Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effects of Long Term Physical Training Once a Week on Fitness and Quality of Life in Elderly Asthmatics
Brief Summary: This controlled study is undertaken to investigate the effects of a long term outpatient training program on physical fitness and quality of life in elderly asthmatics.


Options:
A: Inclusion Criteria:

* Asthma moderate and severe
* Asthma will diagnosed (Global Initiative for Asthma -GINA)
* Body Mass Index between 35 kg/ m2 and 39,9 kg/m2
* Sedentary
* Medical treatment, for at least 6 months
* Clinically stable (i.e., no exacerbation or medication changes for at least 30 days)

Exclusion Criteria:

* Cardiovascular, musculoskeletal or other chronic lung diseases
* Active Cancer
* Pregnant
* Weight loss more than 5 % in the preceding 6 months
* Using weight-loss medications
* History of bariatric surgery, uncontrolled hypertension or diabetes
* Using overnight continuous positive airway pressure
* Lactating
* Current or ex-smoker
B: Inclusion Criteria:

* physician diagnosed asthma
* non-smoker
* stable condition
* informed consent

Exclusion Criteria:

* participation in pulmonary rehabilitation in the past 12 months prior to study inclusion
* unability to attend training sessions on a regular basis for one year
* symptomatic coronary heart disease
* uncontrolled heart failure
* hemodynamically relevant cardiac rhythm disorders
* hemodynamically relevant cardiac valvular disorders
* uncontrolled arterial hypertension
* hypercapnic respiratory failure
* severe hypoxemia (i.e. PaO2 \<50 mm Hg resp. SaO2 \<80% at rest)
* history of decompensated right heart failure
* pulmonary arterial hypertension (PA mean pressure at rest \>20 mm Hg)
* severe osteoporosis
* severe airway obstruction (FEV1 \<50% predicted, FEV1 \<60% predicted following bronchodilatation)
* maximum work rate of less than 50 watt during ergometer testing
* uncontrolled asthma
* COPD exacerbation
* severe adipositas (BMI \>35 kg/m2)
C: Inclusion Criteria:

* Physician diagnosed asthma (confirmed by medical record evidence of bronchodilator reversibility of 12% or a minimum of 180 cc or PC20 methacholine \<= 16 mg/ml)
* Sedentary (currently do less than 60 min of structured / planned physical activity per week)
* Taking at least 250 mg fluticasone equivalent per day
* On stable dose and regimen of asthma medications
* Mild to moderate symptomatic asthma as defined by an Asthma Control Questionnaire score of 1.25 or greater.

Exclusion Criteria:

* Diagnosed co-morbid disease for which there are already established exercise guidelines i.e., cardiac disease or COPD
* Any other medical condition that confers greater illness morbidity than asthma (e.g., active cancer) which will confirmed by physician review
* FEV1 lower than 60% of predicted
* Incapable of exercising
* A BMI \> 30 kg/m2
* Unable to speak or understand either French or English
* \<18 years of age
* Patients who are currently pregnant or intend to become pregnant over the course of the study.
D: Inclusion Criteria:

Participants will meet all of the following:

* Age: 18-70 years of age;
* Obesity: BMI \>30.0 kg/m2;
* Physician-diagnosed asthma that is poorly controlled:

  * Documented diagnosis of asthma on the current medical problem list
  * Currently prescribed an anti-asthma medication
  * Overall score \<20 on the Asthma Control Test (ACT)64 or a score\<3 on any of the first four ACT questions regarding symptoms, nighttime awakening, interference with normal activity, and SABA use for symptom relief
  * Demonstrable airway reversibility
* Seen in primary care at Kaiser at least once in the preceding 24 months;
* KPNC member for \>1 year.

Exclusion Criteria:

Any of the following will exclude participants from the study:

* Inability to speak, read or understand English;
* Intermittent asthma, defined as either seasonal asthma or (daytime asthma symptoms \< 2x/week and nocturnal symptoms \< 2x/month and no use of long-term control medications);
* Diagnosis of COPD (emphysema or chronic bronchitis) on the current medical problem list or suggested by spirometry at baseline;
* Unwilling to attempt weight loss, including unwillingness to perform self-monitoring;
* Body weight change (+/-) \> 10 pounds or use of weight-loss medications in the preceding 3 months;
* Inability to perform pulmonary function tests by spirometry in a consistent manner;
* Significant medical co-morbidities, including uncontrolled metabolic disorders (e.g., thyroid, diabetes, renal, liver), unstable heart disease, heart failure, and ongoing substance abuse;
* Diagnosis of psychiatric disorders that would limit adequate informed consent or ability to comply with study protocol;
* Regular use of medications that can cause weight gain (e.g., oral corticosteroids, insulin, certain oral hypoglycemics, certain antidepressants, etc.);
* Under treatment for cancer or another condition that may prevent completion of follow-up;
* Diagnosis of a terminal illness and/or in hospice care;
* Use of a pacemaker or other implanted medical devices;
* Pregnant, planning to become pregnant, or lactating;
* Actively enrolled in a care management program focused on weight loss at Kaiser or elsewhere;
* Already enrolled or planning to enroll in a research study that would limit full participation in the study or confound the observation and interpretation of the study's findings;
* Family household member already enrolled in the study;
* No longer receiving primary care from Kaiser, or planning not to do so within the study period;
* PCP determination that the study is inappropriate or unsafe for the patient;
* Investigator discretion for clinical safety or protocol adherence reasons.

Answer: B