Original Article
Physical Activity and Exercise Capacity in Severe Asthma: Key Clinical Associations

https://doi.org/10.1016/j.jaip.2017.09.022Get rights and content

Background

Physical inactivity and sedentary time are distinct behaviors that may be more prevalent in severe asthma, contributing to poor disease outcomes. Physical activity and sedentary time in severe asthma however have not been extensively examined.

Objective

We aimed to objectively measure physical activity and sedentary time in people with severe asthma compared with age-matched control participants, describing the associations of these behaviors with clinical and biological outcomes. We hypothesized that people with severe asthma would be less active and more sedentary. In addition, more activity and less sedentary time would be associated with better clinical outcomes and markers of systemic and airway inflammation in people with severe asthma.

Methods

Adults with severe asthma (n = 61) and sex- and age-matched controls (n = 61) underwent measurement of lung function, exercise capacity, asthma control, health status, and airway and systemic inflammation. Physical activity and sedentary time were measured using an accelerometer.

Results

The severe asthma and control groups were matched in terms of age and sex (32 [53%] females in each group). Individuals with severe asthma accumulated less minutes per day in moderate and higher intensity activity, median (IQR) 21.9 (12.9-36.0) versus 41.7 (29.5-65.2) (P < .0001) and accumulated 2,232 fewer steps per day (P = .0002). However, they engaged in more light-intensity physical activity. No differences were found for sedentary time. In a multivariate regression model, steps per day were strongly and independently associated with better exercise capacity in participants with severe asthma (coefficient, 0.0169; 95% CI, 0.008-0.025; P < .001).

Conclusions

People with severe asthma perform less moderate and vigorous activity than do controls. Higher levels of activity and lower levels of sedentary time are associated with better exercise capacity, asthma control, and lower levels of systemic inflammation.

Section snippets

Participant selection

A cross-sectional characterization study was conducted. Adults with severe asthma and sex- and age-matched controls were recruited and underwent a multidimensional assessment with objective measures of physical activity and sedentary time. Participants with severe asthma were recruited consecutively from the respiratory ambulatory care clinics at John Hunter Hospital (Newcastle, Australia) and the clinical research databases of the Priority Research Centre for Healthy Lungs at the University of

Characteristics of the study population

A total of 143 participants (those with severe asthma = 74, controls = 69) completed the study and 122 (those with severe asthma = 61, controls = 61) were included in the analysis; 21 participants were excluded because of not having valid accelerometer data (those with severe asthma = 8, controls = 5) or because they did not fulfill the disease inclusion criteria after assessment (those with severe asthma = 5, controls = 3). Participants with severe asthma had long-standing disease (median, 27

Discussion

This study has described the extent to which individuals with severe asthma engage in physical activity and sedentary time compared with a sex- and age-matched control population. We have demonstrated that people with severe asthma are considerably less active. In addition, we found that levels of activity and sedentary time are strongly and independently associated with exercise capacity, and to a lesser extent with other important clinical and biological outcomes. Our results also demonstrate

Conclusions

This study reports novel data on physical activity and sedentary time in patients with severe asthma. We found that severe asthma is associated with lower levels of MVPA. Higher levels of activity and lower levels of sedentary time were linked to better exercise capacity, asthma control, and decreased systemic inflammation. Our results highlight a need to develop and test interventions in patients with severe asthma that aim to improve exercise capacity and systemic inflammation by increasing

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    This research was supported by a University of Newcastle and Priority Research Centre for Healthy Lungs postgraduate scholarship and the Hunter Medical Research Institute, Australia.

    Conflicts of interest: L. Cordova-Rivera has received research support from John Hunter Hospital Charitable Trust and Hunter Medical Research Institute. P. G. Gibson has participated in educational symposia funded by AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, and Novartis; has participated in studies funded by GlaxoSmithKline and AstraZeneca; and holds a National Health and Medical Research Council (NHMRC) Practitioner Fellowship. P. A. Gardiner is supported by an NHMRC-Australian Research Council Dementia Research Development Fellowship and has participated in an educational symposium funded by Boehringer Ingelheim. V. M. McDonald has received research support from John Hunter Hospital Charitable Trust and Hunter Medical Research Institute, NHMRC Translating Research Into Practice (TRIP) fellowship, University of Newcastle, Cyclopharm, AstraZeneca, GlaxoSmithKline, and Lung Foundation Australia; has received lecture fees for participation in educational symposia funded by AstraZeneca, GlaxoSmithKline, Novartis, and Menarini; has participated in advisory boards for GlaxoSmithKline, AstraZeneca and Menarini; and has received travel support from Menarini. The rest of the authors declare that they have no relevant conflicts of interest.

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