Comparing the effect of pulmonary rehabilitation in patients with uncontrolled and partially controlled asthma

Abstract

Objective: Pulmonary rehabilitation (PR) is an important therapeutic approach in asthmatic patients. Lack of asthma control is associated with high morbidity, poor health outcomes, and decrease in quality of life (QOL). However, there is no clear information about the effectiveness of PR in patients with differing levels of asthma control. This study aimed to compare the efficacy of PR in patients with uncontrolled and partially controlled asthma.

Methods: Before undergoing an 8-week outpatient PR program, patients were classified according to the asthma control test (ACT) as having partially controlled asthma or uncontrolled asthma. Changes in asthma control, exercise capacity, dyspnea perception, pulmonary function tests, arterial blood gas analysis, QOL, and psychological symptoms before and after PR were compared between groups.

Results: A total of 49 patients, 21 of whom were in partially controlled and the rest 28 were in uncontrolled asthma, participated in the study. After PR, asthma control perceived dyspnea, exercise capacity, QOL, anxiety, and depression significantly improved in both groups (p < 0.05). When the two groups were compared in terms of the benefits of PR, the improvement in ACT score was significantly greater in patients with uncontrolled asthma than in partially controlled asthma (p < 0.001), whereas the improvements in other parameters were similar between groups (p > 0.05).

Conclusions: Improvement in asthma control is greater in patients with uncontrolled asthma than in patients with partially controlled asthma after PR. Therefore, patients with uncontrolled asthma, in particular, should be given opportunities to benefit from PR programs.

Keywords: Asthma; asthma control test; dyspnea; exercise capacity; pulmonary rehabilitation; quality of life.