Mancuso Carol A, Choi Tiffany N, Westermann Heidi, Wenderoth Suzanne, Wells Martin T, Charlson Mary E
Hospital for Special Surgery, New York, NY, USA.
J Asthma. 2013 Feb;50(1):103-7. doi: 10.3109/02770903.2012.743150. Epub 2012 Nov 22.
Asthma patients know the benefits of exercise but often avoid physical activity because they are concerned that it will exacerbate asthma. The objective of this analysis was to assess longitudinal asthma status in 256 primary care patients in New York City enrolled in a trial to increase lifestyle physical activity.
Patients were randomized to two protocols to increase physical activity during a period of 12 months. At enrollment, patients completed the Asthma Quality of Life Questionnaire (AQLQ) and the Asthma Control Questionnaire (ACQ) and received asthma self-management instruction through an evaluative test and workbook. Exercise and self-management were reinforced every 2 months. The AQLQ was repeated every 4 months and the ACQ was repeated at 12 months.
The mean age was 43 years and 75% were women. At 12 months there were clinically important increases in physical activity with no differences between groups; thus, data were pooled for asthma analyses. The enrollment AQLQ score was 5.0 ± 1.3 and increased to 5.9 ± 1.1 corresponding to a clinically important difference. Correlations between AQLQ and physical activity were approximately 0.35 (p < .0001) at each time point. In a mixed effects model, the variables associated with improvement in AQLQ scores over time were male sex, less severe asthma, not taking asthma maintenance medications, fewer depressive symptoms, and increased physical activity (all variables, p < .03). According to the ACQ, asthma was well controlled in 38% at enrollment and in 60% at 12 months (p < .0001).
With attention to self-management, increased physical activity did not compromise asthma control and was associated with improved asthma.
哮喘患者了解运动的益处，但常因担心运动会加重哮喘而避免体力活动。本分析的目的是评估纽约市256名参加增加生活方式体力活动试验的初级保健患者的哮喘纵向状况。
患者被随机分为两种方案，在12个月期间增加体力活动。入组时，患者完成哮喘生活质量问卷（AQLQ）和哮喘控制问卷（ACQ），并通过评估测试和工作手册接受哮喘自我管理指导。每2个月强化一次运动和自我管理。每4个月重复一次AQLQ，12个月时重复ACQ。
平均年龄为43岁，75%为女性。12个月时，体力活动有临床上重要的增加，两组之间无差异；因此，将数据合并用于哮喘分析。入组时AQLQ评分为5.0±1.3，增加到5.9±1.1，对应临床上的重要差异。每个时间点AQLQ与体力活动之间的相关性约为0.35（p<.0001）。在混合效应模型中，与AQLQ评分随时间改善相关的变量为男性、哮喘较轻、未服用哮喘维持药物、抑郁症状较少和体力活动增加（所有变量，p<.03）。根据ACQ，入组时38%的患者哮喘得到良好控制，12个月时为60%（p<.0001）。
在关注自我管理的情况下，增加体力活动不会损害哮喘控制，且与哮喘改善相关。
