A comprehensive 8-week behavior change intervention designed to increase physical activity in adults with asthma was associated with improvements in asthma control, sleep quality, and symptoms of anxiety, according to study results published in CHEST.
Researchers conducted a study (ClinicalTrials.gov Identifier: NCT03705702) that included patients with moderate or severe asthma (age range, 18-60 years) who reportedly engaged in fewer than 150 minutes per week of moderate to vigorous intensity physical activity and described poorly controlled asthma on the Asthma Control Questionnaire (ACQ score >1.5) despite receipt of optimal therapy. Patients were randomly assigned to a behavioral change intervention group (n=25) or to a control group that received usual care (n=26).
The intervention group received usual care plus a once-weekly 40-minute face-to-face counseling session that included activities designed to encourage participants to increase their physical activity levels. Behavior techniques used during the sessions included: goal setting; problem solving and action planning; reviewing, monitoring, and providing feedback on behavior; reporting information on health consequences; prompts and cues; behavior substitution; habit formation and reversal; verbal persuasion about capacity; and environment restructuring.
At baseline, participants said they spent an average of 63%±9% of their waking hours sedentary and engaged in 106±48 minutes per week of moderate to vigorous physical activity. Individuals who received the once-weekly counseling sessions for the 8-week study period had significant improvements in asthma control (mean difference [MD] in ACQ score, -0.8; 95% CI, -1.1 to -0.4) as well as in daily step count (MD, 3605 steps/d; 95% CI, 1937-8867), sleep efficiency (MD, 9.2; 95% CI, 6.9-12.2-21.9], and reductions in sedentary time (MD, -1.1 hours/d; -2.9 to -0.6).
In addition, a significantly higher proportion of patients in the intervention group reported a reduction in anxiety symptoms compared with those randomly assigned to the control group (43% vs 0%, respectively; P <.001).
Exacerbations were reported in 26% of patients who received the behavioral intervention and in 60% of patients who received usual care only (P =.04). There was an inverse association between the change in time spent in moderate intensity physical activity with change in ACQ (r= -0.60; P <.001).
Limitations of the study included the high number of women in the cohort (83%), the small sample size, and the short duration of the intervention.
The investigators concluded that this comprehensive behavior change approach “can potentially be a complementary or alternative strategy to supervised exercise training to improve clinical control in adults with moderate to severe asthma.”
Freitas PD, Passos NFP, Carvalho-Pinto RM, et al. A behaviour change intervention aimed at increasing physical activity improves clinical control in adults with asthma: a randomised controlled trial. Published online September 12, 2020. CHEST. doi:10.1016/j.chest.2020.08.2113