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Randomized Controlled Trial
. 2021 Feb 27;21(1):71.
doi: 10.1186/s12890-021-01436-3.

A feasibility randomised controlled trial of Novel Activity Management in severe ASthma-Tailored Exercise (NAMASTE): yoga and mindfulness

Sarah A Hiles  1 , Paola D Urroz  1 , Peter G Gibson  1   2 , Adam Bogdanovs  3 , Vanessa M McDonald  4   5
Affiliations
Randomized Controlled Trial

A feasibility randomised controlled trial of Novel Activity Management in severe ASthma-Tailored Exercise (NAMASTE): yoga and mindfulness

Sarah A Hiles et al. BMC Pulm Med. .

Abstract

Background: Physical inactivity is common in severe asthma and associated with poor health outcomes. New approaches are needed to address physical inactivity in this group.

Objective: To examine whether yoga and mindfulness improves health-related quality of life (HRQoL) compared with a minimal active control group and collect feasibility data to inform future studies.

Methods: Over 12-weeks, adults with severe asthma were recruited. Participants were randomised 2:1 to parallel yoga or control groups. All participants received an activity tracker. The yoga group received tailored group classes twice a week for 16-weeks with a qualified yoga instructor. The control group set activity goals with a research officer and received eight progress calls. Outcomes were assessed at 16-weeks. Primary outcome was St George's Respiratory Questionnaire (SGRQ). Secondary outcomes included asthma control, physical activity, breathlessness, and inflammation. Face-to-face qualitative interviews were conducted to determine acceptability.

Results: There were 15 participants randomised to yoga (mean 67 years; 60% female) and 9 to control (68 years; 56% female). Planned comparisons indicated the yoga group had greater SGRQ improvement than the control group. There was little change in secondary outcomes. Moderate-vigorous activity increased substantially in the control group. Participants found the intervention acceptable; key barriers and facilitators were social connection, the setting, addressing breathing and asthma symptoms, changing their mindset, and the intersection of different elements.

Conclusion: A yoga and mindfulness intervention was feasible, acceptable to patients and improved HRQoL. The findings will inform design of much needed future research into physical activity interventions for severe asthma. World Health Organization International Clinical Trials Registry Platform The study was registered under the Australian New Zealand Clinical Trials Registry (ANZCTR) on the 26th of November 2018, Trial ID ACTRN12618001914257.

Keywords: Asthma management; Exercise; Health-related quality of life; Mindfulness; Physical activity; Sedentary; Severe asthma; Yoga.

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Conflict of interest statement

SAH salary has been supported by grants from GlaxoSmithKline and AstraZeneca paid to her employer (University of Newcastle) for unrelated work. PDU reports no competing interests. AB receives income from yoga instruction. PGG has received research grants and speaker fees from AstraZeneca, GlaxoSmithKline and Novartis. VMM has received speaker fees for unrelated work, grants for organising education for unrelated work, and research funds for unrelated work from AstraZeneca, Menarini and GlaxoSmithKline.

Figures

Fig. 1
Fig. 1
Flow diagram indicting the number of participants contacted, screened, eligible and completing the study
Fig. 2
Fig. 2
Primary outcome of St George’s Respiratory Questionnaire (SGRQ) in the yoga intervention and control groups before and after the intervention, for a total score; b activity domain, c symptom domain and d impact domain. Yellow circles or triangles are individual data values and blue bars indicate group mean or median and 95% confidence interval
Fig. 3
Fig. 3
Secondary outcomes in the yoga intervention and control groups before and after the intervention for a Dyspnea-12 scores; b Asthma Control Questionnaire-5, c minutes of moderate-vigorous physical activity (MVPA) per day, and d steps per day. Yellow circles or triangles are individual data values and blue bars indicate group mean or median and 95% confidence interval
Fig. 4
Fig. 4
Summary of themes regarding barriers and facilitators of the intervention
See this image and copyright information in PMC

References

    1. McDonald VM, Hiles SA, Godbout K, Harvey ES, Marks GB, Hew M, et al. Treatable traits can be identified in a severe asthma registry and predict future exacerbations. Respirology. 2019;24(1):37–47. doi: 10.1111/resp.13389. - DOI - PubMed
    1. Cordova-Rivera L, Gibson PG, Gardiner PA, McDonald VM. A systematic review of associations of physical activity and sedentary time with asthma outcomes. J Allergy Clin Immunol Pract. 2018;6(6):1968–1981. doi: 10.1016/j.jaip.2018.02.027. - DOI - PubMed
    1. Cordova-Rivera L, Gibson PG, Gardiner PA, Powell H, McDonald VM. Physical activity and exercise capacity in severe asthma: key clinical associations. J Allergy Clin Immunol Pract. 2018;6(3):814–822. doi: 10.1016/j.jaip.2017.09.022. - DOI - PubMed
    1. Hiles SA, Lamers F, Milaneschi Y, Penninx BWJH. Sit, step, sweat: Longitudinal associations between physical activity patterns, anxiety and depression. Psychol Med. 2017;47(8):1466–1477. doi: 10.1017/S0033291716003548. - DOI - PubMed
    1. Australian Institute of Health and Welfare . Chronic respiratory diseases in Australia. Canberra: AIHW; 2005.

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