Home-Based Pulmonary Rehab Improves Exercise Tolerance, QoL in Severe Asthma

Home-based pulmonary rehabilitation, which includes exercise training, resumption of physical activities of daily living, therapeutic education, and psychological as well as social and motivational support, improves long-term exercise tolerance and quality of life in patients with severe asthma, study results in Respiratory Medicine suggest.

The study was a retrospective analysis of data from 28 patients with severe asthma (age 61.5±16.2 years; forced expiratory volume in 1 second [FEV₁], 51.4±17.3%) and 164 matched patients with chronic obstructive pulmonary disease (COPD; age 64.3±11.6 years; FEV₁, 47.7±15.5%). Patients included in the analysis had previously completed a home-based pulmonary rehabilitation program, delivered once a week for 8 weeks, and had ≥12 months of follow-up data available for analysis.

Researchers examined the number of pulmonary rehabilitation steps performed during a 6-minute stepper test (6MST), which assessed exercise tolerance. They also assessed changes in Hospital Anxiety and Depression (HAD) scores and the Visual Simplified Respiratory Questionnaire score (VSRQ) between baseline and the post-pulmonary rehabilitation period as well as at 12-month follow-up. Additionally, changes in these scores were compared between the groups of patients with severe asthma and COPD.

Participants with severe asthma had higher scores on the 6MST after pulmonary rehabilitation (504±150 steps; P =.043) and at 12-month follow-up (538±163 steps; P =.016) compared with scores at baseline (450±148 steps). With regard to changes in the VSRQ score from baseline (32.2±12.4), the score was highest at 12 months (39.0±18.6; P =.049) but not immediately after pulmonary rehabilitation (38.7±15.8; P =.119). The researchers observed no difference between baseline, post-pulmonary rehabilitation, and 12-month follow-up in terms of changes in HAD scores. In addition, there was no significant difference between patients with severe asthma and COPD with regard to the number of steps performed during each assessment (P >.05).

Limitations of the study included its retrospective and observational design, the small sample size, and the lack of randomization. Joining a home-based pulmonary rehabilitation program was based on the patient’s personal preference and/or the absence of a local rehabilitation facility.

The researchers wrote that their findings “point out the interest of [pulmonary rehabilitation] in severe asthma, which is likely to ease the burden of the disease for the patient, his/her relatives and society.”

Reference

Grosbois J-M, Coquart J, Fry S, et al. Long-term effect of home-based pulmonary rehabilitation in severe asthma. Respir Med. 2019;157:36-41.