods A total of 360,047 participants (aged 37-73 years) in the UK Biobank free of the 45 common non-communicable diseases (NCDs) were included. Information on sedentary time (sum of television watching, computer using and driving behaviour) and physical activity (measured by International Physical Activity Questionnaire questionnaire) were collected by self-reported at baseline. Participants were followed up for 45 NCDs diagnosis according to the ICD-10 code using linkage to national health records until 2020. Isotemporal substitution models were used to investigate substituting sedentary time with light physical activity (LPA), moderate physical activity (MPA) and vigorous physical activity (VPA) after adjusting for potential confounders. Finding Participants who reported > 6 h/day compared with ≤ 2 h/day sedentary time had higher risks of 12 (26.7%) of 45 NCDs, including ischemic heart disease, diabetes, chronic obstructive pulmonary disease, asthma, chronic kidney disease, chronic liver disease, thyroid disorder, depression, migraine, gout, rheumatoid arthritis and diverticular disease. Theoretically, replacing sedentary time with equivalent LPA, MPA and VPA was associated with risk reductions in 4, 6 and 10 types of NCDs, respectively. Among long sedentary time (> 6 h/day), replacing 1 h/day sedentary time with equivalent VPA showed stronger associations with 5 NCDs (diabetes, depression, chronic liver disease, diverticular disease and sleep disorder), with a larger risk reduction of 11%-31%. Interpretation Sedentary time is associated with multiple adverse health conditions, replacing sedentary time with any equivalent amounts of VPA than LPA and MPA could be associated with risk reductions of more types of NCDs. Funding National Natural Science Foundation of China.
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Affiliation(s)
- Zhi Cao
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Chenjie Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Pengjie Zhang
- School of Public Health, Fudan University, Shanghai, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
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Experiences of exercise in patients with asthma: qualitative analysis of discussions in a UK asthma online community. BJGP Open 2022; 6:BJGPO.2021.0162. [PMID: 35487580 DOI: 10.3399/bjgpo.2021.0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/28/2021] [Accepted: 01/31/2022] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Engagement with exercise in adults with asthma is suboptimal. Limited information is available regarding factors affecting engagement with exercise. AIM To explore experiences of exercise and linked unmet needs in adults with asthma. DESIGN & SETTING Qualitative thematic analysis of posts in a UK asthma online community, written between 2015 and 2020. METHOD Posts were identified using keywords searches. Posts in the 'Exercise' topic section were additionally included. Thematic analysis of posts was undertaken. RESULTS 143 relevant posts were analysed. 92 participants were identified through posts (11M, 33F, 48 gender not stated, aged 26-73 years). Emerging themes included: fear of experiencing asthma symptoms during exercise, lack of information about how to deal with symptoms, external barriers, emotional response, and involvement of healthcare providers. Environmental factors, concomitant life stressors, distrust of healthcare professionals and embarrassment of displaying asthma symptoms during exercise were barriers to engagement. Facilitators included experiencing positive health outcomes following exercise and positive discussions regarding exercise with healthcare professionals. Strategies participants developed to enable exercise were warming up, increasing reliever and preventer inhalers when exercising and finding exercises felt as enjoyable. CONCLUSION Future interventions to address fears of exercise-induced physical symptoms, and clear instructions on the use of inhalers when exercising are needed. Exploring patients' attitudes to exercise in clinical consultations, especially in primary care, may be beneficial.
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McLoughlin RF, McDonald VM. The Management of Extrapulmonary Comorbidities and Treatable Traits; Obesity, Physical Inactivity, Anxiety, and Depression, in Adults With Asthma. FRONTIERS IN ALLERGY 2022; 2:735030. [PMID: 35387051 PMCID: PMC8974714 DOI: 10.3389/falgy.2021.735030] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/19/2021] [Indexed: 12/31/2022] Open
Abstract
Asthma is a complex and heterogenous disease characterized by variability in disease expression and severity. Multiple extrapulmonary comorbidities and treatable traits are common in people with asthma, and there is an increasing appreciation of how these may complicate asthma management. This review will discuss the prevalence and impact of extrapulmonary comorbidities/risk factors or "traits," which have been found to co-exist in asthma (obesity, symptoms of depression and/or anxiety and physical inactivity), the impact these traits have on future outcomes (including exacerbation risk and quality of life) and asthma management, and how we should target treatment in asthma when these extrapulmonary traits are present.
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Affiliation(s)
- Rebecca F McLoughlin
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, New Lambton Heights, NSW, Australia.,School of Nursing and Midwifery, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Vanessa M McDonald
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, New Lambton Heights, NSW, Australia.,School of Nursing and Midwifery, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia
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Shchepikhin EI, Shmelev EI, Zaytseva AS. Respiratory diseases and obesity: special phenotype or independent events: Review. TERAPEVT ARKH 2022; 94:442-447. [DOI: 10.26442/00403660.2022.03.201412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/18/2022] [Indexed: 11/22/2022]
Abstract
A combination of factors, including Western European eating habits, physical inactivity and genetic predisposition, lead to a dramatic increase in adipose tissue mass. A special place is occupied by abdominal obesity, in which there is an accumulation of adipose tissue in the mesentery of the small intestine and the omentum. Developing in conditions of visceral obesity, insulin resistance, dyslipidemia and systemic inflammation are one of the key components of the pathogenesis of type 2 diabetes mellitus, cardiovascular diseases, non-alcoholic fatty liver and pancreas disease, polycystic ovary disease, some forms of cancer (breast cancer, endometrial cancer, colonic and direct intestines). At the same time, the pathogenetic role of adipose tissue is not limited to its participation in the formation of the cardiometabolic continuum and oncogenesis. The most important role of metabolically active fat in the pathogenesis of many respiratory diseases is known, including bronchial asthma, obstructive sleep apnea and pulmonary hypertension. This paper presents an overview of current data on immunological, pathophysiological and clinical features of the phenotype of the combination of respiratory diseases with overweight and obesity.
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Tyson L, Hardeman W, Marquette M, Semlyen J, Stratton G, Wilson AM. A systematic review of the characteristics of interventions that promote physical activity in adults with asthma. J Health Psychol 2021; 27:2777-2796. [PMID: 34963369 PMCID: PMC9537443 DOI: 10.1177/13591053211059386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Physical activity is promoted in the asthma population through pulmonary
rehabilitation, but limited funding and facilities are available. This review
aimed to examine the effectiveness of interventions that promote physical
activity and identify the behaviour change techniques (BCTs) and other
intervention components used. Five databases were searched, and 25 studies met
the inclusion criteria. Interventions had a significant positive effect on
physical activity, sedentary behaviour, quality of life and asthma symptoms.
BCTs used across intervention and control groups were similar in studies that
showed effects and those that did not. Future interventions should employ
techniques that help to maintain behaviour change.
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42
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Press VG, Lugogo N. Utilizing Culturally Tailored Approaches and Participant Feedback to Successfully Implement an Exercise Intervention in Black Women with Asthma: Are There Lessons That Can Be Applied to Address Disparities in Asthma Outcomes? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2021; 9:4322-4323. [PMID: 34893192 DOI: 10.1016/j.jaip.2021.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Valerie G Press
- Section of General Internal Medicine, Department of Medicine, University of Chicago, Chicago, Ill.
| | - Njira Lugogo
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan, Ann Arbor, Mich
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Chéhère B, Pernot J, Costes F. [Physical activity and pulmonary rehabilitation]. Rev Mal Respir 2021; 38:993-1004. [PMID: 34656400 DOI: 10.1016/j.rmr.2021.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/25/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Physical activity in daily life (PA) in patients with chronic respiratory disease is reduced. Inactivity is associated with an increased risk of hospitalisation and mortality. Even though pulmonary rehabilitation (PR) is associated with improved quality of life (fewer symptoms, greater exercise capacity…), its benefits with regard to PA remain unclear. STATE OF THE ART For each patient, it is important during a respiratory rehabilitation (RR) programme to evaluate PA and its determinants. Only programs aimed at improved self-management and including educational therapy (ETP) have shown a short-term increase of PA following PR. Several studies have reported better long-term adherence when professionals help the patient to construct a personalised PA project, with regular follow-up and an array of activities (local facilities, urban walking…) chosen by the patient and adapted to the environment. PERSPECTIVES The ongoing SARS-CoV2 pandemic has highlighted the importance of human interaction, even at a distance using information and communication technologies, as a means of sustaining patient motivation. Future controlled and randomized studies should focus on the long-term impact on PA of innovative strategies in patients with chronic respiratory diseases. Moreover, it would be interesting to quantify the socioeconomic impact as well as the sustainable health benefits of the different strategies outlined in this review. CONCLUSION It is not possible to offer a single solution likely to maintain RR benefits over an extended lapse of time. However, follow-up with an ETP and/or regular and customized support during the post-training period facilitates the long-term adoption of active behavior.
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Affiliation(s)
- B Chéhère
- Université de Bretagne Occidentale, EA4324, laboratoire ORPhy, faculté des sciences du sport et de l'éducation, Brest, France.
| | - J Pernot
- Centre de réadaptation respiratoire, centre hospitalier Métropole Savoie, Aix-les-Bains, France
| | - F Costes
- Université Clermont Auvergne, unité de nutrition humaine, service de médecine du sport et explorations fonctionnelles, CHU Clermont-Ferrand, Clermont-Ferrand, France
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Quirk H, Haake S. Engaging people with long-term health conditions in a community-based physical activity initiative: a qualitative follow-up study evaluating the parkrun PROVE project. BMC Sports Sci Med Rehabil 2021; 13:123. [PMID: 34629089 PMCID: PMC8504078 DOI: 10.1186/s13102-021-00351-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/21/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The "parkrun: running or volunteering for everyone" (PROVE) project was an example of a community-based physical activity and volunteering initiative for people living with long-term health conditions in England. The 3 year project involved appointing volunteer Outreach Ambassadors whose role was to promote parkrun to people living with long-term health conditions through various outreach activities. This qualitative study aimed to understand the experience of delivering the project from the perspective of volunteer Outreach Ambassadors and the PROVE Project Manager. METHODS The PROVE Project Manager and ten PROVE Outreach Ambassadors across nine health condition groups were interviewed by the researcher (asthma, blood pressure, deaf and hard of hearing, dementia, diabetes, endometriosis, heart conditions, learning disabilities and/or autism, and obesity). Interview transcripts were analysed using thematic analysis. RESULTS Four themes and nine sub-themes were generated. The participants highlighted challenges in measuring the project's success and bringing about meaningful and lasting change, and reflected on the value of the project as a learning opportunity. Despite some successes, it was thought that the project had limited reach outside of the existing parkrun community. The Outreach Ambassadors reflected on their experiences in the role and the skills required, finding it rewarding and highlighting the importance of networking and forming connections with key stakeholders. The findings are discussed in comparison to interviews conducted with the Outreach Ambassadors 12 months earlier. CONCLUSIONS This study provides evidence to support the public health potential of parkrun though targeted initiatives such as the PROVE project and provides a critical reflection on what worked and what did not work when delivering the project. The findings have relevance for organisations wishing to implement similar outreach initiatives using a volunteer workforce, including recommendations for resource management, communication, leadership, fostering volunteer autonomy and defining and capturing success.
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Affiliation(s)
- Helen Quirk
- School of Health and Related Research (ScHARR), The University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Steve Haake
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, UK
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Tupper OD, Andersen ZJ, Ulrik CS. Demographic, lifestyle and comorbid risk factors for all-cause mortality in a Danish cohort of middle-aged adults with incident asthma. BMJ Open 2021; 11:e049243. [PMID: 34607861 PMCID: PMC8491292 DOI: 10.1136/bmjopen-2021-049243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We aimed to identify factors associated with all-cause mortality in adults with incident asthma. DESIGN AND SETTING Cross-sectional cohort study, in the metropolitan areas of Copenhagen and Aarhus, Denmark. PARTICIPANTS Adults aged 50-64 years enrolled in the Danish Diet, Cancer, and Health cohort were followed up from baseline (1993-1997) in the National Patients Registry for first-time admissions for asthma and vital status. We defined incident asthma as at least one first-time hospital admission with asthma as the primary registered diagnosis between baseline and end of follow-up (2013) in participants without previously known asthma. Among the cohort comprising 57 053 individuals, we identified 785 adults (aged 50-64) with incident asthma, of whom 76 died during follow-up. PRIMARY AND SECONDARY OUTCOME MEASURES Baseline reported socioeconomic and lifestyle traits, and comorbidities associated with all-cause mortality. RESULTS Self-reported leisure-time physical activity was associated with a substantial reduction in risk with an HR of 0.53 (95% CI 0.33 to 0.85). Being male, single and having a diagnosis of hypertension or diabetes were associated with an increased risk of all-cause mortality with an HR of 1.83 (95% CI 1.14 to 2.38), 2.16 (95% CI 2.06 to 4.40), 2.47 (95% CI 1.54 to 3.95) and of 2.42 (95% CI 0.96 to 6.11), respectively. CONCLUSIONS This long-term study of adults with hospital contacts for incident asthma revealed that self-reported leisure-time physical activity is associated with an approximately 50% reduction in all-cause mortality. In contrast, both hypertension and diabetes were associated with a higher risk of mortality.
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Affiliation(s)
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, University of Copenhagen Department of Public Health, Kobenhavn, Denmark
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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46
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Kuder MM, Clark M, Cooley C, Prieto-Centurion V, Danley A, Riley I, Siddiqi A, Weller K, Kitsiou S, Nyenhuis SM. A Systematic Review of the Effect of Physical Activity on Asthma Outcomes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2021; 9:3407-3421.e8. [PMID: 33964510 PMCID: PMC8434961 DOI: 10.1016/j.jaip.2021.04.048] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Asthma is a chronic respiratory disease that affects millions worldwide. Medication management is the current mainstay of treatment; however, there is evidence to suggest additional benefit with lifestyle changes, particularly with increased physical activity. OBJECTIVE To discover and evaluate the effects of physical activity on asthma outcomes. METHODS Systematic search of PubMed, Excerpta Medica database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Rehabilitation and Sports Medicine Source, Scopus, and Web of Science identified 11,155 results. Thirty-five articles met our inclusion criteria spanning 20 studies. Data extraction was conducted by 6 independent reviewers, and final results were evaluated by a seventh reviewer and the senior author. RESULTS Wide variation among selected studies, including the heterogeneity of interventions and outcome variables, did not support a meta-analysis. Mixed results of the effects of physical activity on asthma outcomes were found. Most studies suggest that physical activity improves asthma control, quality of life, lung function parameters, and inflammatory serologies, whereas 3 found no improvements in any of these outcomes. No studies reported worsening asthma outcomes. CONCLUSIONS This review highlights the emerging and promising role of physical activity as a nonpharmacologic treatment for asthma. Additional high-quality randomized controlled trials are needed to overcome the problems of measurement heterogeneity and the dilution of outcome effect size measurement related to physical activity interventions for asthma.
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Affiliation(s)
- Margaret M Kuder
- Respiratory Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Maureen Clark
- Library of the Health Sciences, University of Illinois at Chicago, Chicago, Ill; Department of Medical Education, University of Illinois at Chicago, Chicago, Ill
| | - Caitlin Cooley
- Department of Medicine, University of Illinois at Chicago, Chicago, Ill
| | | | - Adam Danley
- Department of Medicine, University of Illinois at Chicago, Chicago, Ill
| | | | - Aminaa Siddiqi
- Department of Pediatrics, Stanford University, Palo Alto, Calif
| | - Katherine Weller
- Respiratory Institute, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Spyros Kitsiou
- Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, Ill
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Calik-Kutukcu E, Tekerlek H, Bozdemir-Ozel C, Karaduz BN, Cakmak A, Inal-Ince D, Saglam M, Vardar-Yagli N, Sonbahar-Ulu H, Firat M, Arikan H, Kaya SB, Karakaya G. Validity and reliability of 6-minute pegboard and ring test in patients with asthma. J Asthma 2021; 59:1387-1395. [PMID: 33985406 DOI: 10.1080/02770903.2021.1930040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The 6-minute pegboard and ring test (6PBRT) is a test of upper-extremity functional capacity designed for and validated in chronic obstructive pulmonary disease. The aim of this study was to evaluate the validity and reliability of the 6PBRT in asthma patients. METHODS Thirty-four adults (30 women, 4 men) with well-controlled asthma were included. Unsupported upper-extremity exercise capacity was assessed using 6PBRT, maximal arm exercise capacity using an arm ergometer, handgrip strength using a hand dynamometer, activities of daily living with the London Chest Activities of Daily Living Scale (LCADL), Milliken ADL scale (MAS) and health-related quality of life using the Asthma Quality of Life Questionnaire (AQLQ) and Health Assessment Questionnaire Disability Index (HAQ-DI). RESULTS The 6PBRT showed moderate to excellent test-retest reliability with an intraclass correlation coefficient (ICC) value of 0.872 [95% confidence interval (CI) 0.702-0.941]. The 6PBRT was reproducible according to Bland-Altman analysis, with upper and lower limits of agreement of 53.51 and -25.08 rings moved, respectively. The 6PBRT score was significantly correlated with maximum workload (r = 0.514, p = 0.002) achieved in the arm ergometer test, change in dyspnea during 6PBRT (r = -0.402, p = 0.020), LCADL-self-care (r = -0.364, p = 0.037), MAS total (r = 0.483, p = 0.005), AQLQ-symptom domain (r = 0.420, p = 0.026) and HAQ-DI total scores (r = -0.390, p = 0.025). CONCLUSIONS The 6PBRT can be used as a valid and reliable test to evaluate functional arm exercise capacity in patients with well-controlled asthma.
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Affiliation(s)
- Ebru Calik-Kutukcu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Haluk Tekerlek
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Cemile Bozdemir-Ozel
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Beyza Nur Karaduz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Aslihan Cakmak
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Deniz Inal-Ince
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Melda Saglam
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Naciye Vardar-Yagli
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hazal Sonbahar-Ulu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Merve Firat
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Hulya Arikan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Atilim University, Ankara, Turkey
| | - Saltuk Bugra Kaya
- Faculty of Medicine, Division of Adult Allergy & Clinical Immunology, Hacettepe University, Ankara, Turkey
| | - Gul Karakaya
- Faculty of Medicine, Division of Adult Allergy & Clinical Immunology, Hacettepe University, Ankara, Turkey
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48
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Busse PJ, McDonald VM, Wisnivesky JP, Gibson PG. Asthma Across the Ages: Adults. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 8:1828-1838. [PMID: 32499032 DOI: 10.1016/j.jaip.2020.03.044] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 02/06/2023]
Abstract
Asthma is a common disease affecting approximately 300 million people worldwide, across all age ranges. Despite advances in asthma outcomes of the last few decades, there remains room for improvement in asthma management and for patient outcomes, particularly in older patients. The heterogeneity of asthma is now well recognized, and is known to complicate response to treatment and patient behavior and impact health outcomes. Asthma and its heterogeneity change according to age. Asthma affects people differently across the life span. In adults, prevalence is highest among those in middle age; however, mortality is greater in the older age group. In this clinical commentary, we describe how age impacts asthma prevalence and incidence, outcomes, disease expression, and approach to management in adulthood and in older patients.
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Affiliation(s)
- Paula J Busse
- Division of Allergy and Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Vanessa M McDonald
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, NSW, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, NSW, Australia; Viruses, Immunology, Vaccines, Asthma (VIVA) Programme, Hunter Medical Research Institute, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
| | - Juan P Wisnivesky
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Peter G Gibson
- National Health and Medical Research Council Centre of Excellence in Severe Asthma, Newcastle, NSW, Australia; Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, NSW, Australia; Viruses, Immunology, Vaccines, Asthma (VIVA) Programme, Hunter Medical Research Institute, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia
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49
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Clark VL, Gibson PG, McDonald VM. What matters to people with severe asthma? Exploring add-on asthma medication and outcomes of importance. ERJ Open Res 2021; 7:00497-2020. [PMID: 33816596 PMCID: PMC8005593 DOI: 10.1183/23120541.00497-2020] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/08/2020] [Indexed: 12/19/2022] Open
Abstract
There is an increasing number of new therapies for severe asthma; however, what outcomes people with severe asthma would like improved and what aspects they prioritise in new medications remain unknown. This study aimed to understand what outcomes are important to patients when prescribed new treatments and to determine the characteristics of importance to patients in their choice of asthma treatments. Participants with severe asthma (n=50) completed a cross-sectional survey that ranked 17 potential hypothetical outcomes of treatment using a seven-point Likert scale, as well as selecting their top five overall outcomes. Participants also completed hypothetical scenarios trading off medication characteristics for four hypothetical add-on asthma treatments. Participants (58% male), had a mean±sd age of 62.2±13.5 years. Their top three prioritised outcomes were: to improve overall quality of life (selected by 83% of people), reduce number and severity of asthma attacks (72.3%), and being able to participate in physical activity (59.6%) When trading off medication characteristics, the majority of patients with severe asthma chose the hypothetical medication with the best treatment efficacy (68%). However, a subgroup of patients prioritised the medication's side-effect profile and mode of delivery to select their preferred medication. People with severe asthma value improved quality of life as an important outcome of treatment. Shared decision-making discussions between clinicians and patients that centre around medication efficacy and side-effect profile can incorporate patient preferences for add-on therapy in severe asthma. Improving quality of life is an important treatment outcome. Shared decision-making discussions between clinicians and patients that centre around efficacy and side-effect profile incorporate patient preferences for add-on therapy in severe asthma.https://bit.ly/2GY1Sc4
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Affiliation(s)
- Vanessa L Clark
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Healthy Lungs, The University of Newcastle, Callaghan, NSW, Australia.,School of Nursing and Midwifery, The University of Newcastle, Callaghan, NSW, Australia
| | - Peter G Gibson
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Healthy Lungs, The University of Newcastle, Callaghan, NSW, Australia.,Dept of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Vanessa M McDonald
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Healthy Lungs, The University of Newcastle, Callaghan, NSW, Australia.,School of Nursing and Midwifery, The University of Newcastle, Callaghan, NSW, Australia.,Dept of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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50
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Grosbois JM, Fry S, Tercé G, Wallaert B, Chenivesse C. [Physical activity and pulmonary rehabilitation in adults with asthma]. Rev Mal Respir 2021; 38:382-394. [PMID: 33744072 DOI: 10.1016/j.rmr.2021.02.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 10/26/2020] [Indexed: 11/24/2022]
Abstract
Physical activity is reduced in people with asthma compared to the general population, especially in situations where patients have uncontrolled asthma symptoms, persistent airflow obstruction and other long-term medical problems, in particular obesity and anxiety. Exertional dyspnea, which is of multifactorial origin, is the main cause of reduced physical activity reduction and draws patients into a vicious circle further impairing quality of life and asthma control. Both the resumption of a regular physical activity, integrated into daily life, adapted to patients' needs and wishes as well as physical and environmental possibilities for mild to moderate asthmatics, and pulmonary rehabilitation (PR) for severe and/or uncontrolled asthmatics, improve control of asthma, dyspnea, exercise tolerance, quality of life, anxiety, depression and reduce exacerbations. A motivational interview to promote a regular programme of physical activity in mild to moderate asthma (steps 1 to 3) should be offered by all health professionals in the patient care pathway, within the more general framework of therapeutic education. The medical prescription of physical activities, listed in the Public Health Code for patients with long-term diseases, and pulmonary rehabilitation should be performed more often by specialists or the attending physician. Pulmonary rehabilitation addresses the needs of severe asthma patients (steps 4 and 5), and of any asthmatic patient with poorly controlled disease and/or requiring hospitalized for acute exacerbations, regardless of the level of airflow obstruction, and/or with associated comorbidities, and before prescribing biological therapies.
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Affiliation(s)
- J-M Grosbois
- FormAction Santé, zone d'activité du bois, rue de Pietralunga, 59840 Pérenchies, France; CH Béthune, service de réadaptation respiratoire et de pneumologie, 62400 Béthune, France; Alvéole, groupe de travail de la SPLF, exercice et réadaptation respiratoire, 75006 Paris, France.
| | - S Fry
- CHU Lille, service de pneumologie et immuno-allergologie, université Lille, institut Pasteur de Lille, U1019, UMR 9017, Center for Infection and Immunity of Lille (CIIL), 59000 Lille, France; CRISALIS, F-CRIN INSERM network, Lille, France
| | - G Tercé
- CH Béthune, service de réadaptation respiratoire et de pneumologie, 62400 Béthune, France
| | - B Wallaert
- Alvéole, groupe de travail de la SPLF, exercice et réadaptation respiratoire, 75006 Paris, France; CHU Lille, service de pneumologie et immuno-allergologie, université Lille, institut Pasteur de Lille, U1019, UMR 9017, Center for Infection and Immunity of Lille (CIIL), 59000 Lille, France
| | - C Chenivesse
- CHU Lille, service de pneumologie et immuno-allergologie, université Lille, institut Pasteur de Lille, U1019, UMR 9017, Center for Infection and Immunity of Lille (CIIL), 59000 Lille, France; CRISALIS, F-CRIN INSERM network, Lille, France
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- Alvéole, groupe de travail de la SPLF, exercice et réadaptation respiratoire, 75006 Paris, France
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