Efeitos de um programa de atividade física não supervisionada baseado em pedômetros e avaliação do nível de atividade física na vida diária em adultos com asma moderada a grave

Abstract

Introduction: Supervised physical activity has shown benefits for asthmatic adults, but little is known about the effectiveness of unsupervised exercise programs on subjects with asthma and the daily life physical activity (DLPA) of this population. Objective: To investigate the effects of a 12-week unsupervised pedometer-based physical activity program on asthmatic adults and to assess the DLPA of asthmatic women in comparison to healthy peers. Methods: Two studies were performed (Study 1 and Study 2). In Study 1, volunteers were recruited from the patients seen at the Pneumology Outpatients Clinic of the University Hospital of the Universidade Federal de Juiz de Fora, Minas Gerais, Brazil (HU-UFJF). Sedentary, clinically stable, moderate to severe asthmatic adults, aged 18 to 65 years, were included. After an individual asthma educational session, all participants were encouraged to take daily 30minute walks. Afterwards, they were randomized to pedometer (PG) and control groups. PG received pedometers and individualized incremental daily step targets. Changes in daily steps (average of steps taken during six consecutive days), six-minute walking test (6MWT), health-related quality of life (asthma quality of life questionnaire - AQLQ), asthma control (asthma control questionnaire - ACQ) and anxiety and depression levels (hospital anxiety and depression scale - HADS) were assessed after 12 weeks of intervention and 24-28 weeks after randomization. In Study 2, clinically stable, moderate to severe asthmatic women, aged 18 to 65 years, seen at the Pneumology Outpatients Clinic of HU-UFJF (asthma group - AG), and apparently healthy volunteers seen at the Gynecology. Outpatients Clinic of the same hospital (control group - CG), were included. All subjects underwent DLPA assessment using a pedometer and performed the 6MWT. Additionally, participants in the AG were assessed regarding asthma control (ACQ), health-related quality of life (AQLQ) and anxiety and depression levels (HADS). Results: In Study 1, 37 participants were included and 30 completed the intervention. At 12 weeks, there were significant differences between groups regarding daily steps (adjusted average difference, 2488 steps; 95% confidence interval [CI], 803 to 4172; p = 0.005) and the 6MWT (adjusted average difference, 21.9 m; 95% CI, 6.6 to 37.3; p = 0.006). These differences were not significant 24-28 weeks after randomization. In Study 2, 66 volunteers were included (33 in AG). There was no difference between the AG and the CG regarding DLPA (7490.3 ± 3330.2 vs 6876.4 ± 3242.1 steps respectively, p = 0.45). DLPA was significantly correlated to the activity limitation domain of the AQLQ among asthmatics (r = 0.43, p < 0.01). Conclusion: The unsupervised pedometer-based physical activity program was effective in increasing daily steps of adults with moderate to severe asthma. There was no difference regarding DLPA between a sample of asthmatic women and apparently healthy controls.