Physiotherapy treatment in Asthma

 Physiotherapy treatment in Asthma

Definition: - It is characterized by attacks of wheezing and breathlessness due to narrowing of intrapulmonary airways. Since asthma is episodic and related more to inflammation, it is not considered as classic chronic lung disease.

Types

a. Extrinsic (a topic): Occurs in younger age groups. These patients sensitive to different factors (pollution, house mites) &also have a family history of similar sensitivities.

b. Intrinsic (tends to occur in older patients): It has no family history. It is precipitated by bronchial infections, bronchitis.

Clinical features

Extrinsic

·        Onset sudden and often at night

·        Chest tightness and irritation of URT.

·        Wheeze & dyspnoea on expiration

·        Cough unproductive &barking in nature

·        Pulse rapid

·        Tachycardia  present Cyanosis in later stages.

Investigations

·        Auscultation – breath sounds vesicular with prolonged expiration.

·        Percussion – hyper resonant

·        X-ray – chest over inflated

·        LFT – Hypercapnia may occur due to increased PaCO2 because of hyperinflation.Hypoxemiaoccurs owing to ventilation perfusion mismatch.

Intrinsic

Clinical features

Same as above but

·        wheezing &dyspnoea continues & worse in morning.

·        Cough produces mucoid sputum.

·        Respiratory infections occur with increased frequency.

Treatment

·        Prevention of attacks.

·        Maintenance of general health.

·        Treatment during attack.

Physiotherapy management

Aims

·        Assists in the removal of secretions

·        To gain relaxation of shoulder girdle, neck and specially upper chest muscle

·        To maintain neck, shoulder girdle, thoracic spine and thorax mobility

·        To teach the patient for breathing control

·        To educate the patient for postural awareness

·        To improve the exercise tolerance

·        To encourage for an active life style

Means

·        Postural drainage along with vibration/ daily

·        Effective coughing with minimal effort

·        Forced expiratory technique

·        Thoracic, neck and shoulder mobility exercise

·        Strengthening exercise for weak muscles specially shoulder girdle retractors, abdominal and thoracic spine extensors.

·        Advice to the patient for the breathing control during all daily activities.

Physiotherapy management during an attack

Aims

·        To relieve bronchospasm

·        Assists the removal of secretions

·        To improve the breathing control and pattern

Means

·        High side lying/ half side lying positions with pillows

·        Vibrations

·        Forced expiratory technique

·        Postural drainage

·        Relaxation and breathing control exercises