Effect of an Outpatient Pulmonary Rehabilitation Program on Exercise Tolerance and Asthma Control in Obese Asthma Patients

PURPOSE: To compare the effects of an outpatient pulmonary rehabilitation (PR) program on exercise tolerance and asthma control in obese and nonobese patients with asthma. METHODS: Nonobese (body mass index [BMI] <30 kg/m(2)) and obese (BMI 30 kg/m(2)) patients with asthma who participated in a local multidisciplinary 12-week PR program were analyzed retrospectively. Effects of PR were assessed by changes in 6-minute walking distance (6MWD) and Asthma Control Questionnaire (ACQ). RESULTS: A total of 138 asthma patients were included: 53 (38.4%) obese and 85 (61.6%) nonobese. At baseline, obese patients with asthma had a lower level of exercise tolerance reflected by a lower 6MWD (525 m vs 621 m; P < .001). After PR, the 6MWD improved significantly in both groups (50 m in nonobese vs 45 m in obese; P < .001 in both groups). The improvement in 6MWD was clinically relevant in 71% of the nonobese and 60% of the obese patients. These patients had lower 6MWD (P = .024), higher usage of long-acting -agonist (P = .034) and oral corticosteroids (P = .033). Asthma control also improved in both groups (ACQ -0.3 in nonobese vs ACQ -0.4 in obese; P = .021 and P = .019, respectively). Clinically relevant improvement was achieved by 46.5% of nonobese and 51.9% of obese patients with asthma. The improvements between the groups were not statistically different. CONCLUSIONS: A standardized PR program is feasible in obese patients with asthma and they benefit as much as nonobese patients with asthma. However, there are still a large number of patients who show no clinically significant improvement. Patients with more severe asthma seem to benefit the most from PR.