CLINICAL AND FUNCTIONAL INDICATORS OVER TIME IN OVERWEIGHT PATIENTS WITH BRONCHIAL ASTHMA RECEIVING STANDARD THERAPY VS. STANDARD THERAPY WITH A COMPLEX OF REHABILITATION MEASURES

Abstract

The combination of bronchial asthma and obesity leads to increased severity of bronchial asthma course and poorer control level, the development of resistance to basic therapy, and increased frequency of hospitalizations. Modern approaches to the treatment of bronchial asthma and obesity suggest that more attention should be paid to comprehensive rehabilitation programs using methods aimed at all pathogenesis stages of this combination of diseases. Objective: to analyze changes in clinical and functional indicators over time in overweight patients with bronchial asthma receiving standard therapy vs. standard therapy with a complex of rehabilitation measures The study involved 102 overweight patients (body mass index (BMI) ≤ 39.9 kg/height, m2) with persistent asthma of moderate severity aged 35–60 years. The patients were divided into 2 groups. Group I included 72 patients receiving standard pharmacologic therapy (budesonide 160 μg and formoterol 4.5 μg) along with a diet close to the Mediterranean diet, as well as a complex of rehabilitation measures, which included Buteyko breathing technique plus respiratory gymnastics and dosed walking. Group II (30 patients) received only standard pharmacologic therapy along with a diet close to the Mediterranean diet. The duration of the therapy was 6 months. All patients underwent general clinical studies, spirometry, the 6-minute walk test (6MWT) with dyspnea assessment according to the Borg Dyspnoea Scale, surveys using the Asthma Control Questionnaire-5, St George's Respiratory Questionnaire (SGRQ), Beck Depression Inventory, and Spielberger–Khanin Anxiety Inventory. It was found that the patients receiving treatment along with physical rehabilitation measures presented with more pronounced positive changes, so the indices of FVC and 6MWT medians in Group I were 6 times and 2.4 times higher, respectively. The changes in ACQ5, SGRQ, BDI, and SAI-t score medians in Group I were also more prominent and exceeded the values in Group II by 1.8 times, 4.4 times, 2.5 times, and 3.5 times, respectively. Inclusion of physical rehabilitation measures, i.e. Buteyko breathing technique, respiratory gymnastics, and dosed walking, contributes to a significant increase in FEV1 and statistically significant improvement in quality of life and psychological status after 6 months of therapy.