title: The Role of Exercise in a Weight-Loss Program on Clinical Control in Obese Adults with Asthma. A Randomized Controlled Trial.
abstract: Clinical control is difficult to achieve in obese patients with asthma. Bariatric surgery has been recommended for weight loss and to improve asthma control; however, the benefits of nonsurgical interventions have been poorly investigated.
  
  
  
  To examine the effect of exercise training in a weight-loss program on asthma control, quality of life, inflammatory biomarkers, and lung function.
  
  
  
  Fifty-five obese patients with asthma were randomly assigned to either a weight-loss program plus exercise (WL + E group, n = 28) or a weight-loss program plus sham (WL + S group, n = 27), where the weight-loss program included nutrition (caloric restriction) and psychological therapies. The WL + E group incorporated aerobic and resistance muscle training, whereas the WL + S group incorporated breathing and stretching exercises.
  
  
  
  The primary outcome was clinical improvement in asthma control over 3 months. Secondary outcomes included quality of life, lung function, body composition, aerobic capacity, muscle strength, and inflammatory/antiinflammatory biomarkers. After 3 months, 51 patients were analyzed. Compared with the WL + S group, the WL + E group demonstrated improved clinical control scores (median [25th to 75th percentile], -0.7 [-1.3 to -0.3] vs. -0.3 [-0.9 to 0.4]; P = 0.01) and greater weight loss (mean ± SD, -6.8% ± 3.5 vs. -3.1% ± 2.6; P < 0.001) and aerobic capacity (median [25th to 75th percentile], 3.0 [2.4 to 4.0] vs. 0.9 [-0.3 to 1.3] ml O2× kg-1× min-1; P < 0.001). These improvements in the WL + E group were also accompanied by improvements in lung function, antiinflammatory biomarkers, and vitamin D levels, as well as reductions in airway and systemic inflammation.
  
  
  
  Adding exercise to a short-term weight-loss program should be considered as a useful strategy for achieving clinical control of asthma in obese patients. Clinical trial registered with www.clinicaltrials.gov (NCT 02188940).
authors.affiliation: 1 Department of Physical Therapy.
authors.forename: Patricia D
authors.initials: PD
authors.lastname: Freitas
authors.affiliation: 1 Department of Physical Therapy.
authors.forename: Palmira G
authors.initials: PG
authors.lastname: Ferreira
authors.affiliation: 1 Department of Physical Therapy.
authors.forename: Aline G
authors.initials: AG
authors.lastname: Silva
authors.affiliation: 2 Pulmonary Division, Heart Institute (InCor), Clinics Hospital.
authors.forename: Rafael
authors.initials: R
authors.lastname: Stelmach
authors.affiliation: 2 Pulmonary Division, Heart Institute (InCor), Clinics Hospital.
authors.forename: Regina M
authors.initials: RM
authors.lastname: Carvalho-Pinto
authors.affiliation: 2 Pulmonary Division, Heart Institute (InCor), Clinics Hospital.
authors.forename: Frederico L A
authors.initials: FL
authors.lastname: Fernandes
authors.affiliation: 3 Obesity and Metabolic Syndrome, Endocrinology and Metabolic Service of Clinics Hospital.
authors.forename: Marcio C
authors.initials: MC
authors.lastname: Mancini
authors.affiliation: 4 Laboratory of Medical Investigation in Dermatology and Immunodeficiency-LIM 56, Department of Dermatology, and.
authors.forename: Maria N
authors.initials: MN
authors.lastname: Sato
authors.affiliation: 5 Department of Medicine, Laboratory of Experimental Therapeutics, Medical School, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Milton A
authors.initials: MA
authors.lastname: Martins
authors.affiliation: 1 Department of Physical Therapy.
authors.forename: Celso R F
authors.identifier: 0000-0003-3046-3412
authors.initials: CR
authors.lastname: Carvalho
mesh_terms: D001249:Asthma / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D031204:Caloric Restriction / Q000379:methods; D015444:Exercise; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000503:physiopathology; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D009765:Obesity / Q000150:complications* / Q000628:therapy; D011788:Quality of Life; D055070:Resistance Training; D012129:Respiratory Function Tests; D061217:Weight Reduction Programs / Q000379:methods*
chemical_list: D015415:Biomarkers
keywords: asthma; clinical trial; exercise training; obesity