Abstract
Background: to achieve control of asthma and reduce mortality, as well as improve the patients' quality of life, it requires not only the new drugs development and improvement of stepwise therapy regimens but also new approaches to comprehensive individual rehabilitation programs for patient management. Aim: to assess the impact of comprehensive rehabilitation programs on asthma control, pulmonary function, motor activity, and quality of life (QOL) in multimorbid patients with asthma and obesity. Patients and Methods: 70 patients with asthma and obesity were divided into 2 groups of 35 subjects: group 1, in which patients underwent a rehabilitation program, and group 2, patients who were only under the outpatient supervision of a pulmonologist.The following tests were conducted twice: Asthma Control Questionnaire (ACQ-5), Cumulative Illness Rating Scale (CIRS) for assessing the multimorbid profile, 6-minute walk test for identifying the functional capacity, ODA23+ for motor activity assessment, QOL according to Asthma Quality of Life Questionnaire (AQLQ), pulmonary function test. Results: the patients were comparable in all assessed parameters. Functional capacity in both groups corresponded to the class I. The motor activity level according to ODA23+ was low to moderate. In group 1, the CIRS index was 10.0±1.1, in group 2 – 9.2±1.1 (p>0.005). After rehabilitation actions in group 1, the BMI decreased by 0.7 kg/m2 and waist circumference by 3.3 cm (p<0.05), motor activity increased from 63.8±4.9 to 70.4±4.5 (p<0.0001). In group 2, motor activity increased unreliably: the number of patients with low motor activity increased by 11.4%. The level of asthma control according to ACQ-5 in group 1 was 1.2±0.1, in group 2 — 1.58±0.1 (p<0.05). QOL in group 1 increased from 3.8±0.4 to 4.5±0.3 (p<0.0001) in all major domains except the emotional function, which increased unreliably (p>0.05). In group 2, QOL did not change significantly (p>0.05). Conclusion: to increase the level of asthma control, multimorbid patients with preserved rehabilitation potential should be offered multicomponent rehabilitation programs that affect both asthma and concomitant diseases. The use of rehabilitation programs improves the asthma control, increases the QOL of obese patients, promotes weight loss, increases motor activity level and functional capacity.
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