A29-13 Benefits of Cardiorespiratory Fitness Screening and Intervention in a Pediatric Severe Asthma Clinic

Introduction Children with severe asthma are often less active due to fear of exacerbation, dyspnea on exertion, and limited health literacy impacting quality of life with obesity further compromising ability to be active. Few studies have explored the use of physical therapy (PT) and pulmonary rehab in children in this group. This study describes PT and pulmonary rehab use in management of children in a multidisciplinary severe asthma clinic. Methods A retrospective chart review was conducted from May 2023 to October 2025 on patients aged 6-18 y in a severe asthma clinic consulted to PT for dyspnea on exertion. PT conducted standardized testing of cardiorespiratory fitness (CRF) using the 3 Minute Step Test for ages 6-12 y and the Bruce Treadmill Protocol (BT) for ages 6-18 y. Previously published reference values were applied to assess CRF levels. Patients with below-average CRF (BA-CRF) received education on importance of exercise, respiratory muscle and postural training exercises, and individualized aerobic exercises to improve exercise tolerance and endurance. Follow-up occurred every 2-3 months, with most CRF testing re-assessed between 3 months and 1 year of initial evaluation. Results Between 2023-2025, PT evaluated 93 of 153 (61%) children (6-18 y) in a severe asthma clinic. Among those evaluated, 46% (n = 43) had BA-CRF compared to reference values. High BMI (>85th percentile) was present in 67% (n = 29) of BA-CRF patients versus 24% (n = 12) of those with average or above-average CRF (AA-CRF). PT was able to re-evaluate 23 patients (25%); 12 initially had BA-CRF, and half (n = 6) improved after intervention, while one worsened. Baseline average BMI was 72.7th percentile and 73.4th percentile at re-evaluation. Most with CRF improvement had high BMI which remained unchanged at re-evaluation; the one patient with worsened CRF had increase in BMI. Conclusions Maximal and submaximal exercise testing may be useful in estimating CRF in youth with severe asthma and BA-CRF is associated with high BMI. However, despite high BMI, pulmonary rehab may improve CRF substantially. PT interventions such as progressive respiratory muscle and aerobic training enhance exercise tolerance, highlighting the value of PTs in multidisciplinary severe asthma care. This abstract is funded by: None