Digital coaching boosts asthma control and quality of life

By Priyanjana Pramanik, MSc.Reviewed by Lauren HardakerJan 12 2026

A randomized trial shows that while online coaching may not keep people with asthma moving long term, it can still deliver meaningful improvements in motivation, symptom control, and quality of life.

Study: Short and medium term efficacy of an online behaviour change intervention on physical activity in adults with asthma. Image credit: New Africa/Shutterstock.com

In a recent study published in Scientific Reports, researchers investigated the effectiveness of a behavioral intervention in reducing sedentary behavior and enhancing physical activity among asthmatic individuals.

They found that the intervention did not produce greater long-term improvements in the sedentary behavior or physical activity of participants compared with asthma education alone. However, in the short term, it was associated with improvements in exercise motivation, perceived competence, asthma control, and asthma-related quality of life, indicating that more participants experienced meaningful benefits, even when average group scores did not differ significantly.

Why inactivity and sedentary time worsen asthma outcomes

Adults with asthma are generally less physically active and spend extended periods in sedentary behavior, both of which are linked to poorer asthma outcomes such as reduced lung function, worse symptom control, and increased breathlessness.

Regular physical activity has been shown to improve asthma control and symptoms, and doctors recommend it as part of non-pharmacological asthma management. However, increasing and sustaining physical activity among people living with asthma remains challenging. Behavior change theories suggest that successful interventions should go beyond education and address psychological needs, motivation, and self-regulation. Although behavior change interventions have shown promise in asthma, most studies have been face-to-face, and remote approaches remain underexplored.

With the growing use of telehealth, particularly following the coronavirus disease 2019 (COVID-19) pandemic, online interventions may offer a convenient and scalable approach to promoting physical activity among individuals with asthma.

Testing an online behavior change program against education

This single-blind, multicenter randomized controlled trial recruited adults aged 18–60 years with stable asthma who were insufficiently physically active. Participants were assessed at baseline, immediately after a 12-week intervention, and again at a 6-month follow-up. All participants received an online educational program that covered asthma management and provided information on sedentary behavior and physical activity. The intervention group also received a structured online behavior change program delivered by a trained physiotherapist.

This program combined strategies from established behavioral change models and included weekly individual sessions, four group sessions, goal-setting using an activity monitor, and a workbook to support self-monitoring. Sedentary behavior and physical activity were quantified using accelerometers. Secondary outcomes included asthma control, asthma-related quality of life, exercise motivation, and psychological needs for exercise, which were assessed using validated questionnaires. Statistical analyses included linear mixed models to compare changes between groups over time.

Short-term motivation gains without lasting activity change

A total of 51 adults with stable asthma were included in the analysis and randomly assigned to the intervention group (n = 25) or the control group (n = 26). There were no significant differences between the two groups at baseline in demographic characteristics, asthma severity, lung function, physical activity levels, sedentary time, or psychosocial measures. No significant between-group differences were observed in objectively measured sedentary behavior or physical activity at the post-intervention or six-month follow-up.

However, during the 12-week intervention period, participants in the intervention group progressively increased their average daily step counts, with mean values rising from approximately 6,500 steps early in the program to over 10,500 steps by the final week. These improvements were not sustained once the intervention and activity monitoring ended.

In terms of psychological outcomes, participants in the intervention group reported significantly greater perceived competence to exercise and higher levels of identified, autonomous motivation immediately after the program compared with the control group. Within-group analyses showed short-term improvements in autonomy, competence, relatedness, and overall self-determination in the intervention group, whereas the control group demonstrated more limited motivational changes. These psychological benefits were not maintained at the six-month follow-up.

Asthma control scores did not differ significantly between groups at any time point. Nevertheless, a greater proportion of participants in the intervention group achieved a clinically meaningful improvement in asthma control immediately after the intervention, and their mean asthma control scores remained below the threshold for uncontrolled asthma at follow-up, a finding considered clinically relevant despite the lack of statistical significance.

Similarly, while overall quality-of-life scores did not differ significantly between groups, a significantly greater proportion of intervention participants achieved clinically meaningful improvements, particularly in the symptom-related domain, with these benefits persisting for up to six months. Improvements in asthma control were moderately correlated with improvements in asthma-related quality of life.

Digital coaching improves symptoms without sustaining activity

This study found that adding an online behavior change intervention to asthma education did not result in sustained improvements in physical activity or reductions in sedentary behavior beyond the effects of education alone. However, the intervention was associated with short-term improvements in exercise motivation, perceived competence, and clinically meaningful gains in asthma control and asthma-related quality of life, with longer-term benefits limited to symptom-related quality of life.

The lack of sustained behavioral change may reflect reduced motivation after removal of activity monitors, baseline misclassification of physical activity levels, or the influence of education alone on both groups. The authors further note that behavior change strategies alone may be insufficient without complementary approaches such as structured exercise training.

Strengths include objective measurement of physical activity, theory-based intervention design, use of a widely accessible online platform, and recruitment from multiple centers. Limitations include the modest sample size, lack of stage-specific tailoring, and absence of structured exercise training.

Overall, while the intervention did not change long-term activity behavior, it showed clinically relevant, but not statistically significant, benefits for quality of life and asthma control, supporting the potential value of online, theory-driven approaches as adjuncts to asthma management, particularly when combined with more intensive or face-to-face interventions shown to be effective in prior studies.

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