Introduction and aim The association between physical inactivity and increased morbidity is well documented.1 It is widely recognised that patients with respiratory disease often have decreased exercise capacity, and therefore may be at increased risk of co morbidities such as cardiovascular disease, depression and obesity. The latter have been found to be highly prevalent within severe asthma populations.
In recent years there has been a greater emphasis placed on co-production and service user involvement in shaping interventions for patients with chronic diseases.2 The aim of this study was to gather self-reported activity levels of severe asthma patients and to determine barriers and facilitators to exercise, in order to focus future interventions.
Method Fifty two patients (40 females) aged 18 to 65 years with a confirmed diagnosis of severe asthma following systematic multidisciplinary assessment took part in this study. Patients completed an activity questionnaire anonymously during their clinic visits. The questionnaire included a mixture of open and closed questions that assessed the level and attitudes to physical activities and exercise.
Results 48/51 (94%) of respondents rated themselves as less active than their peers, and 21/49 (43%) did not participate in any exercise. There was a strong theme of fear of exercise induced exacerbation and breathlessness in 21/52 (40%) of patients, with 21/52 (40%) reporting feeling unsafe to exercise, and 33/52 (63%) reporting exercise induced worsening of their asthma symptoms. 45/52 (87%) wanted to become more active. Patients reported a strong preference for exercising alone or with a health professional present as opposed to group activities or classes. Swimming and walking were the activities patients were most likely to show an interest in.
Conclusion This data suggests the main barrier to increasing physical exercise in severe asthma was fear/anxiety of worsening asthma symptoms particularly breathlessness. More research is required to investigate the relationship between this fear of exercise and objective measures of asthma worsening.
References 1 Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. CMAJ 2006;174:801–809
2 National Voices. Policy position on coordinated care [Online]. Available at: http://www.nationalvoices.org.uk/sites/www.nationalvoices.org.uk/files/policy_position_coordinated_care_v.final_.pdf, 2012