It is really important to be updated on asthma because of its high prevalence. In some countries, it's up to 18% of the population that has asthma, so it's really prevalent and it's really important for us to be aware of this condition because there's some basic health advice, some basic treatments that can make a huge difference in our asthma population. Physiotherapists can also provide a range of therapy options to improve quality of life in this cohort. Whereas traditionally it was thought that physiotherapists play a limited role in asthma, but with our new treatable traits model, we can see the large role that physiotherapists have, at improving symptoms and improving quality of life in some of our asthma patients.

If you want to learn more about this topic, you can watch Mitch Taylor's lecture here:

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What is asthma?

Asthma occurs when people have a sensitivity or hypersensitive lining of their lungs. This internal lining of the lung is called epithelium. People can have lungs that are hypersensitive to certain triggers. Triggers can be mold,  pollen, dust or can be a range of different things individualized to each person. And when this person is exposed to this trigger, their lung lining, their sensitive lung lining reacts, causing inflammation, which causes a narrowing of the airways, which is known as bronchospasm. When people get bronchospasm, they get a number of symptoms that we see with asthma.

Symptoms of Asthma

1. Wheezing

This occurs primarily on exhalation as patients cannot get the air out of the narrowed airways in the lungs.

2. Persistent cough

It is also called asthma cough which is usually a dry cough often experienced at night, but it can also be productive as well during times of exacerbations.

3. Breathing difficulties

This occurs because of the narrowed airways in response to the trigger.

4. Chest pain/ tightness

It can feel like a heavy weight on the chest or like a band is tightening around the chest. This is also a result of the bronchospasm.

How physiotherapists manage asthma

1. Weight loss management

Obese individuals have increased risk of asthma, and obese asthmatics have more symptoms, more frequent and severe exacerbations, reduced response to several asthma medications, and decreased quality of life. Thus, weight loss management is important in managing asthma.

2. Mucus hypersecretion

Some people with asthma have mucus hypersecretion and physiotherapists play a huge role to expectorate these secretions by using airway clearance techniques like Active cycle breathing technique, chest percussion, postural drainage etc.

3. Osteopenia

As asthma patients use inhaled corticosteroids for a long period of time they tend to have osteopenia. Physiotherapists can help by prescribing strengthening  exercises, impact exercises to improve bone mineral density in these patients.

4. Deconditioning

Because of the breathlessness associated with asthma, a lot of patients don’t exercise so they have sarcopenia as well. Physiotherapists can be involved to prevent or improve deconditioning in these patients which helps with their quality of life and their symptoms.

5. Inhaler technique

Many asthma patients have really poor technique with their inhalers. There is evidence which shows that up to 87% of people don’t take their inhalers correctly which can impact their recovery. Thus, physiotherapists can play an important role by spending time in teaching the proper techniques of using an inhaler.

5.  Confidence with activity or exercise

Because of breathlessness asthma patients often don’t feel confident to perform exercise or their activities of daily living. Physios are primed to coach the patients and to get them more confident with activities of daily living.

6. Assess and treat dysfunctional breathing

Asthma ‘itself’ can be a trigger for dysfunctional breathing. 29-64% of asthmatics have concomitant dysfunctional breathing. By assessing and treating dysfunctional breathing physios can help improve the symptoms and quality of life.

If you want to learn more about this topic, you can watch Mitch Taylor's lecture here:

Click here

SOURCES:

1. ‘Respiratory physiotherapy – Asthma’ lecture by Mitch Taylor

2. Obesity and Asthma Ubong Peters , Anne Dixon and Erick Forno, J Allergy Clin Immunol 2018