Aerobic Training Versus Behavioral Intervention to Increase Physical Activity in Patients With Asthma

Clinical control will be evaluated by the Asthma Control Questionnaire (ACQ). The ACQ contains 7 items rated on a 7- point scale (0 = without limitation, 6 = maximum limitation), with a higher score indicating worse control. Scores lower than 0.75 are associated with good asthma control, whereas scores greater than 1.5 are indicative of poorly controlled asthma, and a change of at least 0.5 points in the ACQ score is regarded as clinically significant.

Sedentary behaviour will be objectively quantified using a movement sensor (ActiGraph, Pensacola, USA) for 7 consecutive days on the hip using an elastic belt. Sedentary behaviour will be quantify by the time spent sedentary (<100 counts/min).

Physical activity will be objectively quantified using a movement sensor (ActiGraph, Pensacola, USA) for 7 consecutive days on the hip using an elastic belt.

Health related quality of life will be assessed by Asthma Quality Life Questionnaire (AQLQ). The AQLQ consists of 32 items rated on a 7-point scale (1 = great deal, 7 = not at all) divided into the following 4 domains: activity limitations, symptoms, emotional function and environmental stimuli. Higher AQLQ scores indicate a better quality of life, and treatments resulting in a 0.5-point increase in scores following an intervention are considered to be clinically effective.

Symptoms of anxiety and depression symptoms will be assessed by the Hospital Anxiety and Depression scale (HADs), which consists of 14 items divided into 2 subscales (7 for anxiety and 7 for depression). Each item is scored from 0 to 3, with a maximum score of 21 points for each subscale. A score greater than 8/9 in each subscale suggests a diagnosis of either anxiety and/or depression.

Bioimpedance (Octopolar InBody 720).

Bioimpedance (Octopolar InBody 720).

Bioimpedance (Octopolar InBody 720). ,Fat-free mass, and skeletal muscle mass will be calculated.

Bioimpedance (Octopolar InBody 720).

muscle mass Bioimpedance (Octopolar InBody 720).

The possible answers to the questionnaire Barriers to the practice of Physical Activities of Daily Living are never, rarely, sometimes, almost always or always and the score for each item varies from 0 to 4. It will be considered as limiting domain for physical activities those in which individuals report a value equal to or greater than 3 in at least half of the barriers.

Asthma exacerbation will be assessed by the following criteria: the use of ≥4 puffs of rescue medication per 24 hours during a 48-hour period, a need for systemic corticosteroids, an unscheduled medical appointment, and either a visit to an emergency room or hospitalization

The Behavioral Stage Assessment Questionnaire for the Practice of Physical Activity qualitatively assesses thinking in relation to the practice of physical activity, and may present the following stages of behavior: 1. Pre-contemplation; 2.

Contemplation; 3. Preparation; 4. Action; 5- Maintenance.

Lung volumes will be assessed by spirometry

Waist circumference (cm) and hip circumference (cm) will be combined to report wait to hip ratio (WHR).

The assessment of sleep quality will be performed by the accelerometer (Actigraph, GT9) for seven nights before and after the interventions, throughout the day. The outcomes derived from the monitor will be sleep latency (the amount of time needed to fall asleep) and sleep efficiency (number of sleep minutes divided by the total number of minutes the participant was in bed).

CPET will be performed on an electric cycle ergometer (Corival; Lode BV Medical Technology, Netherlands) equipped with an electronic system (CPX System; CareFusion, Germany). During the test there will be verbal encouragement for the patient to reach maximum effort. The maximum oxygen consumption (VO2 peak in ml.kg.min) will be evaluated, considered the highest value in the test phase; anaerobic threshold (will be determined from the exponential growth of ventilation, additionally by the increase in VCO2, fall and/or stabilization of VO2, also considering the VCO2/VO2 ratio close to 1; respiratory compensation point (will be determined from the second point inflection, exponential growth in ventilation, additionally due to the increase in VCO2 and exponential fall in VO2, also considering the VCO2/VO2 ratio greater than or equal to 1.10; maximum heart rate (established by electrocardiogram examinatio).