Asthma rehabilitation at high vs. low altitude: randomized parallel-group trial.
Altitude
Asthma
Pulmonary rehabilitation
Journal
BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563
Informations de publication
Date de publication:
24 Jul 2019
24 Jul 2019
Historique:
received:
21
09
2018
accepted:
02
07
2019
entrez:
26
7
2019
pubmed:
26
7
2019
medline:
16
1
2020
Statut:
epublish
Résumé
To investigate the effect of asthma rehabilitation at high altitude (3100 m, HA) compared to low altitude (760 m, LA). For this randomized parallel-group trial insufficiently controlled asthmatics (Asthma Control Questionnaire (ACQ) > 0.75) were randomly assigned to 3-week in-hospital rehabilitation comprising education, physical-&breathing-exercises at LA or HA. Co-primary outcomes assessed at 760 m were between group changes in peak expiratory flow (PEF)-variability, and ACQ) from baseline to end-rehabilitation and 3 months thereafter. 50 asthmatics were randomized [median (quartiles) LA: ACQ 2.7(1.7;3.2), PEF-variability 19%(14;33); HA: ACQ 2.0(1.6;3.0), PEF-variability 17%(12;32)]. The LA-group improved PEF-variability by median(95%CI) -7%(- 14 to 0, p = 0.033), ACQ - 1.4(- 2.2 to - 0.9, p < 0.001), and after 3 months by - 3%(- 18 to 2, p = 0.103) and - 0.9(- 1.3 to - 0.3, p = 0.002). The HA-group improved PEF-variability by - 10%(- 21 to - 3, p = 0.004), ACQ - 1.1(- 1.3 to - 0.7, p < 0.001), and after 3 months by - 9%(- 10 to - 3, p = 0.003) and - 0.2(- 0.9 to 0.4, p = 0.177). The additive effect of HA vs. LA directly after the rehabilitation on PEF-variability was - 6%(- 14 to 2), on ACQ 0.3(- 0.4 to 1.1) and after 3 months - 5%(- 14 to 5) respectively 0.4(- 0.4 to 1.1), all p = NS. Asthma rehabilitation is highly effective in improving asthma control in terms of PEF-variability and symptoms, both at LA and HA similarly. Clinicaltrials.gov: NCT02741583, Registered April 18, 2016.
Sections du résumé
BACKGROUND
BACKGROUND
To investigate the effect of asthma rehabilitation at high altitude (3100 m, HA) compared to low altitude (760 m, LA).
METHODS
METHODS
For this randomized parallel-group trial insufficiently controlled asthmatics (Asthma Control Questionnaire (ACQ) > 0.75) were randomly assigned to 3-week in-hospital rehabilitation comprising education, physical-&breathing-exercises at LA or HA. Co-primary outcomes assessed at 760 m were between group changes in peak expiratory flow (PEF)-variability, and ACQ) from baseline to end-rehabilitation and 3 months thereafter.
RESULTS
RESULTS
50 asthmatics were randomized [median (quartiles) LA: ACQ 2.7(1.7;3.2), PEF-variability 19%(14;33); HA: ACQ 2.0(1.6;3.0), PEF-variability 17%(12;32)]. The LA-group improved PEF-variability by median(95%CI) -7%(- 14 to 0, p = 0.033), ACQ - 1.4(- 2.2 to - 0.9, p < 0.001), and after 3 months by - 3%(- 18 to 2, p = 0.103) and - 0.9(- 1.3 to - 0.3, p = 0.002). The HA-group improved PEF-variability by - 10%(- 21 to - 3, p = 0.004), ACQ - 1.1(- 1.3 to - 0.7, p < 0.001), and after 3 months by - 9%(- 10 to - 3, p = 0.003) and - 0.2(- 0.9 to 0.4, p = 0.177). The additive effect of HA vs. LA directly after the rehabilitation on PEF-variability was - 6%(- 14 to 2), on ACQ 0.3(- 0.4 to 1.1) and after 3 months - 5%(- 14 to 5) respectively 0.4(- 0.4 to 1.1), all p = NS.
CONCLUSION
CONCLUSIONS
Asthma rehabilitation is highly effective in improving asthma control in terms of PEF-variability and symptoms, both at LA and HA similarly.
TRIAL REGISTRATION
BACKGROUND
Clinicaltrials.gov: NCT02741583, Registered April 18, 2016.
Identifiants
pubmed: 31340793
doi: 10.1186/s12890-019-0890-y
pii: 10.1186/s12890-019-0890-y
pmc: PMC6657156
doi:
Banques de données
ClinicalTrials.gov
['NCT02741583']
Types de publication
Comparative Study
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
134Subventions
Organisme : Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
ID : 168254
Références
Biometrics. 1975 Mar;31(1):103-15
pubmed: 1100130
Clin Exp Allergy. 2001 Mar;31(3):400-8
pubmed: 11260151
Cochrane Database Syst Rev. 2003;(1):CD001117
pubmed: 12535399
Cochrane Database Syst Rev. 2003;(1):CD004107
pubmed: 12535511
Scand J Public Health. 2005;33(1):57-64
pubmed: 15764242
Respir Med. 2006 Apr;100(4):616-21
pubmed: 16226443
Scand J Immunol. 2006 Apr;63(4):304-10
pubmed: 16623931
Am J Respir Crit Care Med. 2006 Jun 15;173(12):1390-413
pubmed: 16760357
J Allergy Clin Immunol. 2007 Aug;120(2):471-2
pubmed: 17498787
Pediatrics. 2009 Mar;123(3):1051-8
pubmed: 19255039
J Allergy Clin Immunol. 2010 Mar;125(3):550-8
pubmed: 20153032
Thorax. 2011 Oct;66(10):910-7
pubmed: 21106547
Clin Exp Allergy. 2011 Jun;41(6):775-82
pubmed: 21518039
Am J Respir Crit Care Med. 2011 Sep 1;184(5):602-15
pubmed: 21885636
Eur Respir J. 2012 Dec;40(6):1374-80
pubmed: 22441741
Allergy Asthma Clin Immunol. 2012 Aug 03;8(1):13
pubmed: 22863207
Cochrane Database Syst Rev. 2013 Sep 30;(9):CD001116
pubmed: 24085631
J Asthma. 2014 Jun;51(5):552-8
pubmed: 24494625
J Allergy Clin Immunol. 2015 Oct;136(4):914-22
pubmed: 25936565
J Asthma. 2015;52(9):969-73
pubmed: 26287942
High Alt Med Biol. 2017 Jun;18(2):93-101
pubmed: 28453305
J Allergy Clin Immunol. 1987 Dec;80(6):755-75
pubmed: 3320157
Br Med J. 1971 Jan 9;1(5740):82-4
pubmed: 5539181
Aviat Space Environ Med. 1983 Dec;54(12 Pt 1):1063-73
pubmed: 6661120
J Clin Invest. 1995 Nov;96(5):2393-403
pubmed: 7593627
Respir Med. 1996 Sep;90(8):453-7
pubmed: 8869437