Core function and its relationship with breathlessness in severe asthma

Published: February 2, 2024

Asthma can be extremely burdensome for some people, especially for those with severe disease. Some studies have observed muscle weakness in people with asthma; however, no studies have previously investigated the core muscles in this population. Core muscles are located around the abdominal cavity, and they are an important component for postural control, but they also participate in breathing movements. Breathlessness can be more intense if the muscles involved in breathing do not work properly. Therefore, it is important to know if people with severe asthma have impaired core muscles and if core muscle function is related to breathlessness.

In a recent study published in The Journal of Allergy and Clinical Immunology: In Practice, Oliveira et al. assessed adults with severe asthma and compared them with healthy adults with no respiratory disease. The study aimed to verify if adults with severe asthma have impaired core function and to observe if the core function is related to breathlessness. All participants were invited to perform three different tests to assess core muscle function. Each test focused on assessing one side of the core using different positions, which were held for as long as possible. Participants also answered questionnaires on different aspects of breathlessness (i.e., the impact of breathlessness on daily life activities, breathlessness while resting, and dysfunctional breathing, which has breathlessness as its main symptom).

Compared to healthy adults, people with severe asthma held the core test positions for a shorter time in two out of the three core tests, which means that adults with severe asthma have impaired core function. When males and females were compared separately, those with severe asthma still presented worse results than the healthy adults. The researchers also compared the core tests results adjusting for age and body mass index and found similar results. In other words, people with severe asthma have impaired core function independent of sex, age, or body mass index. Furthermore, this study showed that the core function is weakly to moderately related to breathlessness, especially with the impact of breathlessness on daily life activities. The more impaired the core function, the worse the breathlessness.

This study raises awareness regarding the core muscles, which have been overlooked in respiratory management. The researchers suggest that as part of multidisciplinary team management, adults with severe asthma should have their core muscles assessed and treated in case of dysfunction. Moreover, they hypothesized that promoting a better core function may reduce breathlessness in this population.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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