Physical activity and sedentary behavior as treatable traits for clinical control in moderate-to-severe asthma

Background Physical activity and sedentary behavior are treatable traits that may impact asthma control in distinct manners, but this impact remains poorly understood. Objective To evaluate the influence of physical activity and sedentary behavior on clinical control in adults with moderate-to-severe asthma. Methods This cross-sectional multicentric study included 426 individuals with moderate-to-severe asthma. Assessments included physical activity and sedentary time (actigraphy), clinical asthma control (Asthma Control Questionnaire [ACQ]), quality of life (Asthma Quality of Life Questionnaire [AQLQ]), anxiety and depression symptoms (Hospital Anxiety and Depression Scale [HADS]), anthropometric data, and lung function. Participants were grouped according to physical activity levels and sedentary behavior. Results Participants who walked ≥7,500 steps/day presented better ACQ scores than those who walked <7,500 steps/day (p<0.05), independent of sedentary status. The percentage of patients with controlled asthma was higher in the active/sedentary (43.9%) and active/nonsedentary (43.8%) groups than in the inactive/sedentary (25.4%) and inactive/nonsedentary (23.9%) groups (p<0.02). The likelihood of having uncontrolled asthma according to the treatable traits of physical inactivity (odds ratio [95% CI]: 2.36 [1.55-3.59]), higher anxiety (2.26 [1.49-3.42]), and depression symptoms (1.95 [1.28-2.95]) was significant (p≤0.002). Obesity and sedentary time were not associated with asthma control. Conclusion Our results show that ≥7,500 steps/day is associated with better asthma control independent of sedentary time in adults with moderate-to-severe asthma. Physical inactivity, anxiety, and depression symptoms are associated with higher odds of uncontrolled asthma. These results suggest that interventions should mainly focus on increasing physical activity rather than reducing sedentary time.