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. 2023 Oct:217:107349.
doi: 10.1016/j.rmed.2023.107349. Epub 2023 Jul 7.

Home-based pulmonary rehabilitation for adults with severe asthma exposed to psychosocial chronic stressors

Sarah Gephine  1 , Stéphanie Fry  2 , Emilie Margoline  2 , Alice Gicquello  3 , Cécile Chenivesse  4 , Jean-Marie Grosbois  5
Affiliations
Free article

Home-based pulmonary rehabilitation for adults with severe asthma exposed to psychosocial chronic stressors

Sarah Gephine et al. Respir Med. 2023 Oct.
Free article

Abstract

Objective: To evaluate the effects of a home-based pulmonary rehabilitation (PR) programme on hyperventilation symptoms, anxiety and depressive symptoms, general fatigue, health-related quality of life (HRQoL) and exercise capacity in adults with severe asthma who have been exposed to psychosocial chronic stressors.

Methods: Data on 111 non-selected consecutive adults with severe asthma who enrolled in an 8-week home-based PR programme (weekly supervised 90-min session) was retrospectively analysed. Chronic stressors included physical, sexual and psychological violence and/or a traumatic experience related to an intensive care unit stay. Hyperventilation symptoms (Nijmegen questionnaire), Hospital Anxiety and Depression Scale, Fatigue Assessment Scale, COPD Assessment Test, Six-Minute Stepper Test and Timed-Up and Go test were assessed at baseline and after PR.

Results: At baseline, participants who have been exposed to chronic stressors (n = 48, 43.2%) were younger, more often female, more often treated for anxiety and depressive disorders, and had a higher score for anxiety symptoms, hyperventilation symptoms and a poorer HRQoL, compared to those who had not been exposed to chronic stressors (p < 0.05). All the study assessments were statistically improved after PR for both groups (p < 0.001). Anxiety and depressive symptoms, fatigue and health-related quality of life questionnaires were also clinically improved based on the minimal clinically important difference.

Conclusion: A large proportion of adults with severe asthma, mainly women, have been exposed to chronic stressors at the time of starting a PR programme, resulting in higher anxiety symptoms and hyperventilation symptoms. However, it did not prevent these individuals from benefiting from PR.

Keywords: Hyperventilation; Pulmonary rehabilitation; Severe asthma; Traumatic experience; Violence.

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Conflict of interest statement

Declaration of competing interest SG and EM has nothing to disclose. JMG reports personal fees and non-financial support unrelated to the submitted work from AstraZeneca, Boehringer Ingelheim, Chiesi, CSL Behring, GlaxoSmithKlein. AG reports personal fees and non-financial support unrelated to the submitted work from Sysmed, GlaxoSmithKlein, AstraZeneca, Sanofi, Thermo Ficher and Lowenstein. SF reports personal fees and non-financial support unrelated to the submitted work from AstraZeneca, Sanofi, GlaxoSmithKlein, Santelys, Vitalaire. CC reports personal fees and non-financial support unrelated to the submitted work from ALK-Abello, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKlein, MEDA Pharma, Medexact, Novartis, Pierre Fabre, Pfizer, Roche, Sanofi, Santélys, and TEVA.

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