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Effects of Pilates Exercises in Asthmatic Patients

Not Applicable
Conditions
Asthma
Interventions
Other: Pilates
Other: Muscle stretching
Registration Number
NCT03670654
Lead Sponsor
University of Sao Paulo General Hospital
Brief Summary

Asthma is a chronic respiratory disease with high prevalence worldwide, considered an important cause of morbidity, mortality and high economic costs. Aerobic physical exercise has great merit as non-pharmacological treatment and other exercise modalities have being studied. However, there are few data in the literature about the effects of Pilates method in patients with asthma. The objective of this study is evaluate the effects of a program of exercise using Pilates on health factors related to quality of life in patients with moderate or severe persistent asthma. Patients will be also evaluated about disease control, anxiety and depression symptoms, functional capacity, lung function, respiratory muscle strength, thoracoabdominal mechanics and level of daily life physical activity. The investigators' hypothesis is that strengthening of the deep trunk muscles promotes a mechanical fixation of the thorax, contributing to the clinical improvement of patients with asthma.

Detailed Description

This is a randomized, controlled and single blinded trial. Thirty adults with moderate or severe persistent asthma will be randomly assigned into two groups: Pilates method - PM (training group) or muscle stretching exercises - MSE (control group). All subjects will receive the same educational session and will perform the physical exercise proposed for the group for 12 weeks, 3 times/week, 40-minute sessions. The data normality will be analyzed by Kolmogorov-Smirnov, the variables obtained before interventions will be compared with the Student t-test or Mann-Whitney U-test. Comparisons of the initial and final data on outcomes will be analyzed with repeated measures ANOVA with appropriate post hoc of Holm-Sidak. The significance level will be set to 5% for all tests.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Asthma moderate and severe
  • Asthma will diagnosed (Global Initiative for Asthma -GINA)
  • Asthma medication according recommendations from GINA
  • Body Mass Index ≥18.5 kg/m2 and <35 kg/m2
  • Sedentary
  • Medical treatment, for at least 6 months
  • Clinically stable (i.e., no exacerbation or medication changes for at least 30 days)
Exclusion Criteria
  • Current or ex-smokers (who have given up smoking less than 1 year and/or tobacco charge greater than 10 pack-years)
  • Cardiovascular, musculoskeletal and other chronic lung diseases
  • Pregnant
  • Active cancer
  • Uncontrolled hypertension or diabetes
  • Continuous use of oral corticosteroid
  • Psychiatric disease or cognitive deficit

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Pilates MethodPilatesThe intervention of active comparator will be Pilates Method exercises.
Muscle stretching exercisesMuscle stretchingThe intervention of sham comparator will be muscle stretching exercises.
Primary Outcome Measures
NameTimeMethod
Change in health related quality of lifeChange from baseline after 3 months of intervention

Health related quality of life will be assessed by Asthma Quality Life Questionnaire (AQLQ). The AQLQ is composed by 32 items rated on a 7-point scale ranging from 7 = without limitation to 1 = maximum limitation and grouped in 4 domains: activity limitations (11 items), symptoms (12 items), emotional function (5 items) and environmental stimuli (4 items). Total score will be obtained by the average of the 32 items. The score of each domain will be obtained by the average of the items that compose the domain. A higher score indicates a better quality of life in relation asthma disease and a minimal important difference of 0.5 points results in clinically improvement or deterioration for total score and for each domain.

Secondary Outcome Measures
NameTimeMethod
Change in clinical controlChange from baseline after 3 months of intervention

Clinical control will be evaluated by asthma control questionnaire (ACQ). The ACQ consists of 7 items rated on a 7-point scale ranging from 0 = without limitation to 6 = maximum limitation and the score will be obtained by the average of the items. A higher score indicates worse control and a change of 0.5 point after intervention is clinically important. Asthma will be considered as controlled (ACQ \<0.75 points), not well controlled and poorly controlled asthma (ACQ \>1.5 points).

Change in the level of anxiety and depressionChange from baseline after 3 months of intervention

The symptoms of anxiety and depression will be assessed by Hospital Anxiety and Depression Scale (HADS). The scale is composed by 14 items divided into 2 subscales, each containing 7 items. Each item was scored from 0 to 3, with a maximum score of 21 points for each subscale. The score of each subscale will be obtained by summing the items.

Change in thoracoabdominal mechanicsChange from baseline after 3 months of intervention

The thoracoabdominal mechanics will be assessed by optoelectronic plethysmography

Change in respiratory muscle strengthChange from baseline after 3 months of intervention

The strength of the respiratory muscles will be assessed by manovacuometry

Change in pulmonary functionChange from baseline after 3 months of intervention

Lung volumes will be assessed by Spirometry

Change in functional capacityChange from baseline after 3 months of intervention

The functional capacity will be assessed by the Incremental Shuttle Walking Test (ISWT)

Change in daily life physical activityChange from baseline after 3 months of intervention

Daily life physical activity will be assessed using an accelerometer (actigraph activity monitor)

Trial Locations

Locations (1)

Clinical Hospital of São Paulo University medical school (HCFMUSP)

🇧🇷

São Paulo, Brazil

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