Please select the eligibility criteria that correspond to the clinical trial below.
Title: Impact of Aerobic Exercise on Asthma Morbidity
Brief Summary: Asthma is a chronic disorder of the airways primarily driven by increased airway inflammation, and is an escalating medical problem in Canada. For example, between 1994 and 2001 there was a 40% increase in the number of Canadians who had asthma. Not only is the prevalence of asthma increasing but there has been a rapid rise in the number of asthma events and costs associated with asthma and poor asthma control. It has been estimated that the global cost of caring for asthma exceeds that of AIDS/HIV and tuberculosis combined. These increases have occurred in spite of the development of clear asthma management guidelines. There is evidence to suggest that aerobic exercise, e.g., running or cycling, may improve asthma symptoms and control in children. However, there are currently no studies that have systematically assessed the effects of exercise on asthma control or symptoms in adults. The current proposed study will assess the effects of aerobic exercise in sedentary patients with poorly controlled asthma. In addition to usual medical care, 52 patients will participate in a supervised aerobic exercise program. The program will consist of 3 X 1hr sessions of supervised exercise per week for 12 weeks. Another 52 patients will only maintain usual medical care. The asthma control, quality of life, and inflammatory profile will be evaluated at baseline and following the 12 weeks of treatment. The investigators believe that: (1) The exercise intervention will significant improve asthma control and asthma quality of life; (2) The exercise intervention will result in significant improvements in inflammatory profiles; and (3) These changes in the inflammatory profile will be directly related to the improvements in asthma control and quality of life.


Options:
A: 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)
B: 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.
C: 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
D: Inclusion Criteria:

* Patients with moderate and severe persistent asthma
* Asthma will diagnosed according to Global Initiative for Asthma (GINA)
* Body Mass Index \<35 kg/ m2
* Patients will submitted the medical treatment, followed by pulmonary specialists for at least 6 months.

Patients will considered clinically stable (i.e., no exacerbation or changes in medication for at least 30 days).

Exclusion Criteria:

* Patients will diagnosed with cardiovascular, musculoskeletal or other chronic lung diseases;
* Patients with current participation in exercise programs
* current smokers or ex-smokers will excluded from the study.

Answer: B