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Asthma is a most common respiratory chronic disease and involves 24 million persons in the United States. It is a chronic obstructive pulmonary disease (COPD). Asthma is characterized by narrowing of bronchial airways, reversible expiratory airflow obstruction, and spasm of the respiratory tract. Asthma can severely affect a person’s quality of life and physical activity.
Sign and symptoms off asthma
- Difficulty breathing
- Wheezing – production of whistling sound during breathing
- Increased production of sputum due to hypersensitivity and hyperactivity of bronchial airways
- coughing – forced expiration against closed glottis
- chest tightness – feel pressure on the chest
Asthma is a chronic disease which requires treatment and management. Although a cure is not known but medication and physiotherapy treatment can play an important role in managing and controlling its symptoms.
Physiotherapy treatment goals
- control the symptoms of asthma and prevent further aggravation
- Remove excess sputum and maintain a normal breathing pattern
- prevent occurrence of asthmatic attack
- keep pulmonary function as normal as possible
- Breathing exercise
Diaphragmatic breathing exercise and pursing lip breathing technique are widely used in asthma to prevent breathing abnormalities. It will increase air redistribution to the lungs, maximize oxygenation and relieve dyspnea.
Diaphragmatic – patient should sit on the ground and should place both the hands on the rectus abdominal muscle or on the Erbs. The Patient should breathe in through the nose and feel abdomen go out. After that patient should breath out and feel abdomen go in. expiratory time should be double than inspiratory time. Do this for 10 to 15 times, twice a day.
Pursed lip breathing – this technique prevents trapping of air into the lungs. It enhances distribution of air in all lobes of the lungs and reduces the difficulties of breathing. Patient should be comfortable in position. Patient should breathe in through the nose and breathe out through the mouth as pursed lip or whistling. It creates vibrations of air which cause positive back pressure and maximizes oxygenation.
Removal of secretions
There are some various techniques available for mobilizing and removing secretions. Percussions, vibrations, huffing and shaking techniques are used to mobilize the secretion and move these secretions to central airways to evacuate it. Postural drainage, suctioning and coughing techniques are used to remove mobilized secretions. Active cycles of breathing and autogenic drainage are also used for this purpose.
Patient should be in tripod position while asthmatic attack. Both hands should be on ground with wide base and neck should be in forward flexion. It relieves breathing difficulties. Chest expansion exercise also improves air re distribution and oxygenation.
Breathing control techniques
Buteyko breathing – patient should be in sitting position. Patient should breathe in shallow and slowly. Expiration should be prolonged until patients feel no air in the lungs. After that, breathing should be held for 5 seconds. This technique maintains normal carbon dioxide level, eliminate hyperventilation of the lungs through breath control and breathe holding.
These above stated management helps to eliminate hyperventilation of lungs, reduces use of bronchodilator and anti inflammatory drugs, air trapping and dyspnea. It also improves quality of life.