Background

Achieving symptom control, minimizing the future risk of poor outcomes and improving quality of life (QoL) are priorities for asthma management. Pulmonary rehabilitation (PR) is recognized as a core component of management of individuals with chronical respiratory diseases, but that is still poorly investigated in uncontrolled asthma. Aim of our study is to investigate the effectiveness of a multidisciplinary PR on exercise tolerance, asthma control and QoL.

Methods

These data are from an ongoing study. After a comprehensive assessment by a multidisciplinar team (pulmonologist, psychologist, pulmonary nurse, physiotherapist and social worker), during which treatable traits were identified, forming the basis of a personalized PR program aimed at individual treatment goals, patients were admitted to a 10-week PR. Primary endpoints were exercise tolerance, QoL and asthma control as measured by an Endurance Shuttle Walking Test (ESWT), Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Questionnaire (ACQ) total scores, respectively, at baseline and at the end of PR.

Results

43 patients (16% males, age 51,7 ± 15.4 ys,) with uncontrolled asthma and treated according to GINA steps 4 or 5 completed a 10-week PR. All patients showed a significant increase in ESWT (474 versus 675 meters, p<0,001), an improvement in ACQ (15,8 versus 10,7, p<0,001) and in AQLQ (4,2 versus 5,1, p<0,001). A decrease in baseline dyspnea and muscle fatigue was also reported.

Conclusions

Subjects with severe and difficult to control asthma seem to benefit from a pulmonary rehabilitation in in terms of exercise tolerance, asthma-related QoL and control.