Daily Walking Matched Supervised Aerobic Training in an Asthma Trial

For physically inactive adults with uncontrolled moderate-to-severe asthma, a program focused on increasing daily walking produced results comparable to supervised aerobic training in a randomized clinical trial led by researchers at the University of São Paulo. The findings were published in Pulmonology.

The study enrolled 52 adults between 18 and 65 after 480 people were invited to participate. Participants had been receiving medical treatment for at least six months, had no asthma exacerbation in the previous 30 days, engaged in less than 150 minutes of moderate-to-vigorous activity per week, and were nonsmokers.

Before the interventions began, all participants attended an in-person educational session covering asthma, medication use, and physical activity. They were then randomly assigned to one of two eight-week programs.

The aerobic-training group attended the Heart Institute of Hospital das Clínicas twice each week for 45-minute treadmill sessions supervised by professionals. The behavioral-intervention group visited once weekly for up to 90 minutes of counseling and guidance aimed at increasing physical activity through walking and weekly step goals. Participants in that group received smartwatches to monitor their steps.

Researchers assessed physical activity, asthma control, quality of life, and symptoms of anxiety and depression at baseline, immediately after the intervention, and four months later. During each assessment period, participants also wore accelerometers on their waist during the day and wrist at night to measure steps and sleep quality. The assessors did not know which intervention each participant had received.

Both groups reported fewer respiratory symptoms after the intervention, and those improvements were still present at the four-month follow-up. The researchers also reported improvements in asthma control, quality of life, and symptoms of anxiety and depression, with neither approach outperforming the other.

Daily steps rose by an average of 1,537 in the aerobic-training group immediately after the program, compared with 1,126 in the behavioral group. Four months later, the increases were 983 and 996 steps, respectively, relative to baseline. Step counts declined after the intervention in both groups but remained above their starting levels.

The study population primarily consisted of overweight or grade 1 obese women who began with low quality of life and symptoms of anxiety and depression. Some participants stopped their activities during follow-up, citing changing weather as the main reason.

The researchers described walking as a potentially more accessible strategy because it requires less equipment and supervision than treadmill training. The intervention was intended to complement—not replace—the medication regimen recommended by the Global Initiative for Asthma, according to the study report.