Use of a multidisciplinary pulmonary rehabilitation program in patients with severe asthma is effective in improving functional exercise capacity and symptoms. Exercise capacity has been shown to improve in the presence of obstructive sleep apnea and bronchiectasis as well. A retrospective study was conducted among patients with severe asthma who were admitted to Istituti Clinici Scientifici Maugeri of Tradate, Italy, between January 2007 and June 2017. Results of the study were published in the Journal of Asthma.

The investigators sought to explore the effectiveness of pulmonary rehabilitation on functional exercise, dyspnea, and muscle fatigue among patients with severe asthma. A total of 371 participants ≥18 years of age with a diagnosis of severe asthma, based on current Global Initiative for Asthma guidelines, were enrolled in the study. The median participant age was 66 years (range, 57 to 72 years); 35.9% of the patients were men. Of the 371 patients evaluated, 39 had bronchiectasis, 163 had obstructive sleep apnea, and 17 had both conditions.

All participants underwent a multidisciplinary 3-week inpatient rehabilitation program, with an adherence of >80% to pulmonary rehabilitation. Enrollees also needed to exhibit the ability to perform and complete a 6-minute walk test (6MWT). Pulmonary rehabilitation included endurance training, chest physiotherapy, breathing exercises, psychological support, and educational meetings.

Prior to and following pulmonary rehabilitation, 6-minute walking distance, as well as the Borg scale for dyspnea and muscle fatigue, were recorded.

Results of the analysis showed that pulmonary rehabilitation significantly improved 6MWT, Borg dyspnea and muscle fatigue, and mean peripheral oxygen saturation recorded during 6MWT (P <.0001 for all outcomes). The median delta 6-minute walking distance was 33 meters (range, 14 to 60 meters). Furthermore, 6MWT distance (P <.0001) and oxygen saturation (P <.01) were both significantly improved in those participants with severe asthma who also had obstructive sleep apnea and/or bronchiectasis.

The investigators concluded that the current study provides first-time evidence in a large sample of patients with severe asthma that a multidisciplinary pulmonary rehabilitation program improves exercise capacity and symptoms. Additional studies are warranted to estimate these values in patients with chronic obstructive pulmonary disease.

Reference

Zampogna E, Centis R, Negri S, et al. Effectiveness of pulmonary rehabilitation in severe asthma: a retrospective data analysis [published online August 13, 2019]. J Asthma. doi:10.1080/02770903.2019.1646271

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