Breathing & Mild Physical Exercise Therapy for Asthma

• Change in Post-bronchodilator Forced Expired Volume in one second (FEV1) [ Time Frame: At baseline (pre-exercise) and two different time points (3 and 6 months of post-exercise) ] [ Designated as safety issue: No ]
  Investigators are expecting positive changes (improvement) in Forced Expired Volume in one second (FEV1) over the course of time. FEV1 is an indicator of improvement in the lung functions and, therefore, asthma control.
  
  

• Improvement in other pulmonary functions as well as quality of life assessment [ Time Frame: At baseline (pre-exercise) and two different time points (3 and 6 months of post-exercise) ] [ Designated as safety issue: No ]
  Other pulmonary function tests will be measured for the assessment of pulmonary function. A standard Asthma Control Questionnaire will be used to measure improvement in the quality of life
  
  
• Change in Fraction of exhaled nitric oxide (FeNO) [ Time Frame: At baseline (pre-exercise) and two diiferent time points (3 and 6 months of post-exercise) ] [ Designated as safety issue: No ]
  
• Change in Immunological Markers [ Time Frame: At baseline (pre-exercise) and two different time points (3 and 6 months of post-exercise) ] [ Designated as safety issue: No ]
  To determine how the protocol specific intervention affects Immunological Markers.
  
  

Asthmatics particularly obese have major constraints impeding regular physical activity and exercise. Indeed, the few studies that have resorted to the option of exercise in asthmatic patients also recognized the exacerbation of associated symptoms as a major limitation of this approach. Considering the other obstacles that are often involved, such as lack of time and motivation, inadequate social support and lack of access to facilities etc, it is therefore all the more necessary to design a simple, feasible and carefully tailored breathing exercise modality in obese patients with asthma, and to study its impact on the improvement of clinico-immunological parameters, lung function and overall quality of life. To this end, investigators have developed a safe and feasible light breathing exercise program for individuals with asthma based on our previous observations.

Study Aims & Objectives:

The investigators' main goal is to apply a well defined simple exercise program that includes physical and breathing exercise lessons and evaluate its effects on the improvement of clinico-immunological outcome in obese patients with asthma. There are three main objectives based on clinic-immunological outcome.

1. To assess the improvement of asthma control, lung function and airways hyper-reactivity after the intervention.
2. To test if the proposed intervention will result in the improvement of pro-inflammatory profiles.
3. To determine if physical and psychological performances as well as health related quality of life are positively impacted by the proposed exercise modality.

About 200 individuals with asthma will be enrolled in this study and divided into two groups: The intervention group and controls. The intervention group will receive standard asthma care along with breathing/mild physical exercise. The control group will be the asthmatic patients who are not willing to receive the exercise intervention. At study entry, participants will undergo a clinical assessment which includes physical exam, asthma control/ quality of life questionnaires, pulmonary function tests, and lung inflammation test (Exhaled Nitric Oxide). To monitor participants throughout the study, follow up visits will be done at 6, 12, 18 and 24 weeks after starting the exercise. About 40 ml blood will be collected at baseline (pre-exercise) and two different time points (3 and 6 months of post-exercise). The blood samples will be used for pro-inflammatory profiles. Duration of the study will be three years.