Pilot of a Remote Digital Therapeutic Exercise Program in Obesity and Asthma

Individuals with obesity and asthma experience poor asthma-related quality of life and asthma control, and high rates of asthma-related hospitalizations.

Aerobic exercise can improve asthma control, but minimal data are available in obesity and asthma. This study evaluated feasibility and efficacy of a remote digital therapeutic exercise program in obesity and asthma.

Twenty participants with body mass index ≥30 kg/m² and poorly controlled asthma defined as an Asthma Control Test (ACT) score of ≤19, rescue inhaler use more often than twice weekly, nocturnal asthma awakenings at least weekly, emergency department or hospital visit for asthma within 6 months, or steroid course within 6 months were enrolled in a single-arm, 12-week pilot study conducted between November 2024 and December 2025. Feasibility was defined as ≥60% of participants completing ≥50% of prescribed exercises. Efficacy was defined as ≥30% of participants experiencing an improvement in ACT of ≥3.

Fifty percent of participants completed ≥50% of prescribed exercises, not achieving our feasibility target. Forty percent of participants achieved a ≥3-point increase in ACT. ACT scores increased significantly from a median of 16 (interquartile range: 14-19) to 20 (17-21).

Completing ≥75 minutes of exercise weekly was attainable in 50% of participants; remote digital therapeutic exercise programs may improve physical activity levels and asthma control among individuals with obesity and poorly controlled asthma. Larger cohorts are necessary to expand upon these results.