– Dr Palak Dengla, Chief Physiotherapist, Aster RV Hospital
Asthma is a chronic respiratory disease characterized by inflammation and narrowing of the breathing tubes, which can cause symptoms such as coughing, wheezing, and shortness of breath. As the airways are under bronchospasm, coughing out mucus becomes difficult leading to further accumulation of the mucus and thus secondary bacterial infections. Treatment for asthma involves acute medical management and long-term management of prevention of exacerbation of the disease to improve the quality of life.
Many breathing techniques and devices available in Physiotherapy have been proven to be effective in controlling the acute impact of the disease as well as reducing the frequency of attacks.
One such type of breathing technique is Buteyko breathing. Buteyko breathing is a type of breathing technique that has been used to manage asthma symptoms. Using slow nasal breathing with breath holds (control pause) following an exhalation is the key to Buteyko technique, with regular practice over a few weeks, breathing is brought towards normal. It is proved to be an effective treatment for not only asthma, but also rhinitis, anxiety, and sleep disorders.
While the Buteyko breathing technique may be a helpful addition to an asthma management plan for some people, it should always be used under the guidance of a Physiotherapist. It’s important to work with your healthcare professional to determine whether this technique is appropriate for you and to develop a treatment plan that addresses all aspects of your asthma management.
Another type of device that can be used to help manage asthma symptoms is a Positive Expiratory Pressure (PEP) device. PEP devices are designed to help remove mucus from the lungs and bronchioles by creating positive pressure during exhalation. Physiologically, when one exhales out, there is a negative suction pressure created in the breathing tubes but as the tubes are strong enough, they do not collapse in a normal individual. On the other hand, in an asthmatic patient, due to repetitive infection, the tubules have lost their recoil capacity, and thus collapses on exhalation or on cough even during a mild infection.
PEP devices work by creating a resistance to exhalation, which creates a back positive pressure in the lungs and airways. This prevents collapse of the infected tubules by improving their recoil capacity and patency. Additionally, they create vibration of airways which help in the dislodge of the mucus, thereby reducing the sputum production and aiding its clearance when coughed up. Some of the commonly used PEP devices are Acapella, RC- Cornet, Flutter, etc, which help to keep the airways open and allows for better clearance of mucus. They can be used alone or in combination with other asthma medications. PEP devices are meant to be used 2-3 times during the day for 15- 20 times each.
PEP devices can aid asthma management, but they should always be used under the guidance of a Physiotherapist.