Effect of exercise training in a weight loss program on asthma clinical and health related quality of life in obese adults with asthma

The obese-asthma phenotype is characterized by a severe asthma in which the clinical control is more difficult to achieve, even under optimized pharmacological therapy. Bariatric surgery has been recommended for weight-loss and to improve asthma control; however, the benefits of nonsurgical interventions have been poorly investigated. OBJECTIVE: To examine the effect of exercise training in a weight loss program on asthma control, quality of life and psychosocial symptoms in obese adults with asthma. METHODS: Fifty-five obese grade II (BMI >=35 and <40 kg/m2) adults with moderate to severe asthma were randomly assigned to either a weight loss program + exercise (WL+E) group or a weight loss program + sham (WL+S) group, where the weight loss program included nutrition and psychological therapies (12 weekly sessions of 60 minutes each). The WL+E group incorporated aerobic and resistance muscle training, whereas the WL+S group incorporated sham exercises (breathing and stretching), 2 times per week, 60 minutes/session for 3 months. Before and after interventions, asthma clinical control, health related quality of life (HRQoL), physical capacity, body composition, symptoms of anxiety and depression, sleep, lung function and airway and systemic inflammation were evaluated . The comparison of continuous data between groups was analysed via two-way ANOVA with repeated measures and categorical variables by chi-square test. Linear correlation and multiple regression were used to test associations between variables. RESULTS: Fifty-one patients were analyzed after 3 months. Compared with the WL+S group, patients who exercised demonstrated improved clinical control (-0.7 [-1.3, -0.3] vs. -0.3 [-0.9, 0.4] score ACQ; p=0.01) and HRQoL (0.8 [0.3, 2.0] vs. 0.4 [-0.3, 0.9] score AQLQ; p=0.02), respectively. This improvement seems to be result of the increase in physical capacity (3.0 [2.4, 4.0] vs. 0.9 [-0.3, 1.3] ml.O2/kg/min; p < 0.001) and...