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Randomized Controlled Trial
. 2020 Jul 2;56(1):1901820.
doi: 10.1183/13993003.01820-2019. Print 2020 Jul.

Short-term and long-term effect of a high-intensity pulmonary rehabilitation programme in obese patients with asthma: a randomised controlled trial

Yasemin Türk  1 , Willy Theel  2 , Astrid van Huisstede  3   4 , Gert-Jan M van de Geijn  5   6 , Erwin Birnie  6   7 , Pieter S Hiemstra  8 , Jacob K Sont  9 , Christian Taube  8   10 , Gert-Jan Braunstahl  3   11
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Free article
Randomized Controlled Trial

Short-term and long-term effect of a high-intensity pulmonary rehabilitation programme in obese patients with asthma: a randomised controlled trial

Yasemin Türk et al. Eur Respir J. .
Free article

Abstract

Objective: To determine the short-term and long-term effects of a high intensity pulmonary rehabilitation programme on asthma control, body composition, lung function and exercise capacity in obese asthma patients.

Methods: Patients with obesity (body mass index (BMI)≥30 kg·m-2) and suboptimal controlled asthma (Asthma Control Questionnaire (ACQ)≥0.75) were randomly assigned to a 3-month pulmonary rehabilitation programme (PR only), pulmonary rehabilitation programme with the use of an internet based self-management support programme (PR+SMS) or usual care. The pulmonary rehabilitation programme included high-intensity interval training, nutritional intervention and psychological group sessions. Patients in the usual care group were advised to lose weight and to exercise. The primary outcome was the difference of change of ACQ between PR only and PR+SMS after 3 months. Total follow-up was 12 months.

Results: 34 patients were included in the study (14 PR only, nine PR+SMS, 11 control). Compared with patients in usual care, patients in the PR only group had a significant reduction in BMI and significant improvements in asthma control, exercise capacity and aerobic capacity after 3 months. These improvements persisted during 12 months of follow-up. No difference in ACQ between PR+SMS and PR only groups was observed. However, users of the SMS programme had a significantly lower BMI after 12 months compared with subjects in the PR only group.

Conclusion: A high-intensity pulmonary rehabilitation programme provides sustained improvements in asthma control, body composition and exercise capacity in obese asthmatics that are not optimally controlled and, therefore, should be considered in the treatment of these patients.

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Conflict of interest statement

Conflict of interest: Y. Türk reports grants from GSK, TEVA, Novartis and Chiesi, during the conduct of the study. Conflict of interest: W. Theel has nothing to disclose Conflict of interest: A. van Huisstede has nothing to disclose. Conflict of interest: G-J.M. van de Geijn reports personal fees for lectures and non-financial support (travel and accommodation reimbursement, reagents and equipment for research) from Beckman Coulter, outside the submitted work. Conflict of interest: E. Birnie has nothing to disclose. Conflict of interest: P.S. Hiemstra has nothing to disclose. Conflict of interest: J.K. Sont has nothing to disclose. Conflict of interest: C. Taube has nothing to disclose. Conflict of interest: G-J. Braunstahl reports grants from GSK, Teva, Novartis and Chiesi, during the conduct of the study; personal fees from ALK Abello, GSK, AstraZeneca, Sanofi, Chiesi and Novartis, outside the submitted work.

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