Promoting Physical Activity and Exercise in Patients With Asthma and Chronic Obstructive Pulmonary Disease

Prevalence of anemia and its associated factors among adult asthmatic patients in Northwest Ethiopia

BACKGROUND

Asthma is a heterogeneous disease characterized by chronic airway inflammation. The pathophysiologic processes of asthma can disrupt iron homeostasis, resulting in anemia. However, the association between asthma and anemia among adult asthma patients remains limited. Therefore, the main aim of this study was to determine the prevalence and factors associated with anemia among adult asthmatic patients from May to August 2021.

METHODS

An institution-based, cross-sectional study was conducted among 291 asthmatic patients in Northwest Ethiopia. A pre-tested structured questionnaire and checklist were used to collect sociodemographic and clinical data. A blood specimen was collected from asthmatic patients for a complete blood count analysis and morphology assessment. The data were entered into the Epi data software and exported to the statistical package for social science version 20 software for analysis. Non-parametric Mann-Whitney U test was used to compare red blood cell parameters among groups with acute and chronic exacerbations. Binary logistic regression models were used to determine the factors associated with anemia. A p-value less than 0.05 was considered statistically significant.

RESULT

The overall prevalence of anemia in this study was 11% (95% CI: 7.2-14.8%). Acutely exacerbated asthmatic patients had significantly lower median values of red blood cell parameters such as red blood cell count, hemoglobin, and mean cell hemoglobin when compared to chronic exacerbations. In addition, using systemic corticosteroids (AOR = 4.07, 95% CI: 1.126-14.71, p = 0.032) and being hospitalized in the emergency department (AOR = 3.74, 95% CI: 1.26-11.07, p = 0.017) were found to be significantly associated with anemia.

CONCLUSION

This study demonstrated that anemia was predominant in adult asthma patients. Red blood cell number, hemoglobin level, and mean corpuscular hemoglobin were significantly lower in acute asthma exacerbations. Therefore, appropriate intervention strategies should be undertaken to reduce the prevalence of anemia among adult asthma patients to reduce further complications and provide better monitoring of asthma patients.

Peripheral blood eosinophilia in adult asthmatic patients and its association with the severity of asthma

BACKGROUND

Asthma is a diverse disease with various etiologic bases. Severe asthma can be associated with increased mortality, hospitalization, and decreased quality of life for asthma patients. High blood eosinophil counts were associated with severe asthma, but recent studies have failed to confirm this as a marker of severe asthma among adult asthma patients. As a result, the purpose of this study was to determine the association between the severity of asthma and high blood eosinophil count.

METHODOLOGY

A simple random sampling technique was used to select 291 asthmatic patients for an institution-based cross-sectional study. Socio-demographic, behavioral, and clinical characteristics were collected by using a pre-tested structured questionnaire. Four milliliters of venous blood were collected from asthmatic patients for complete blood count and peripheral morphology assessment. The eosinophil count was analyzed by the Unicel DxH 800 (Beckman Coulter, Ireland) analyzer. A statistical package for social science version 20 (SPSS) software was used to analyze the data. The non-parametric (Mann-Whitney U) test was used to compare the eosinophil count with different background variables. A binary logistic regression analysis was used to assess the factors associated with eosinophilia. A p-value less than 0.05 in multivariable logistic regression analysis was considered statistically significant.

RESULT

In this study, the overall magnitude of eosinophilia was 19.6% (95% CI = 14.8-24.1). Being admitted to the emergency department (AOR = 0.25; 95% CI: 0.09-0.69, p = 0.007) and being female (AOR = 0.49; 95% CI: 0.26-0.9, p = 0.025) were shown to have a statistically significant association with eosinophilia. Moreover, the absolute eosinophil count was significantly higher among asthmatic patients infected with intestinal parasitic infection (p < 0.045).

CONCLUSION

Being female and admission to the emergency department were negatively associated with eosinophilia. Lack of eosinophilia can be related to the low-T2 asthma phenotype. The absolute eosinophil counts were higher among intestinal parasite-infected patients. Therefore, different biomarkers will be considered for the proper diagnosis and management of adult asthma patients.

Combination of diaphragmatic breathing with therapeutic walking exercise to increase peak expiratory flow rate in asthma patients

Objective: This study aimed to determine the effect of combined diaphragmatic breathing and therapeutic walking exercise on peak expiratory flow in asthma patients.

Methods: The research design used a quasi-experiment nonequivalent pretest and posttest design. The research sample contained 38 respondents divided into intervention and control groups, selected by simple random sampling. The control group received standard drug therapy, while the intervention group received standard drug therapy and a combination of diaphragmatic breathing and therapeutic walking exercise for 2 weeks. This exercise was carried out in the morning, 6 times a week, with 5 diaphragmatic breathing and exhalations per exercise. After that, a 1-min break was followed by a therapeutic walking exercise of 5–15 min, with an increased duration. Both groups measured the peak expiratory flow before and after the intervention using a peak flow meter. The data analysis used central tendency and t-test.

Results: The results showed that the mean peak expiratory flow in the intervention group was 306.84, while in the control group, it was 232.63, with the value of the t-test being −14.17 (P < 0.0001).

Conclusions: Diaphragmatic breathing and therapeutic walking exercise significantly increased the peak expiratory flow in asthma patients.

Dyslipidemia and Its Associated Factors Among Helicobacter pylori-Infected Patients Attending at University of Gondar Comprehensive Specialized Hospital, Gondar, North-West Ethiopia: A Comparative Cross-Sectional Study

Background

Dyslipidemia refers to a lipid profile disturbance due to decreased high-density lipoprotein cholesterol and elevated low-density lipoprotein cholesterol, triglycerides, and total cholesterol. Helicobacter pylori infection can lead to some appetite-related disorders that may cause deregulated absorption of nutrients in the digestive system, contributing to changes in serum lipids. The purpose of this study is to assess dyslipidemia and its associated factors among H. pylori-infected patients attending at University of Gondar Comprehensive Specialized Hospital.

Methods

A comparative cross-sectional study was conducted on 231 H. pylori-positive and control groups, which were included by the convenience sampling technique from March to May 2021 at University of Gondar Specialized Hospital. Sociodemographic and behavioral characteristic data were collected using a pretested questionnaire, and 5mL of venous blood were used to determine the lipid profiles using DxC 700 AU chemistry analyzer. The data were analyzed using SPSS version 25. Mann–Whitney U-test and multivariable logistic regression were applied, and P-value <0.05 is considered statistically significant.

Results

The magnitude of dyslipidemia among H. pylori-infected patients was 71.8% (95% CI: 62.7–79.7). There was a statistically significant difference in lipid profiles between H. pylori-infected patients and control groups. The median (IQR) of lipid profiles in H. pylori-infected patients and control groups were for low-density lipoprotein: 108 (89.8, 145.5) vs 95 (79.45, 115.8, P<0.001), for triglycerides: 93 (65,117) vs 83 (58.5, 102, P=0.031), and cholesterol: 143 (119.5, 169,) vs 125 (110,143, P<0.001) mg/dl, respectively. Helicobacter pylori infection, alcohol drinking, unable to read and write, primary school, and secondary school were a significant associated variables with dyslipidemia (P<0.05).

Conclusion

There was a median lipid profile statistically significant difference between H. pylori-positive and control groups. Helicobacter pylori infection, educational status, and alcohol drinking habit had statistically significant association with dyslipidemia.

Selected hematological abnormalities and their associated factors among asthmatic patients in Northwest Ethiopia: a cross-sectional study

Background

Asthma is a chronic inflammatory disease that affects the lungs. Variation in whole blood cell lines is caused by the progression and severity of asthma. Common hematological abnormalities encountered during asthma include eosinophilia, neutrophilia, leukocytosis, and increased erythrocyte sedimentation rate. The main aim of this study was to assess the selected hematological abnormalities and their associated factors among asthmatic patients in Northwest Ethiopia from March to May 2021.

Methodology

A hospital-based cross-sectional study was conducted on a total of 320 asthmatic patients in Northwest Ethiopia. A simple random sampling technique was employed to select study participants. A pre-tested structured questionnaire and a checklist were used to collect data. Blood samples were collected from asthmatic patients for complete blood count and erythrocyte sedimentation rate determination. Hematological profiles were analyzed by Unicel DxH 800 (Beckman Coulter, Ireland). The erythrocyte sedimentation rate was determined by using the Westergren method. The data were entered into EpiData version 3.0.4 and analyzed with a statistical package for social science version 20 software. The bi-variable and multi-variable binary logistic regression models were used to assess the factors associated with hematological abnormalities. A p value of less than 0.05 in the multivariable logistic regression analysis was considered statistically significant.

Results

The overall prevalence of neutrophilia, eosinophilia, thrombocytopenia, leukocytosis, and basophilia was 35.3%, 20%, 11.9%, 10.3%, and 4.1%, respectively. Neutrophilia was associated with a lack of physical activity (AOR = 3.25; 95% CI 1.43–7.37) and a history of taking non-asthmatic drugs within the previous three months (AOR = 2.63; 95% CI 1.22–5.65). Being admitted to the emergency department (AOR = 0.27; 95% CI 0.11–5.67) was found to be associated with eosinophilia. In addition, being admitted to the emergency department (AOR = 5.44; 95%CI: 2.6–11.3) was associated with thrombocytopenia.

Conclusion

The current study demonstrated the predominant prevalence of neutrophilia, followed by eosinophilia, among asthma patients. Therefore, hematological abnormalities should be taken into account for proper monitoring and management of asthmatic patients.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12890-022-02020-z.

Experiences of exercise in patients with asthma: qualitative analysis of discussions in a UK asthma online community

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.

How do healthcare professionals perceive physical activity prescription for community-dwelling people with COPD in Australia? A qualitative study

OBJECTIVES

Clinical practice guidelines recommend that people with chronic obstructive pulmonary disease (COPD) should be encouraged to increase their physical activity levels. However, it is not clear how these guidelines are applied in clinical practice. This study aimed to understand the perspectives of respiratory healthcare professionals on the provision of physical activity advice to people with COPD. These perspectives may shed light on the translation of physical activity recommendations into clinical practice.

DESIGN

A qualitative study using thematic analysis.

SETTING

Healthcare professionals who provided care for people with COPD at two major tertiary referral hospitals in Victoria, Australia.

PARTICIPANTS

30 respiratory healthcare professionals including 12 physicians, 10 physical therapists, 4 nurses and 4 exercise physiologists.

INTERVENTIONS

Semistructured voice-recorded interviews were conducted, transcribed verbatim and analysed by two independent researchers using an inductive thematic analysis approach.

RESULTS

Healthcare professionals acknowledged the importance of physical activity for people with COPD. They were conscious of low physical activity levels among such patients; however, few specifically addressed this in consultations. Physicians described limitations including time constraints, treatment prioritisation and perceived lack of expertise; they often preferred that physical therapists provide more comprehensive assessment and advice regarding physical activity. Healthcare professionals perceived that there were few evidence-based strategies to enhance physical activity. Physical activity was poorly differentiated from the prescription of structured exercise training. Although healthcare professionals were aware of physical activity guidelines, few were able to recall specific recommendations for people with COPD.

CONCLUSION

Practical strategies to enhance physical activity prescription may be required to encourage physical activity promotion in COPD care.