Pulmonary Rehabilitation inAsthma
Pulmonary Rehabilitation
•A well-established and widely acceptedtherapeutic tool that improves the quality oflife and functional capacity of patients withchronic lung disease
•Bronchial asthma is one of the most commonpulmonary disorders referred for pulmonaryrehabilitation in centers where this isavailable.
Optimal Asthma Rehabilitation Program
•Child and family education of thepathophysiology, symptoms and treatmentof asthma
•Objective measures for patients/family toassess the severity of asthma and monitorresults of a comprehensive pharmacologictreatment
Optimal Asthma Rehabilitation Program
•Specific exercise prescriptions to preventthe physical deconditioning common inasthmatics
•Preventive/environmental controls to avoidacute exacerbation.
Breathing exercises for asthma- Holloway EA,Lasserson TJ Cochrane Database of Systematic Reviews 2004
•A review looked at the evidence for theeffectiveness of breathing retraining forpatients with asthma.
•Comparisons and conclusions were difficultto evaluate as treatment interventions andoutcome measurements from the seventrials varied considerably.
•No reliable conclusions can be drawnconcerning the use of breathing exercisesfor asthma in clinical practice.
Physical training for asthma - Ram FSF, Robinson SM,Black PN, Picot J. Cochrane Database of Systematic Reviews2005
•A systematic review on physical training forasthma, done on subjects 8 years and older,concluded that though it can improvecardiopulmonary fitness, it had no effect onresting lung function or the number of daysof wheeze.
• It is not known whether improved fitness istranslated into improved quality of life.
Consensus recommendation
•Pulmonary rehabilitation may beincorporated into the long-termmanagement and care of children withasthma, especially in centers wherethis is available.
Area of concern
•More studies are needed on the effect ofpulmonary rehabilitation among childrenwith asthma, including full descriptions oftreatment methods and outcomemeasurements such as quality of life,changes in symptoms, exercise tolerance,frequency and duration of exacerbations