Asthma

Asthma

1. Centre for Physiotherapy and Rehabilitation Sciences JAMIA MILLIA ISLAMIA ASTHMA submitted by;- hafiza Sania Urooj Submitted to :-DR. Jamal ali moiz Class:- bpt 4 th year Subject:- physiotherapy in cardiopulmonary condition (402) Date of submission :- 05-01- 2021

2. A sthma Introduction:- Asthma is defined as a chronic inflammatory disorder of the airways which manifests itself as recurrent episodes of wheezing, breathlessness, chest tightness and cough. It is characterized by bronchial hyper-responsiveness and variable airflow obstruction, that is often reversible either spontaneously or with treatment. The prevalence of asthma in India is about 2%, and asthma is responsible for significant morbidity . Asthma develops primarily at a young age, but may also occur in adulthood. The prevalence of asthma is about 10% in children and approximately 3% in adults . There are different type of asthma (called phenotype ) Allergic asthma Nonallergic asthma Adult onset asthma Obesity asthma Air flow limitation asthma

3. Etiology and risk factor Asthma occur in families which suggest it is inherited disorder allergy is the predisposing factor for asthma Chronic exposures to airway irritant or allergenic also increases the risk for developing asthma . Common allergenic can be seasonal ( grass, tree, pollen ) Excitatory state ( stress, cry) Occupational environments Other factor such as air pollution, cold air , infection Triggers for an asthma attack :- Upper respiratory tract viral infections Exercise without warmup Cold air stress , irritant inhalation Medication ( beta – blocker )

4. Signs and Symptoms:- Wheeze Dry Cough:- Increased with Exercise Worse Early Morning/Night Chest Tightness, shortness of breath (SOB) Sputum (stringy, thick) Fatigue Runny Nose Headache Clinical Features Hyperventilation/Increased Respiratory Rate ,Increased Work of Breathing Decreased Peak Expiratory Flow Rate FEV 1 FEV 1 /FVC Decreased PaO 2  (partial pressure of oxygen in blood) Increased PaCO 2  (partial pressure of carbon dioxide in blood) Increased Heart Rate

5. Investigations and Diagnosis Medical History Family History :- If the patient has a family history of asthma or allergies, they are more likely to also suffer from asthmatic symptoms. Physical Assessment Firstly, the patient’s nose, throat and  upper airways  will be examined for signs of asthma or allergies. Wheezing (high-pitched whistling sounds when the patient exhales) Coughing, chest tightness Shortness of breath (SOB) A runny nose Swollen nasal passages. Diagnostic Tests:- The following tests are used to assess the patient’s breathing as well as to monitor the effectiveness of asthma treatment. Lung function tests Spirometry Peak flow test  

6. Spirometry may be used to assess lung function by measuring the amount of expired air as well as the speed of expiration. Peak flow testing Peak flow testing is a self-assessment lung function test using a peak flow meter to provide an objective measure of airway function based upon peak expiratory flow rate (PEFR). Allergic test Blood test Chest X-ray Electrocardiogram ( ECG)

7. Assessing the patient with asthma:- assess asthma control assess asthma risk factor Assess for comorbidities Assess treatment issue

8. Assess for comorbidities :-  rhinitis gastro-oesophageal reflux), assess comorbidities that may influence asthma outcomes depression or cognitive impairment, anxeity Obesity sleep apnoea

9. Management of asthma The goals of asthma treatment are to achieve good symptom control, maintain normal activity levels , minimize future risk of exacerbations , and reduce adverse effects from medications. Non-Pharmacologic Interventions :- Provide asthma education Basic facts about asthma How medication works Importance of taking daily controller medication Inhaler technique Environmental control measures Use of written action plan (symptom- and/or peak flow–based) Need for regular follow-up visits

10. Encourage patient self-management :- Take medication correctly Promote lifestyle interventions Encourage physical activity. Exercise has significant health benefits; exercise-induced asthma symptoms can be controlled, and engagement in regular exercise is encouraged Encourage tobacco cessation. Encourage weight management . Treat comorbid conditions that worsen asthma :- Allergic bronchopulmonary aspergillosis Environmental allergies Obesity Obstructive sleep apnoea Stress or depression Smoking

11. Pharmacological management :- Inhaled corticosteroid (ICS) ICS and Long-acting inhaled beta2-agonist (LABA), Combination ICS/LABA Leukotriene modifier Physiotherapy treatment :- Three physiotherapy techniques breathing exercises, IMT and physical training techniques which are uses in asthmatics. 1 Breathing exercise Techniques  Breathing Retraining Techniques  The aim of breathing retraining is to normalize breathing patterns by stabilizing respiratory rate and increasing expiratory airflow, pursed lip breathing technique advice . Breathing retraining physiotherapy session :- SESSION 1 Duration : 30-45 mints Position :- patient should be comfortable sitting position and leg outstretched on a couch raised (45degree) support with head and back . Session 2 :- Duration :- 30 to 40 mint

12. Position :- patient should be comfortable sitting or lying down position for relxatation exercise Session 3 Duration :- 20 -30 mint position ;- patient should be sitting position

13. 2. Inspiratory muscle training and asthma :- muscles can be trained for both strength and endurance . It is reasonable to suggest that increasing the strength of the inspiratory muscles in people with asthma may reduce the intensity of dyspnea and improves exercise tolerance. 2 -5 times a week over 3–8/12 weeks . Physical training should be advised for improvements in fitness and cardiorespiratory performance in patients with asthma. Physical training should be advised to help reduce breathlessness and improve health-related quality of life in people with asthma. duration :-150 minutes moderate-intensity physical activity throughout the week, or do at least 75 minutes of vigorous-intensity physical activity throughout the week

14. Reference Physiotherapy in respiratory care unit ,alexander Hough third edition foetus, Patricia A.; Wise, Sarah K Rhizopodia . Bruton A, Thomas M. Global strategy for asthma management and prevention 2019 (GINA) Breathing exercise for asthma ,ESR publication