Daily Steps May Match Aerobic Training in Moderate-to-Severe Asthma

At the Heart Institute of Hospital das Clínicas, one group of asthma patients trained on a treadmill twice a week while the other pursued weekly walking goals in daily life. After eight weeks, a randomized clinical trial led by the University of São Paulo (USP) found that increasing daily steps controlled moderate-to-severe asthma as effectively as supervised aerobic training among 52 enrollees.

The comparison was designed around two different levels of support. The aerobic-training group attended two 45-minute treadmill sessions each week under professional supervision. The behavioral-intervention group visited the hospital once a week for up to 90 minutes for guidance, counseling and encouragement, then pursued weekly walking targets with a smartwatch tracking their steps.

The researchers measured physical activity, asthma control, quality of life, anxiety and depression at the start, after the eight-week intervention and four months later. Participants wore a waist activity sensor during the day and a wrist sensor at night to assess sleep. All had received medical treatment for at least six months, and they were instructed to continue taking their prescribed medication.

Both groups experienced fewer respiratory symptoms and maintained those benefits four months after the program. Average daily steps rose by 1,537 in the aerobic group immediately after the intervention and by 983 at follow-up. The walking group rose by 1,126 and then 996 steps. The researchers found that neither strategy outperformed the other, while the study population was limited to inactive, clinically stable adults with moderate-to-severe asthma.

And so, concretely? Walking can give patients and doctors a more flexible, accessible nonpharmacological option when supervised treadmill training requires equipment and regular professional oversight. Not all participants continued their activities: weather changes were the main reason some stopped. Pinheiro emphasized that exercise complements medication recommended by the Global Initiative for Asthma (GINA); it does not replace the treatment prescribed by a doctor.