Characteristics of Responders and Short- and Medium-Term Effects of a Behavioral Intervention to Increase Physical Activity in Moderate-to-Severe Asthma.

Abstract

Behavioral interventions (BI) to increase physical activity in daily life (PADL) seem to improve asthma control. However, studies have included fewer individuals and assessed only the short-term effect. In addition, the responders' profiles remain unknown. To identify the characteristics of patients who respond to a BI to increase PADL and assess the clinical response to BI in the short and medium term. In this prospective pragmatic study, 100 inactive individuals with uncontrolled or partially controlled moderate-to-severe asthma (Asthma Control Questionnaire [ACQ] >0.75) underwent an 8-week BI (up to 90 minutes/session, once a week). Preintervention, postintervention (short-term), and postintervention 4-month follow-up (medium-term) assessments included PADL (triaxial accelerometry), ACQ, health-related quality of life (HRQoL) (Asthma Quality of Life Questionnaire, AQLQ), and anxiety and depression symptoms (Hospital Anxiety and Depression Scale, HADS). The stage of change for physical activity was classified using the transtheoretical model. Individuals who increased their activity by ≥2500 steps/day were considered responders. Most individuals were female (89%), and had a median age of 53 years, a body mass index (BMI) of 31.0 kg/cm², an ACQ score of 2.17, 4340 steps/day, and a moderate-to-vigorous physical activity (MVPA) of 69.5 minutes/week. After intervention, individuals increased steps/day, MVPA, and AQLQ scores and decreased ACQ and HADS scores (P < .05). Most individuals also demonstrated a positive behavior change toward becoming more physically active. Improvements in PADL, ACQ, and AQLQ were maintained at follow-up. At baseline, responders had lower BMI, fewer steps/day, and spent less time in MVPA than nonresponders (P < .05). Individuals who responded to BI had lower BMI and lower levels of PADL at baseline. BI improves PADL, clinical control, and HRQoL in the short and medium term. The intervention also promoted sustained behavior change toward a more active lifestyle.