Background Patients with difficult-to-treat asthma often have dyspnoea which limits their physical activity. This may lead to progressive deconditioning which may further hamper exercise capacity. We aimed to assess current levels of activity, perceptions of current fitness and interest in a structured exercise programme in patients attending the Glenfield Hospital Difficult Asthma Clinic.
Method Patients completed the General Practice Physical Activity Questionnaire which provides a simple Physical Activity Index (PAI) and answered structured questions about their satisfaction with current fitness and their interest in participating in an exercise programme. They were also asked to rate their current fitness compared to peers of the same age on a 100 mm visual analogue score. Responses were compared to demographic details and markers of asthma severity and control.
Results Sixty patients participated (37 female, mean (SD) age 53(13)). Only 15/60 (25%) was classified as ‘active’ by the PAI. There were no significant differences in age, gender, body mass index or Juniper asthma control scores between those patients who were active compared to the remaining group but active patients had less severe airflow obstruction (post-bronchodilator FEV1 83.7(16.5)% predicted vs 68.7(21.8), p=0.04) and better self-reported fitness scores (55.3(27.4) vs 36.7(23.0), p=0.013). There was a statistically significant inverse correlation between fitness scores and Juniper asthma control scores (r = −0.5, p<0.0001) and Hospital Anxiety (r=−0.4, p=0.004) and Depression scores (r=−0.4,p=0.001) but no association with age, BMI or FEV1. 65% of patients reported that they had stopped exercising due to their asthma symptoms and 86.7% of patients wanted to be fitter. 71.7% were interested in participating in an exercise programme. Of these 13 (30%) preferred a hospital setting with the remainder preferring a community scheme or an independent programme with support from healthcare professionals.
Conclusion Many patients with difficult asthma reported concerns about their current fitness and most were not exercising at the recommended level. There appears to be a demand for the development of a community-based structured exercise programme and further work is needed to determine whether this would improve asthma related outcomes for this group of patients.
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