Abstract
BackgroundPhysical inactivity is common in severe asthma and associated with poor health outcomes. New approaches are needed to address physical inactivity in this group.ObjectiveTo examine whether yoga and mindfulness improves health-related quality of life (HRQoL) compared with a minimal active control group and collect feasibility data to inform future studies.MethodsOver 12-weeks, adults with severe asthma were recruited. Participants were randomised 2:1 to parallel yoga or control groups. All participants received an activity tracker. The yoga group received tailored group classes twice a week for 16-weeks with a qualified yoga instructor. The control group set activity goals with a research officer and received eight progress calls. Outcomes were assessed at 16-weeks. Primary outcome was St George’s Respiratory Questionnaire (SGRQ). Secondary outcomes included asthma control, physical activity, breathlessness, and inflammation. Face-to-face qualitative interviews were conducted to determine acceptability.ResultsThere were 15 participants randomised to yoga (mean 67 years; 60% female) and 9 to control (68 years; 56% female). Planned comparisons indicated the yoga group had greater SGRQ improvement than the control group. There was little change in secondary outcomes. Moderate-vigorous activity increased substantially in the control group. Participants found the intervention acceptable; key barriers and facilitators were social connection, the setting, addressing breathing and asthma symptoms, changing their mindset, and the intersection of different elements.ConclusionA yoga and mindfulness intervention was feasible, acceptable to patients and improved HRQoL. The findings will inform design of much needed future research into physical activity interventions for severe asthma.World Health Organization International Clinical Trials Registry Platform The study was registered under the Australian New Zealand Clinical Trials Registry (ANZCTR) on the 26th of November 2018, Trial ID ACTRN12618001914257.
Highlights
People with severe asthma have a range of comorbidities and risk factors that worsen prognosis and impair quality of life [1]
Given the benefits of physical activity in healthy populations [5, 6], asthma [7, 8] and Chronic obstructive pulmonary disease (COPD) [9, 10], it is likely that increasing physical activity and reducing sedentary time will lead to improved outcomes for people with severe asthma
High quality studies are lacking, evidence suggests that yoga and mindfulness have positive effects on asthma-related quality of life when compared with usual care in mild to moderate disease, with mixed or limited evidence as to whether yoga influences spirometry, biomarkers or asthma control [13,14,15]
Summary
People with severe asthma have a range of comorbidities and risk factors that worsen prognosis and impair quality of life [1]. Physical inactivity is associated with negative health outcomes, including obesity, anxiety and depression, which are common comorbidities in severe asthma [1, 3, 4]. Given the benefits of physical activity in healthy populations [5, 6], asthma [7, 8] and COPD [9, 10], it is likely that increasing physical activity and reducing sedentary time will lead to improved outcomes for people with severe asthma. This can be complex in severe asthma as exercise can increase symptoms and lead to fear of exercising and increased sedentary behaviour [10].
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