Does the severity of asthma affect exercise capacity and daily physical activity?

Abstract

Objective

Exercise capacity, daily physical activity, and psychological profile are crucial aspects in the management of asthmatic patients. Whether these features are expressed in a different way in mild-moderate (MMA) and severe asthma (SA) is unknown.

Methods

In this observational cross-sectional study, patients matching the American Thoracic Society/European Respiratory Society (ATS/ERS) definition for SA underwent incremental cardiopulmonary exercise testing (CPET), full lung function testing, and an evaluation of daily step count and physical activity. Questionnaires on quality of life, general fatigue, and presence of anxiety and depression traits (Hospital Anxiety and Depression Scale - HADS) were administered. Patients were compared with a cohort of age- and gender-matched MMA patients.

Results

We enrolled 16 SA, 17 MMA patients, and 16 healthy subjects. Compared to MMA, SA subjects showed a median (interquartile range) reduced peak oxygen consumption during CPET (20.4 (17.2-23.3) vs. 25.6 (18.5-30.3) ml/min/kg; p = 0.019), a reduced resting lung function (FEV1% of predicted 77 (67-84) vs. 96 (84-100); p < 0.001) and a pronounced anxiety trait at HADS (9.5 (3-11.7) vs. 4.0 (2.0-7.5); p = 0.023). In addition, SA patients showed a significantly higher reduction in inspiratory capacity from rest to peak (310 (160-520) vs. 110 (-65-325) ml; p = 0.031). We found no significant differences in mean daily step count or quality of life.

Conclusions

Compared to MMA, SA patients present a reduced exercise capacity and a more pronounced anxiety trait, but not worse daily physical activity or quality of life. These aspects should be considered in the clinical management and research development of SA.

Keywords:

• Severe asthma
• exercise capacity
• cardiopulmonary exercise test
• pulmonary function testing
• psychological profile
• daily physical activity
• quality of life

Acknowledgements

The authors wish to acknowledge Ludovica Serafini and Dr. Elena Brambilla for their help in data collection. The authors also wish to thank our outstanding CPET Laboratory nurses Mrs. Giulia Merli, Mrs. Claudia Migliaccio and Mrs. Caterina Spagnuolo.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Contributorship statement

Rocco F Rinaldo: Conceptualization, Data curation, Formal analysis, Project administration, Methodology, Investigation, Writing - original draft, review & editing; Gianluca Imeri: Conceptualization, Methodology, Investigation, Writing - original draft, review & editing; Michele Mondoni: Data curation, Methodology, Investigation, Writing - original draft, review & editing; Elena Maria Parazzini: Conceptualization, Investigation, Writing - review & editing; Beatrice Vigo: Data curation, Investigation, Writing - review & editing; Alessandra Masseroni: Data curation, Investigation, Writing - review & editing; Stefano Centanni: Conceptualization, Methodology, Supervision, Writing - review & editing; Fabiano Di Marco: Conceptualization, Methodology, Formal analysis, Supervision, Writing - original draft, review & editing.

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.