Clinical Research Directory

Inclusion Criteria: Aged 18 to 80 years Able and willing to give informed consent Diagnosis of asthma determined by 1. clinical diagnosis of difficult asthma as defined by BTS steps 4-5 and 2. enrolled in WATCH or meet WATCH inclusion criteria. 3. Demonstration of suboptimal symptom control through an ACQ ≥ 1.5 at enrolment 4. Normal lung function or mild/moderate airflow obstruction at baseline (FEV1\>50% predicted) 5. Not achieving WHO recommendations for physical activity for people living with chronic health conditions(62) (150-300 minutes of moderate-intensity aerobic physical activity; or at least 75-150 minutes of vigorous-intensity aerobic physical activity; or an equivalent combination of moderate- and vigorous-intensity activity throughout the week) 6)12 lead ECG without clinically significant abnormality - Exclusion Criteria: 1. Intercurrent exacerbation or exacerbation within 4 weeks prior to enrolment in study requiring treatment with oral corticosteroids and/or antibiotics. Note participants can be rescreened 4 weeks post exacerbation if they had not commenced the study 2. Initiation of biologic treatment within 6 months prior to recruitment or during study participation 3. Investigator determined significant change in regular asthma medication in the 12 weeks preceding or during trial period 4. Other medical or psychiatric conditions (including cognitive decline) limiting ability to exercise or that may in the opinion of the study clinician carry inherent risk for exercise 5. Contraindication to ISWT 6. Positive pregnancy test 7. Beta blocker treatment (due to impact on exercise prescription using HR) -