Combined effect of pulmonary rehabilitation and vitamin D supplementation on pulmonary function tests in asthma...

To evaluate the Combined Effect of Pulmonary Rehabilitation and Vitamin D Supplementation on Pulmonary Function Tests in Asthma Patients.

In this 12-week comparative interventional study, 90 adults (aged 30-55 years) with mild to moderate asthma and serum 25(OH)D < 30 ng/mL were randomized into three groups (n = 30 each): Group A (PR + vitamin D), Group B (PR only), and Group C (vitamin D only). PR consisted of supervised exercise sessions three times per week for 8 wk, while vitamin D supplementation was administered as oral cholecalciferol 60,000 IU weekly. Pulmonary function tests (FEV₁, FVC, FEV₁/FVC) and serum 25(OH)D levels were measured pre- and post-intervention. Within-group and between-group differences were analyzed using paired t-tests and ANOVA with Tukey post-hoc tests.

All interventions significantly improved FEV₁ and FVC (p < 0.05), with the greatest gains observed in Group A (FEV₁ Δ0.44 ± 0.10 L; FVC Δ0.44 ± 0.12 L; FEV₁/FVC Δ2.7 ± 1.4%), followed by Group B (FEV₁ Δ0.32 ± 0.09 L; FVC Δ0.28 ± 0.11 L; FEV₁/FVC Δ1.4 ± 1.2%) and Group C (FEV₁ Δ0.18 ± 0.08 L; FVC Δ0.15 ± 0.10 L; FEV₁/FVC Δ1.0 ± 1.1%). Between-group comparisons showed Group A > Group B > Group C for pulmonary function improvement (p < 0.001). Serum 25(OH)D increased significantly in Groups A and C (p < 0.001) but remained unchanged in Group B. Compliance was high, and no serious adverse events occurred.

Pulmonary rehabilitation and vitamin D supplementation independently improve pulmonary function in patients with mild to moderate asthma, but their combination produces superior outcomes. Integrating vitamin D supplementation into structured PR programs offers a safe, feasible, and potentially synergistic strategy to optimize asthma management.