Kyrgyz Asthma Rehabilitation at High Altitude

Low altitude baseline measurements will be performed in Bishkek. Participants will then either be assigned to a rehabilitation program in Bishkek (760m) or in Tuja Ashu (3200m).

The rehabilitation programs in high or low altitude will be identically performed and will comprise

• asthma education and awareness
• instruction on inhaled therapies
• smoking cessation counseling
• respiratory and skeletal muscle training in groups
• guided walks / cycle ergometer training
• questionnaires on asthma control, quality of life
• spirometry and peak flow measurements
• echocardiography

Measurement on study subjects will be performed at baseline (Bishkek), during the rehabilitation program, after completion of the rehabilitation program and during a follow-up at week 15.

Inclusion criteria

• diagnosed with atopic or non-atopic Asthma for at least 3 months
• partly controlled on regular or on demand inhaled therapy according to guidelines.
• asthma variability in peak expiratory flow > 10%/day and/or a reversible airflow obstruction in spirometry
• History of asthma consisting of variable symptoms (cough, dyspnea, wheezing).

Exclusion criteria

• Unstable and severely uncontrolled asthma needing systemic corticosteroids.
• Need of continuous oral steroids for their asthma control
• Heavy smokers (>20 cigarettes per day)
• Severe concomitant diseases preventing patients to adhere to the protocol and/or altitude exposure (severe metabolic, kidney- or liver disease, heart failure (ejection fracture <50%).
• Chronic lung diseases with a persistent FVC < 60% an/or arterial oxygen saturation <92%).
• Severe mental- or musculoskeletal disorders
• Pregnant or breast feeding women
• Patient which are unable to comply with the study procedure.