World Asthma Day is an annual event organized by the Global Initiative for Asthma to improve asthma awareness and care around the world. World Asthma Day is observed on the first Tuesday of May. The inaugural World Asthma Day was held in 1998.
In Asthmatics dysfunctional breathing pattern is common. Breathing re-education and breathing based therapies have begun to re-emerge as a means of helping asthmatic and others suffering from breathing disorders.
One of the main ways in which a physiotherapist will work with asthmatics is breathing retraining. There are number of breathing retraining techniques that can be learnt to help prevent and reduce the effects of an asthma attack. Taking fewer, smaller breaths is one example of a popular breathing retraining technique. Although issues and requirements vary from patient to patient, this is a widely applicable technique.
Inspiratory muscle training is defined as a course of therapy consisting of a series of breathing exercises that aim to strengthen the respiratory muscles making it easier for people to breath. Inspiratory muscle training is normally aimed at people who suffer from asthma, bronchitis, emphysema and COPD.
Timing & rhythm of breathing are also major aspects of breathing retraining. Breathing in through the nose and out the mouth at a slow pace will encourage an efficient, relaxing airflow. These techniques optimize oxygen intake and satisfy the body’s demand for oxygen.
Apart from breathing retraining, physiotherapy can be used to strengthen the body and its ability to breathe in general, thereby reducing the onset of asthma attacks. Many asthmatics will avoid physically exerting activities as they fear it may induce an asthma attack. While this is not a totally unfounded concern, as many activities can bring on such an attack, this reduced physical activity will gradually reduce the body’s breathing ability and worsen the condition. Working closely with a physiotherapist can not only help exercise the body to prevent such deterioration, but also build up the strength of respiratory muscles such as the diaphragm. This is known as respiratory muscle training, and can drastically increase a person’s quality of life, breathing, and physical abilities.
It is important to remember the importance of working with doctors and continuing to take any prescribed medicine, but working with a physiotherapist can reduce a person’s reliance on that medication as well as the frequency and severity of future attacks.
Breathing exercises such as:
• Diaphragmatic breathing: This is a basic and simple breathing technique that maximizes air distribution in your lungs.You can lie down or sit. Concentrate on your breathing. Preferably you should breathe in slowly through your nose. When you inhale your abdomen should go out (not your chest). Exhale slowly with your abdomen going inward. Ideally exhalation should be twice as long as inhalation.
• Physical movement exercises: This type of breathing exercise combines physical elements and breathing elements. Focus on good posture. Relax (tense all muscles, and then relax, paying particular attention to muscles in shoulders and belly). Concentrate on breathing (close eyes). Focus on breathing while relaxed in rest position. Focus on breathing with shoulder rotation. Focus on breathing with forward curl. Focus on breathing with arm raises.
• Buteyko breathing: This is a breathing technique that teaches asthmatics to consciously reduce either breathing rate or breathing volume. Sit upright, relax. Relax chest and belly muscles while breathing. Focus, close your eyes and look up. Breathe through your nose gently (keep mouth closed). Breath slowly and shallow. Exhale slowly until you feel their is no air left in your lungs. Hold your breath as long as you can and then return to gentle breathing.
• Pursed lip breathing: This can be used when you are having an asthma attack. Since asthma causes air to become trapped in your lungs, this may help you get more air out and may make breathing easier. This is where you inhale slowly through your nose and then exhale through pursed lips, or exhale slowly as though you were going to whistle. You should exhale twice as long as you inhale. This should be done while using diaphragmatic breathing as described above.
• Progressive relaxation technique: This technique helps to relax all the muscles in your body. Lie down and close your eyes. Concentrate on breathing through your nose. Use diaphragmatic breathing. Tighten muscles of right foot, relax, feel tension, release. Do same for other limbs. When done your body should feel weightless. Stay in relaxed state for as long as you want or need.
Important: Do not stop your inhalers or asthma medication. These breathing techniques do not affect your lung function but used alongside your asthma medication and chest clearance methods they can be effective in helping you to cope better by reducing symptoms and improving your quality of life.
If this article is motivating you to make a change, then do something straight away rather than just thinking “that sounds like a good idea, I will start next week”. Sit down, determine how much time you can devote each day and write a plan. Your exercise plan should be written in consultation with your physiotherapist and your respiratory specialist.
Of course, even when you’re exercising and improving your health, the risks don’t go away. When exercising, make sure not only that your medications are close by, but you have an action plan in case you have a flare up. Also stay wary of your triggers, including dust, pollen, pollution, other irritants like chlorine and of course colds or flus – as these might be causing a flare-up you could easily blame on the exercise itself. Adjust your plan if these triggers are getting in the way.
Dr Shadman Pandit PT is Consultant Physiotherapist, MPT(Neuro), MPT(Cardio)