D102-25 Pilot of a Remote Digital Therapeutic Exercise Program in Obesity and Asthma

Rationale

Obesity is a significant risk factor for the development of asthma. Individuals with asthma and concomitant obesity experience diminished asthma-related quality of life, worse asthma control, and higher asthma-related hospitalization rates. Despite increased asthma morbidity and the potential benefits of aerobic exercise in improving asthma control, few studies have addressed the impact of exercise programs in this population. This single-arm pilot study evaluated the feasibility and efficacy of a remote digital therapeutic exercise program in individuals with obesity and poorly controlled asthma.

Methods

Potential participants with obesity and asthma were identified within a pulmonary medicine and a primary care clinic associated with an academic medical center. All participants were assigned to a 12-week remote exercise program and encouraged to complete 150 minutes of exercise per week utilizing a mobile application that facilitates the prescription and monitoring of individualized exercise regimens consisting of walking, running, cycling, and strength training. Participants completed pre- and post-intervention assessments including the Asthma Control Test (ACT). We defined feasibility a priori as ≥ 60% of participants completing on average ≥ 50% of the 12-week exercise program and efficacy as ≥ 30% of participants achieving an ACT score increase of ≥ 3 points over the study period.

Results

Twenty individuals were enrolled. The median age of participants was 62.5 (IQR 49.5-66.5) years. The median BMI was 33.2 (31.5-36.5) kg/m2. The retention rate was 100%. Fifty percent of participants completed ≥ 50% of prescribed exercises. A clinically meaningful ACT score increase of ≥ 3 points was achieved by 40% of participants. Composite ACT scores increased from a median of 16.00 (IQR 14.00-19.00) pre-intervention to 19.50 (17.00-21.00) post-intervention with a median change of + 2.00 (0.00-6.00), a significant increase from baseline (p = 0.033) by Wilcoxon signed-rank test.

Conclusion

Completing ≥ 75 minutes of aerobic exercise per week was attainable for 50% of participants. Our results suggest that despite slightly lower adherence than expected, remote digital therapeutic exercise programs may be efficacious in improving asthma control among individuals with obesity and poorly controlled asthma. These data suggest future appropriately powered, randomized-controlled studies are needed to assess the potential efficacy of exercise programs in patients with obesity and poorly controlled asthma. This study was registered with https://clinicaltrials.gov as #NCT06651385.

This abstract is funded by: Vermont Lung Center at the University of Vermont Larner College of Medicine