The effects of exercise training in a weight loss lifestyle intervention on asthma control, quality of life and psychosocial symptoms in adult obese asthmatics: protocol of a randomized controlled trial.
BACKGROUND
Asthma and obesity are public health problems with increasing prevalence worldwide. Clinical and epidemiologic studies have demonstrated that obese asthmatics have worse clinical control and health related quality of life (HRQL) despite an optimized medical treatment. Bariatric surgery is successful to weight-loss and improves asthma control; however, the benefits of nonsurgical interventions remain unknown.


METHODS
This is a randomized controlled trial with 2-arms parallel. Fifty-five moderate or severe asthmatics with grade II obesity (BMI ≥ 35 kg/m(2)) under optimized medication will be randomly assigned into either weight-loss program + sham (WL + S group) or weight-loss program + exercise (WL + E group). The weight loss program will be the same for both groups including nutrition and psychological therapies (every 15 days, total of 6 sessions, 60 min each). Exercise program will include aerobic and resistance muscle training while sham treatment will include a breathing and stretching program (both programs twice a week, 3 months, 60 min each session). The primary outcome variable will be asthma clinical control. Secondary outcomes include HRQL, levels of depression and anxiety, lung function, daily life physical activity, body composition, maximal aerobic capacity, strength muscle and sleep disorders. Potential mechanism (changes in lung mechanical and airway/systemic inflammation) will also be examined to explain the benefits in both groups.


CONCLUSIONS
This study will bring a significant contribution to the literature evaluating the effects of exercise conditioning in a weight loss intervention in obese asthmatics as well as will evaluate possible involved mechanisms.


BACKGROUND
NCT02188940.
Department of Physical Therapy, University of São Paulo, Av. Dr. Arnaldo 455, Rm 1210, São Paulo, SP, 01246-903, Brazil. pattydfreitas@yahoo.com.br.
Patricia D
PD
Freitas
Department of Physical Therapy, University of São Paulo, Av. Dr. Arnaldo 455, Rm 1210, São Paulo, SP, 01246-903, Brazil. palmira.ferreira@incor.usp.br.
Palmira G
PG
Ferreira
Department of Psychology, University of São Paulo, Sao Paulo, Brazil. analuci.s@hc.fm.usp.br.
Analuci
A
da Silva
Department of Nutrition, University of São Paulo, Sao Paulo, Brazil. soniatrecco@uol.com.br.
Sonia
S
Trecco
Department of Pulmonary Heart Institute (InCor), University of São Paulo, Sao Paulo, Brazil. rafael.stelmach@incor.usp.br.
Rafael
R
Stelmach
Department of Pulmonary Heart Institute (InCor), University of São Paulo, Sao Paulo, Brazil. alberto.cukier@incor.usp.br.
Alberto
A
Cukier
Department of Pulmonary Heart Institute (InCor), University of São Paulo, Sao Paulo, Brazil. regina.carvalho@incor.usp.br.
Regina
R
Carvalho-Pinto
Department of Pulmonary Heart Institute (InCor), University of São Paulo, Sao Paulo, Brazil. joao.salge@incor.usp.br.
João Marcos
JM
Salge
Department of Pulmonary Heart Institute (InCor), University of São Paulo, Sao Paulo, Brazil. frederico.fernandes@incor.usp.br.
Frederico L A
FL
Fernandes
Department of Medicine, School of medicine, University of São Paulo, Brazil, Av. Dr. Arnaldo 455 - room 1210, Sao Paulo, SP, 01246-903, Brazil. mmancini@usp.br.
Marcio C
MC
Mancini
Department of Medicine, School of medicine, University of São Paulo, Brazil, Av. Dr. Arnaldo 455 - room 1210, Sao Paulo, SP, 01246-903, Brazil. mmartins@usp.br.
Milton A
MA
Martins
Department of Physical Therapy, University of São Paulo, Av. Dr. Arnaldo 455, Rm 1210, São Paulo, SP, 01246-903, Brazil. cscarval@usp.br.|Department of Medicine, School of medicine, University of São Paulo, Brazil, Av. Dr. Arnaldo 455 - room 1210, Sao Paulo, SP, 01246-903, Brazil. cscarval@usp.br.
Celso R F
CR
Carvalho
D061725:Accelerometry; D001007:Anxiety / Q000523:psychology; D001249:Asthma / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D001521:Behavior Therapy; D001823:Body Composition; D001944:Breath Tests; D003863:Depression / Q000523:psychology; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D006801:Humans; D009043:Motor Activity; D053580:Muscle Strength; D009569:Nitric Oxide / Q000032:analysis; D009765:Obesity / Q000150:complications / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life / Q000523:psychology; D055070:Resistance Training / Q000379:methods; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders; D013147:Spirometry; D016896:Treatment Outcome; D061217:Weight Reduction Programs / Q000379:methods*
D009569:Nitric Oxide