ASTHMA & PHYSIOTHERAPY

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.