Assessment of physical activity level in patients with asthma depending on body weight

Regular physical activity (PA) is a key protective factor for the prevention and treatment of chronic noncommunicable diseases, including bronchial asthma (BA).

Objective: to comprehensively evaluate the PA of patients with BA depending on body weight, taking into account the degree of disease control.

Material and methods. The study included 237 patients aged 18–78 years with BA who were divided into 3 groups according to body mass index: 1st group with normal body weight, 2nd group with overweight, 3rd group with obesity. Patient examination included assessment of BA control level, exercise tolerance, dyspnoea intensity, PA, questionnaire on motivation to PA.

Results. The highest number of physically inactive and unmotivated to physical activity (PA) was in the overweight and obese groups – 34,7 and 34,9%, respectively (p_{1, 3} < 0,0001). PA tolerance was quite high (FC-1) in all groups, but patients with obesity had the lowest 6-minute walk test score (p_{1, 3} <0,0001). Dyspnea at rest and during exercise was more bothersome in patients with obesity (mean score 4,16±0,43) than in normal and overweight patients (p_{1, 3} <0,0001). When motor activity was analyzed by ODA23+ test, a lower PA was found in patients with obesity 60,7±13,3 points in group 3 vs. 87,2±8,62 in group 1 (p <0,0001). The IPAQ test evaluation of PA level showed that group 1 patients had high PA (66,1%), group 2 patients had moderate PA (52,2%), and group 3 patients with low and moderate PA prevailed – 47,7% and 37,6%, respectively. The parameters calculated by IPAQ test «MET-minutes per week» and energy expenditure (≥3 METs, kcal/day) showed significant differences between patients of the 3 groups (F=49,87; p=0,0000 and F=35,97; p=0,0002) with the lowest values in patients with obesity. The level of BA control by ACQ-5 questionnaire was associated with the level of motor activity in all study groups. With uncontrolled asthma PA was significantly lower in patients with obesity (p=0,0002) for all questionnaires. The obtained data were confirmed by correlation analysis. The IPAQ questionnaire index PA level had a direct correlation with the 6-minute walk test (r=0,3648) and an inverse correlation with BMI (r=-0,4530), with the level of dyspnea according to the Borg scale (r=-0,3535), with the level of asthma control according to ACQ-5 (r=-0,3444), with the degree of asthma severity (r=-0,3135). MET-minutes-per-week score had an inverse correlation with age (r=-0,1444), with the level of asthma control by ACQ-5 (r=-0,1327), with BA severity (r=-0,1654), and with the level of dyspnea by Borg scale (r=-0,2508). The ODA23+ result had an inverse correlation with age (r=-0,1837), with BMI (r=-0,5523), with the level of dyspnea according to the Borg scale (r=-0,8596,) with the level of BA control according to the ACQ-5 (r=-0,6310).

Conclusion. In comorbid patients with BA and obesity, PA should be evaluated as an important overlooked personalizing feature of asthma. To improve BA control in both patients with obese and overweight and patients with normal body weight, increased PA should be included in comprehensive rehabilitation. Assessment of PA in patients with BA and obesity should include consideration of the number of steps per day and energy expenditure ≥3 METs, kcal/day to develop rehabilitation interventions.