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Patient perceived barriers to exercise and their clinical associations in difficult asthma

Patient perceived barriers to exercise and their clinical associations in difficult asthma
Patient perceived barriers to exercise and their clinical associations in difficult asthma
Background: exercise is recommended in guidelines for asthma management and has beneficial effects on symptom control, inflammation and lung function in patients with sub-optimally controlled asthma. Despite this, physical activity levels in patients with difficult asthma are often impaired. Understanding the barriers to exercise in people with difficult asthma is crucial for increasing their activity, and in implementing successful, disease modifying, and holistic approaches to improve their health.
Methods: 62 Patients within the WATCH Difficult Asthma Cohort (Southampton, UK) completed an Exercise Therapy Burden Questionnaire (ETBQ). The results were analyzed with contemporaneous asthma-related data to determine relationships between perceived exercise barriers and asthma and comorbidity characteristics.

Results: patients were reflective of a difficult asthma cohort, 66% were female, and 63% were atopic. They had a high BMI (median [Inter-quartile range]) of 29.3 [25.5-36.2], age of 53.5 [38.75, 42 65.25], impaired spirometry with FEV1 73% predicted [59.5, 86.6%] and FEV/FVC ratio of 72 [56.5, 78.0] and poor symptom control, as defined by an Asthma Control Questionnaire (ACQ6) result of 2.4 [1.28, 3.2]. A high perceived barriers to exercise score was significantly correlated with increased asthma symptoms (r=0.452, p<0.0001), anxiety (r=0.375, p=0.005) and depression (r=0.363, p=0.008), poor quality of life (r=0.345, p=0.015) and number of rescue oral steroid courses in the past 12 months (r=0.257, p=0.048). Lung function, blood eosinophil count, FeNO, Njimegen and SNOT22 scores, BMI and hospitalisations in the previous year were not related to exercise perceptions.
Conclusion: in difficult asthma, perceived barriers to exercise are related to symptom burden and psychological morbidity. Therefore, exercise interventions combined with psychological input such as CBT to restructure thought processes around these perceived barriers may be useful in facilitating adoption of exercise.
2054-7064
Freeman, Anna Teresa
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Hill, David
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Newell, Colin
412feb1c-ae29-4663-8720-a5ab96fa27c1
Moyses, Helen E.
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Azim, Adnan
87c31e0e-c9bf-4258-9ae9-889e2382e7ba
Knight, Deborah
4f44f912-5106-4fb5-9cf2-b4f86440523c
Laura, Presland
36a180f6-4ecc-4f1c-bb72-527a19228b9c
Harvey, Matt
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Haitchi, Hans Michael
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Watson, Alastair
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Staples, Karl J
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Kurukulaaratchy, Ramesh
9c7b8105-2892-49f2-8775-54d4961e3e74
Wilkinson, Tom M. A.
8c55ebbb-e547-445c-95a1-c8bed02dd652
Freeman, Anna Teresa
3d83f907-e7ce-4649-a018-a7a31b19f934
Hill, David
5d8b9125-4615-4946-918b-e4193a1eb9e7
Newell, Colin
412feb1c-ae29-4663-8720-a5ab96fa27c1
Moyses, Helen E.
6dba7e08-81cf-4162-8a88-0c86fc8eece2
Azim, Adnan
87c31e0e-c9bf-4258-9ae9-889e2382e7ba
Knight, Deborah
4f44f912-5106-4fb5-9cf2-b4f86440523c
Laura, Presland
36a180f6-4ecc-4f1c-bb72-527a19228b9c
Harvey, Matt
4bb9ff8e-52c0-47f7-9647-90b5de76a02c
Haitchi, Hans Michael
68dadb29-305d-4236-884f-e9c93f4d78fe
Watson, Alastair
9eb79329-8d32-4ed4-b8b9-d720883e8042
Staples, Karl J
e0e9d80f-0aed-435f-bd75-0c8818491fee
Kurukulaaratchy, Ramesh
9c7b8105-2892-49f2-8775-54d4961e3e74
Wilkinson, Tom M. A.
8c55ebbb-e547-445c-95a1-c8bed02dd652

Freeman, Anna Teresa, Hill, David, Newell, Colin, Moyses, Helen E., Azim, Adnan, Knight, Deborah, Laura, Presland, Harvey, Matt, Haitchi, Hans Michael, Watson, Alastair, Staples, Karl J, Kurukulaaratchy, Ramesh and Wilkinson, Tom M. A. (2020) Patient perceived barriers to exercise and their clinical associations in difficult asthma. Asthma Research and Practice, 6. (doi:10.1186/s40733-020-00058-6).

Record type: Article

Abstract

Background: exercise is recommended in guidelines for asthma management and has beneficial effects on symptom control, inflammation and lung function in patients with sub-optimally controlled asthma. Despite this, physical activity levels in patients with difficult asthma are often impaired. Understanding the barriers to exercise in people with difficult asthma is crucial for increasing their activity, and in implementing successful, disease modifying, and holistic approaches to improve their health.
Methods: 62 Patients within the WATCH Difficult Asthma Cohort (Southampton, UK) completed an Exercise Therapy Burden Questionnaire (ETBQ). The results were analyzed with contemporaneous asthma-related data to determine relationships between perceived exercise barriers and asthma and comorbidity characteristics.

Results: patients were reflective of a difficult asthma cohort, 66% were female, and 63% were atopic. They had a high BMI (median [Inter-quartile range]) of 29.3 [25.5-36.2], age of 53.5 [38.75, 42 65.25], impaired spirometry with FEV1 73% predicted [59.5, 86.6%] and FEV/FVC ratio of 72 [56.5, 78.0] and poor symptom control, as defined by an Asthma Control Questionnaire (ACQ6) result of 2.4 [1.28, 3.2]. A high perceived barriers to exercise score was significantly correlated with increased asthma symptoms (r=0.452, p<0.0001), anxiety (r=0.375, p=0.005) and depression (r=0.363, p=0.008), poor quality of life (r=0.345, p=0.015) and number of rescue oral steroid courses in the past 12 months (r=0.257, p=0.048). Lung function, blood eosinophil count, FeNO, Njimegen and SNOT22 scores, BMI and hospitalisations in the previous year were not related to exercise perceptions.
Conclusion: in difficult asthma, perceived barriers to exercise are related to symptom burden and psychological morbidity. Therefore, exercise interventions combined with psychological input such as CBT to restructure thought processes around these perceived barriers may be useful in facilitating adoption of exercise.

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Accepted/In Press date: 2 June 2020
Published date: 9 June 2020

Identifiers

Local EPrints ID: 441399
URI: http://eprints.soton.ac.uk/id/eprint/441399
ISSN: 2054-7064
PURE UUID: 858efb83-73aa-4e78-ad6a-7ddb45616803
ORCID for Hans Michael Haitchi: ORCID iD orcid.org/0000-0001-8603-302X
ORCID for Karl J Staples: ORCID iD orcid.org/0000-0003-3844-6457
ORCID for Ramesh Kurukulaaratchy: ORCID iD orcid.org/0000-0002-1588-2400

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Date deposited: 11 Jun 2020 16:31
Last modified: 18 Feb 2021 16:54

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Contributors

Author: Anna Teresa Freeman
Author: David Hill
Author: Colin Newell
Author: Helen E. Moyses
Author: Adnan Azim
Author: Deborah Knight
Author: Presland Laura
Author: Matt Harvey
Author: Alastair Watson
Author: Karl J Staples ORCID iD

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