Aerobic training versus behavioural intervention to increase physical activity on clinical control of people with moderate-to-severe asthma: A randomised clinical trial.

BACKGROUND

Aerobic training (AT) or behavioural interventions (BI) to increase physical activity in daily life (PADL) improve clinical control in people with asthma; however, comparisons between these interventions remain poorly known.

OBJECTIVE

To compare the effects of AT versus BI on clinical control in people with moderate to severe asthma in the short- and medium-term.

METHODS

This two-arm, randomised, assessor-blinded trial included physically inactive adults with moderate to severe uncontrolled asthma assigned to either an aerobic training group (ATG, n = 27) or a behavioural intervention group (BIG, n = 25). AT was performed on a treadmill (2x/week;45 min/session), and intensity was determined by a cardiopulmonary exercise test (CPET). BI was based on social cognitive theory (1x/week; 90 min/session). At baseline, post-intervention (short-term), and after 4-month follow-up (medium-term) assessments included clinical control (ACQ), quality of life (AQLQ), anxiety and depression symptoms (HADS), and barriers to PADL.

RESULTS

Most individuals were women, overweight or obese, with anxiety and depression symptoms, and low quality of life. AT and BI improved clinical control, reaching the minimal clinically important difference (MCID) post-intervention, and maintaining it in follow-up (Δ scores of -1.01 vs. -1.46 and -0.57 vs. -0.94, respectively). Furthermore, both groups achieved the MCID for AQLQ after the interventions and at follow-up (Δ scores of 1.33 vs. 1.40 and 0.97 vs. 0.88, respectively).

CONCLUSION

Both interventions yield similar improvements in clinical control and most outcomes. These results suggest that the choice of intervention should be based on the patient's preferences and the intervention centre's capacity to provide care.