ASTHMA & PHYSIOTHERAPY

Great Health Guide - - FRONT PAGE - Words Mar­garita Gure­vich De­sign Olha Blagodir

Asthma is one of the most com­mon res­pi­ra­tory con­di­tions, with the epi­demi­o­log­i­cal preva­lence in Aus­tralia be­ing one of the high­est in the world ac­cord­ing to the Aus­tralian In­sti­tute of Health and Wel­fare. Asthma af­fects 1 in 9 Aus­tralians and has a higher in­ci­dence in the fe­male pop­u­la­tion. Statis­tics show that asthma is more com­mon in males aged 0 – 14, how­ever among those aged 15 and over, asthma is more com­mon in fe­males. While asthma is not a ma­jor cause of death it is one of the most com­mon prob­lems man­aged by doc­tors and is a fre­quent rea­son for the hos­pi­tal­i­sa­tion of chil­dren, es­pe­cially boys. In 2000-01, health sys­tem ex­pen­di­ture on asthma was about $693 mil­lion, with more than 50% spent on phar­ma­ceu­ti­cals.

Com­mon symp­toms in­clude the fol­low­ing:

• breath­less­ness

• wheez­ing

• a tight feel­ing in the chest

• con­tin­u­ing cough

So, what can be done about it? Although asthma can­not be cured, with the right treat­ment it can of­ten be suc­cess­fully man­aged and con­trolled. The type of treat­ment will de­pend on the sever­ity of asthma but gen­er­ally in­volves res­cue in­halers to treat symp­toms and con­troller in­halers that pre­vent symp­toms. Se­vere cases may re­quire longer-act­ing in­halers that keep the air­ways open, as well as oral steroids.

Be­sides the above-men­tioned op­tions there are also sev­eral ev­i­dence-based and highly ef­fec­tive physiotherapy treat­ment meth­ods avail­able.

Th­ese in­clude SCENAR ther­apy, spe­cialised ex­er­cise pro­grams and breath­ing ex­er­cises. Let’s briefly ex­am­ine each one in turn and see how they can as­sist pa­tients with asthma. Please note, it is im­por­tant to see your GP first, to con­firm the di­ag­no­sis of asthma.

1. SCENAR Ther­apy

This is an acro­nym which stands for Self-Con­trolled En­ergy Neuro Adap­tive Reg­u­la­tor. It is a small, hand-held de­vice that can be ap­plied to most prob­lem ar­eas. It works by im­prov­ing blood cir­cu­la­tion and de­liv­er­ing more oxy­gen to the af­fected ar­eas, thus speed­ing up the re­cov­ery process. When it comes to asthma the mech­a­nism of ac­tion in­volves di­lat­ing the res­pi­ra­tory air­ways which helps to re­lax the res­pi­ra­tory mus­cles and al­lows more air to come in and out of the lungs. The re­sult is im­proved breath­ing.

2. Spe­cialised Ex­er­cise Pro­grams

It is well proven that ex­er­cise is an im­por­tant as­pect of a good asthma man­age­ment plan. How­ever, a state­ment such as ‘ex­er­cise is ben­e­fi­cial for asthma pa­tients’ is too broad and needs ad­di­tional clar­i­fi­ca­tion. When it comes to ex­er­cis­ing in the case of pa­tients suf­fer­ing from asthma, it is im­por­tant to re­alise that there are some types of ex­er­cises which are use­ful but there are also some which should be avoided. Gen­er­ally ex­er­cises which

in­clude short, in­ter­mit­tent pe­ri­ods of ex­er­tion, are tol­er­ated best. Th­ese can in­clude walk­ing, Clin­i­cal Pi­lates and swim­ming.

Be­sides im­prov­ing gen­eral health and fit­ness, spe­cialised ex­er­cise pro­grams can also greatly im­prove the res­pi­ra­tory func­tion. Clin­i­cal Pi­lates in par­tic­u­lar is highly ef­fec­tive as the ses­sions are strictly mon­i­tored by a phys­io­ther­a­pist. For the ex­er­cise pro­gram to be spe­cialised, it is im­por­tant to use spirom­e­try mea­sure­ments. This will serve as an ob­jec­tive method to mea­sure whether the ex­er­cise pro­gram is work­ing. Spirom­e­try should al­ways be used dur­ing Clin­i­cal Pi­lates for asthma pa­tients.

It is im­por­tant to note, how­ever, that ex­er­cise can oc­ca­sion­ally trig­ger a flare up of asthma, known as ex­er­cise-in­duced asthma. For that rea­son, it is im­por­tant to con­sult with your doc­tor first, be­fore start­ing any new type of phys­i­cal ac­tiv­ity. Make sure that you al­ways have your asthma med­i­ca­tion with you while ex­er­cis­ing if it is part of your asthma man­age­ment plan.

3. Breath­ing Ex­er­cises

Breath­ing ex­er­cises are aimed to­wards im­prov­ing the res­pi­ra­tory func­tion.

Your phys­io­ther­a­pist will be able to pro­vide you with spe­cific breath­ing ex­er­cises, some of which will be done dur­ing the ses­sion as well as some which you will be able to do at home. Prior to pre­scrib­ing the ex­er­cises a thor­ough as­sess­ment should be car­ried out by your phys­io­ther­a­pist as an aid to di­ag­no­sis. This in­volves aus­cul­ta­tion which uses a stetho­scope to lis­ten to sounds that arise within the lungs and spirom­e­try to mea­sure the lung ca­pac­ity for the vol­ume and flow of air that can be in­haled and ex­haled. The as­sess­ment will help de­ter­mine what kind of breath­ing ex­er­cises will be most ben­e­fi­cial for you and will help to mon­i­tor your progress.

In con­junc­tion with your lo­cal doc­tor, th­ese three physiotherapy pro­grams can be part of a good asthma man­age­ment plan.

Mar­garita Gure­vich is Se­nior Phys­io­ther­a­pist and uses Clin­i­cal Pi­lates, SCENAR Ther­apy & other ev­i­dence-based tech­niques, in­clud­ing Real Time Ul­tra­sound and McKen­zie Treat­ment. Mar­garita spe­cialises in sports in­juries, women’s health (in­clud­ing in­con­ti­nence) and gas­troin­testi­nal is­sues. Mar­garita may be con­tacted via her web­site.

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