Exercise therapy and massage for bronchial asthma. Therapeutic breathing exercises for bronchial asthma

Bronchial asthma is a chronic inflammatory and allergic disease that requires complex treatment. Today, not only and, but also physiotherapy, as well as physiotherapy exercises are used.

A set of exercises for bronchial asthma not only helps to reduce the number of relapses of the disease, but also improves the general well-being and condition of patients. However, this method is effective only if you do gymnastics correctly and regularly, so every person suffering from this disease must master the technique of doing exercises.

Tasks of exercise therapy for asthma

Physiotherapy in this disease is aimed mainly at improving general state respiratory system, as well as to reduce the symptoms of the disease during the attack. Thanks to training, blood circulation and lymph flow in the chest organs are improved, trophism (nutrition) of the lung tissue is stimulated, and its elasticity improves.

Also, thanks to exercise therapy, the normal ratio of inhibition and excitation in the cerebral cortex is restored, as a result of which the physiological autonomic regulation of the respiratory system improves. This leads to stress and physical exercise have less effect on the respiratory system and do not cause bronchospasm.

In addition, exercise therapy is an excellent prevention of emphysema - thanks to training, the respiratory volume increases and the ability to exchange gases improves.

Exercise therapy trainers teach their patients how to breathe correctly during an attack (the technique of prolonged expiration is especially important) - this can significantly alleviate the patient's well-being and reduce the intensity of shortness of breath.

Training helps improve chest mobility, develop respiratory muscles, and increase bronchial mucociliary clearance (mucus evacuation).

Since physical education in this disease has a huge amount of positive effects, it is recommended not only to patients suffering from an ailment, but also to people who smoke or have a predisposition to allergic or inflammatory diseases of the upper respiratory tract.

How to do gymnastics correctly

Before you perform any exercise, you need to consult a specialist. Only a doctor can determine when, with what intensity and frequency you can exercise. The doctor, prescribing physical therapy, must take into account many factors - the age of the patient, the stage of the disease, the presence of concomitant pathologies, the duration of the course of the disease, the general condition of the patient and his physical fitness.

Regardless of doctor's orders, there are general rules, which should always be followed when performing a set of exercises for bronchial asthma:

Training is desirable outdoors or after airing the room.
You can only train outside the period of exacerbation when the respiratory rate does not exceed 20-25 times per minute.
If during gymnastics the state of health worsened - need to stop exercising.
Therapeutic exercise gives more noticeable result in combination co race walking and swimming.
Gradually need increase the number of approaches and exercises, but only after the permission of the attending physician.

By following these requirements, there is no risk of harming your health and worsening the course of the disease.

How gymnastics affects the patient: the main mechanisms

Therapeutic gymnastics includes not only physical education, but also sound and breathing exercises. Regular execution this complex leads to an improvement in the neuropsychic state of the patient, and also helps to strengthen the respiratory and circulatory organs.

Physical education contributes to the development of muscles, not only intercostal, but also the muscles of the back, the press, and the diaphragm. This allows you to normalize the respiratory process, and also increases the vital capacity of the lungs.

Breathing exercises improve the elasticity of the bronchi and lung tissue and their blood circulation. This, in turn, leads to a decrease in edema of the mucous membrane, expansion of the lumen of the smallest bronchioles, as well as to the rapid evacuation (excretion) of mucus, which is secreted by the glands. All this helps a person to relieve exacerbations of the disease.

Sound breathing exercises also improves the resistance of the bronchi and alveoli, which allows you to keep the lungs in good shape, prevents the frequent occurrence of attacks of this disease.

And in combination with drug treatment, exercise therapy helps to alleviate the patient's condition and transfer the disease to the stage of stable remission.

Contraindications to exercise therapy in bronchial asthma

Despite the high effectiveness of training in bronchial asthma, not all patients can do such exercises.

There are a number of conditions in which physical activity is contraindicated:

serious condition of the patient (exacerbation of the disease, severe shortness of breath);
the threat of pulmonary hemorrhage;
malignant tumors;
fever;
severe pain during training;
severe pathologies of the cardiovascular system of the body.

It is necessary to perform gymnastics with bronchial asthma, but you should not do this if there are obvious contraindications. If you ignore this recommendation, there is a high risk of worsening your own condition.

Remember that if discomfort or pain occurs during training, you should immediately inform your doctor about it.

Exercise therapy complex for bronchial asthma

Need to turn around and spread both arms with palms up. Repeat 12-13 times in each direction alternately.
The exercise is carried out in a sitting position, it is necessary to perform leaning to the side, while the hand should slide off the leg of the chair. The tilt should be accompanied by a long exhalation. In the initial position, you need to inhale deeply and slowly. Do 15 times.
Stand straight, put your feet shoulder-width apart, fix your hands at waist level. To attempt bring your elbows in front of you exhaling as much as possible. Perform 20-26 times.
Lean on the back of the chair, then you need to sit down slowly taking a long, slow breath. Get up, take a deep breath. Perform 8-10 times.
The position is the same. Do forward tilt of the body exhaling. Inhale, return to the original position. Repeat 25 times.
In the supine position, it is necessary raise your leg exhaling at the same time. Hold this position for 5-10 seconds, lower your leg, inhale. Repeat 5-10 times alternately with the left and right limbs.
Stand straight, with a straight back. Walking in place within 2-3 min. You can do up to 8 sets per workout.

Additional exercises for asthma

If the body responds positively to the implementation of the main set of exercises, the condition does not worsen, then after 2-3 weeks you can add other loads. These include:

Stand facing gymnastic wall, put your hands on the crossbar, which is at chest level. Take a deep breath stretch the muscles of the hands as much as possible, exhale. Do 5-7 times.
Take the ball in hand take a shoulder throw(on the exhale). Alternately repeat to the left and right hand(6-10 times).
Take the ball in your hands raised above your head. Throw the ball down hard exhale and relax your hands. Perform 10-13 times.
In a seated position, arms extended elbow joints, located in a horizontal position, extremely divorced. The legs are bent at the knees, apart. Take a deep breath turn sideways exhaling. Stay in this position for 5 seconds. You need to do it alternately left and right, 10-14 times in each direction.
In a standing position, arms are extended and spread apart. Inhalation is accompanied raising one leg, on exhalation, the leg must be relaxed and lowered. Repeat alternately for each leg, 7-10 times.

Breathing exercises for bronchial asthma

Breathing exercises can be divided into 2 stages - one part of the exercises is performed at the beginning of the workout, and the second at the end. Most effective methods breathing exercises:

Within 1 minute breathe deeply, while the respiratory rate should become less and less.
Palms of two hands must be clenched, and then bring to the shoulder, at the same time exhaling.
Legs in order bend and press to the stomach taking a deep breath. Exhale as you return to the original position.
Inhale deeply, exhale as long as possible, pronouncing the sounds "zh" and "sh".
Perform in a standing position. Put your left hand on your stomach, your right hand on chest. Controlled breathing for 30 seconds. At the same time, when exhaling, the muscles abdominals should be drawn in and tightened.
Put your feet shoulder-width apart and your hands on your waist. Take a deep breath, next hold your breath for about 3-5 seconds, exhale slowly, pronouncing the sounds "o", "a". Perform 10-13 times.
Straighten your spine, lean your hands on the back of a chair or crossbar wall bars. Breathe in through your nose as much as possible hold the breath, drawing in the stomach and tensing the abdominal muscles as much as possible. Stay in this position for 15-30 seconds (depending on the patient's capabilities). Exhale slowly, relax. Perform 1-2 times, it is allowed to do 3-5 sets per workout, but with breaks of at least 5 minutes.

Exercise during an asthma flare

During periods of exacerbation of the disease, only light gymnastics should be performed, it should be done under the supervision of a doctor, preventing deterioration of the condition. Physical therapy experts recommend the following exercises:

Lie on your back with a high pillow under your head. Inhale, inflating the stomach, exhale, drawing it in as much as possible. During the exercise, you should feel a slight tension in the abdomen and diaphragm. Repeat 5-7 times.
Sitting on a chair with a back. While inhaling through the nose, bend your arms at the elbows and touch your shoulders, stay in this position for a few seconds. Exhaling, cross your arms over your chest. Run 5-10 times.
Sitting on the edge of a stool (preferably low). Spread your arms wide inhale strongly while exhaling, bend down and touch the floor with your fingers. Repeat 10-12 times.
In a sitting position, arms bent, brought to shoulder joints. In this position raise your hands in horizontal position , inhaling deeply. Do 5-10 times.
Sitting on the edge of a chair bend and straighten the foot. At the same time, breathe deeply and clench your hands into fists. Repeat 15 times.

What is the best time to practice

It is necessary to prescribe the implementation of the primary set of measures during the period of remission of the disease. After assessing the patient's condition, you need to make sure that he is ready to perform exercise therapy exercises.

The first few weeks it is better to conduct classes with an exercise therapy trainer. Then, when the patient can independently perform gymnastics, it is allowed to do it at home.

The first half of the day is best time for doing exercises. Perfect option- perform a set of exercises 2 hours after a light breakfast. In no case should you start physical therapy immediately after eating. Experts say that exercises performed on fresh air. But if this is not possible (for example, in the cold season), then it is worth exercising in a room with a window open for ventilation - this will ensure a sufficient supply of oxygen.

Summing up, we can highlight the main list of recommendations compiled by experienced specialists in the field of exercise therapy. If you strictly adhere to the rules from this list, the effectiveness of the set of exercises increases dramatically, and the number of complications is significantly reduced. These rules include:

Needs to be done regularly, at least 4-5 times a day, without interrupting the course of treatment for more than 2-3 days.
The duration of the course should be 30 to 60 minutes- this is enough to work out all the muscles, do breathing and sound exercises.
Lessons need to be done outdoors or in a room where there is enough oxygen.
You can only hold your breath under the supervision of a coach. At the same time, be sure to lean with your hands on the back of a chair or the crossbar of a gymnastic wall.
Exhalation should be 2-4 times longer than inhale.
Every week you need to complicate and change exercises. But this should be done gradually and under the supervision of a specialist.
If the condition worsens or worsens, it is necessary to inform the doctor and reduce load in training.

Summing up, we can say that the complex of therapeutic loads for bronchial asthma is an excellent addition to drug therapy. Regular exercise will improve overall well-being and ease the course of the disease.

According to the results of studies, it was noticed that in people doing exercise therapy for 3 months, the frequency of exacerbations decreased by 40-50%, and in patients who perform exercises for more than six months, the number of relapses decreased from 60 to 80%. Therefore, to engage in physical activity with a disease is not only possible, but also necessary.

Exercise therapy for bronchial asthma is one of the important ways to restore and maintain functional pulmonary activity and improve the general condition of the patient.

Regular physical activity in combination with drug therapy helps to reduce the frequency of asthmatic attacks and prevent recurrence of the disease.

Goals of exercise therapy

Features of physiotherapy exercises during bronchial and pulmonary diseases pursue the following directions:

normalization of mechanical breathing;
functional improvement of the respiratory center and mobility in the chest area;
strengthening the drainage capacity of the bronchi with increased production of exudative secretions;
general aerobic training aimed at improving physical qualities;
normalization of the patient's emotional state.

As a rule, a specially designed set of breathing exercises is used to strengthen the respiratory muscles, increase ventilation of the lungs and normalize drainage functionality.

Rules for performing exercise therapy

It is important to remember that physical activity can be performed only outside the stage of exacerbation of the disease. During the training, it is recommended to open the window, thereby ensuring the access of oxygen.

Exercise therapy is contraindicated in the development of status asthmaticus, shortness of breath (usually 25 breaths per minute). In addition, you can not do gymnastics if the patient is diagnosed with stage 3 respiratory failure. With severe development of bronchial asthma, it is recommended to take bronchodilators before training. A combination of exercise therapy with swimming or walking has a positive effect.

The method of physical therapy classes is built on a preliminary diagnostic examination of the patient. Based on the results of the examination, the severity of bronchial asthma, the frequency of attacks, taking into account the age category of the patient, are revealed.

Before the start of an active load, it is necessary to prepare (2-3 days) to test the physical and emotional capabilities of the patient. Quite often, breathing exercises for bronchial asthma provide for sound pronunciation and elementary gymnastic movements. Such a set of exercises allows you to assess the degree of necessary intervention.

The mechanism of action of exercise therapy

Exercise therapy exercises should be carried out in interictal lull with an improvement in the condition and the absence of circulatory failures. Therapeutic exercise for bronchial asthma solves the problem of strengthening the body, as well as normalizing the neuro-emotional process. In addition, with the help of dosed physical activity, bronchospasms are actively removed and breathing is restored.

Complex physical activities normalizes visceral-motor reflexes, as a result of which the respiratory rate is reduced and bronchial vascular tone is regulated;
sound respiratory warm-up is aimed at preventing the development of pulmonary emphysema, as well as enhancing the metabolic process in the body. Under the influence of muscle activity, adrenaline is released into the bloodstream, which positively affects the general condition of the patient;

as a result of the fact that there is an additional load on the muscles involved in respiratory activity, the patient can independently prevent the development of an asthmatic attack in the initial stage and control it in the future;
Exercise therapy for bronchial asthma is formed individually, based on the characteristics of the course of the disease, the age category of the asthmatic, the severity of symptoms and physical fitness;
the complex of classes includes general strengthening therapy, as well as breathing exercises that allow you to control the mobility of the chest.

Particular emphasis should be placed on exercises for the development of diaphragmatic breathing with an extended breath. In addition, exercise therapy allows you to strengthen abdominal muscles. It is important to combine breathing exercises with alternate pronunciation of sounds. This contributes to the contraction of facial muscles.

A set of exercise therapy exercises

Exercise therapy can only be performed between attacks. Its tasks are the normalization of nervous processes, the neutralization of bronchospasm and the establishment of normal breathing.

Within 30-40 sec. breathing is performed, which gradually decreases.
The palms of both hands are clenched into a fist, and then brought to the shoulder with a simultaneous breath. After returning to the starting position, exhale.
One leg is bent and pulled to the abdomen. In this case, you should exhale, when returning to the original position, you need to take a deep breath.

It is necessary to turn to the side and at the same time take both hands away, turning the palms up. Take a deep breath, and after returning to the starting position, you can exhale.
It is recommended to take an extended breath while pronouncing the sound "w" and "g".
In a sitting position, tilts are performed in different sides. Hands should slide on the leg of the seat. This is followed by a deep breath. In the initial position, inhalation is performed.
Inhalation is performed when the patient is standing with legs wide apart, hands should be on the belt, and the elbows are laid to the side. When bringing the elbows together, exhale.
The patient is standing, leaning on a chair. During the squat, exhalation occurs. In the initial position, inhalation is performed.

Legs should be spread shoulder width apart, palms placed on the waist. In this case, the patient during exhalation should pronounce the sounds "o" and "a".
Breathing can be combined with slow walks.
The legs should be spread apart, and the palms should be placed in the waist area. At the same time, forward bends are made with exhalation, rising (inhale).
Lying down, you should raise your hand while inhaling, after muscle relaxation, the hand lowers with exhalation.
Lying face up while exhaling, one leg rises. After returning to the starting position, a deep breath is taken.
Sitting, you need to put both hands on your knees. Slowly unbending and bending the ankles, you should clench and unclench your hands into a fist.

Breathing exercises for children

To date, there are several unique respiratory gymnastics complexes for children. You don't need much preparation to complete these classes. Traditional breathing exercises prescribed for children, as well as for adult patients, allow a positive effect on the body. However, when performing classes for children, there is a time limit: you can not carry out procedures for more than 30 minutes a day.

Very often, an asthmatic attack occurs with a sedentary lifestyle, as a result of which there is a lack of carbon dioxide in the pulmonary system of children. In this case, a good effect is achieved by breathing exercises according to Buteyko, which have practically no restrictions.

The most accessible breathing exercises for children are breath holding exercises, after which it is necessary to normalize respiratory activity with the most calm and shallow breathing. Assign individual complex Exercise therapy should be the attending physician, since only a highly qualified specialist can choose physiotherapy exercises, based on the age of the children and concomitant diseases. This helps to reduce asthmatic attacks in children in the future.

Sound gymnastics

Enough good efficiency shows sound gymnastics when you need to inhale through the nose and exhale, while pronouncing consonants and vowels. At the preparatory stage, the patient begins the lesson by pronouncing vowels (e, y, o, and). In the next period, consonants are used (s, s, p), and in conclusion (u, g, w).

The exhalation sound is pronounced for a short time (4-5 seconds) with a gradual increase in time up to 30 seconds. During exhalation, it is recommended to pronounce short syllables with the sounds p, b, x, d (brohh, bah, drruhh, bat, etc.). Sound warm-up should be repeated 2-3 minutes at least 5 times during the day with a pause between exercises of 30 seconds.

Breathing exercises for bronchial asthma according to Buteyko and Strelnikova are widely used among all groups of patients. The implementation of these techniques should be carried out with the participation of a professional instructor. Subsequently, the patient can perform some exercises independently.

Features of the course of bronchial asthma determine the tactics of treatment and physical activity. Therapeutic exercise is selected individually for each patient. This will avoid unforeseen complications and get the fastest possible positive effect.

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Peoples' Friendship University of Russia

University of the Foreign languages

ABSTRACT

on the topic of: " Therapeutic exercise for bronchial asthma"

Performed:

1st year student

group №111-LD

Egorova D.S.

Moscow 2012

Introduction

Definition of exercise therapy

Bronchial asthma

Exercise

Exercise examples

Conclusion

Bibliography

Introduction

Everywhere, especially in industrialized countries, there is a significant increase in the number of diseases of the respiratory system, which have already taken 3-4th place among the causes of death of the population. As for, for example, lung cancer, this pathology in terms of its prevalence is ahead of all other malignant neoplasms in men. Such an increase in the incidence is associated with the constantly increasing pollution of the surrounding air, smoking, and the growing allergization of the population (primarily due to household chemicals). All this currently determines the relevance of timely diagnosis, effective treatment and prevention of respiratory diseases.

Bronchial asthma is a chronic disease that is manifested by asthma attacks. The main condition causing the development of bronchial asthma is congenital or acquired hypersensitivity of the bronchi to stimuli. different kind. The provoking factors of bronchial asthma are called infectious and non-infectious exoallergens. The disease is a consequence of a non-standard reaction of the body to various stimuli that provoke changes in the bronchi - suffocation, coughing, viscous sputum is separated.

In my essay, I will consider the use of therapeutic physical education with bronchial asthma.

Definition of exercise therapy

Therapeutic physical culture (LFK) is a method of treatment consisting in the application of physical exercises and natural factors of nature to a sick person with therapeutic and prophylactic purposes. This method is based on the use of the main biological function of the body - movement.

The term "therapeutic physical culture" refers to a variety of concepts. This includes breathing exercises after a major operation, and learning to walk after an injury, and developing movements in a joint after removing a plaster cast.

Therapeutic physical education brings up a conscious attitude to the use of physical exercises, develops strength, endurance, coordination of movements, instills hygiene skills, hardens the body. At present, no one doubts that physiotherapy exercises are an obligatory and necessary component of all sections of modern practical medicine.

The structure of the human respiratory system

The human respiratory system is a set of organs that provide external respiration in the human body, or the exchange of gases between the blood and the environment, and a number of other functions.

The main organs of the respiratory system are the lungs. The lungs are located in the chest cavity, surrounded by the bones and muscles of the chest. The lungs provide oxygen to the body and remove from it the gaseous waste product - carbon dioxide. Atmospheric air enters and exits the lungs through a system of tubes called airways.

Separate upper and lower Airways. The transition of the upper respiratory tract to the lower is carried out at the intersection of the digestive and respiratory systems in the upper part of the larynx. The upper respiratory system consists of the nose, nasopharynx and oropharynx, as well as part of the oral cavity, as it can also be used for breathing. The lower respiratory system consists of the larynx, trachea, bronchi, bronchioles, and alveoli.

The lungs occupy most of the chest. Of the two lungs, the right one is more voluminous, since the heart occupies a considerable place in the left side of the chest. Each lung is divided into lobes. The right lung has three lobes - upper, middle and lower. The left lung has two lobes - upper and lower. The lobes are separated from each other and have grooves on the surface - furrows.

The lungs form a rather dense lattice of tubes. The largest of them are the bronchi, which in the upper part of the lungs separate the trachea on the left and right, entering the substance of the corresponding lung. Inside the lung, the bronchi branch into secondary and tertiary bronchi, which in turn divide into smaller tubes called bronchioles. Bronchioles end in air sacs called alveoli.

If the lungs are removed from the chest, they will shrink like popped balloons. The lungs do not compress due to surface tension. It is created by fluid secreted by the thin pleural membrane that covers the lungs and the walls of the chest cavity. There are two types of pleural membranes in the lungs: the inner (visceral) pleura and the outer (parietal) pleura. The visceral pleura covers the lung itself, going into its furrows. The parietal pleura covers the walls of the chest cavity from the inside. These two membranes join only at the gates of the lung - where the lung is connected to the trachea by the bronchus and to the heart by the pulmonary blood vessels. In all other cases, the pleural membranes are separated from each other.

When an adult is at rest, the frequency of his breathing is on average 14 times per minute. During the day, a person inhales and exhales more than 800 liters of air. During heavy physical exercise, breathing quickens up to 80 times per minute.

The purpose of inhaling and exhaling such a significant amount of air is to force the lungs to perform two functions: to extract oxygen from the air, which is necessary for the maintenance of the body, and to release carbon dioxide, a product of the exchange of internal chemical processes. The process of respiration is carried out due to a number of successive processes:

1. The exchange of gases between the environment and the lungs, which is usually referred to as "pulmonary ventilation".

2. Exchange of gases between the alveoli of the lungs and blood (pulmonary respiration).

3. Exchange of gases between blood and tissues.

4. Transition of gases inside the tissue to the places of consumption (for O2) and from the places of formation (for CO2) (cellular respiration).

The loss of any of these four processes leads to respiratory disorders and endangers human life.

Bronchial asthma

Bronchial asthma is a chronic inflammatory disease of the airways involving a variety of cellular elements. The key link is bronchial obstruction (narrowing of the lumen of the bronchi), caused by specific immunological (sensitization and allergies) or non-specific mechanisms, manifested by recurring episodes of wheezing, shortness of breath, feelings of congestion in the chest and cough. The attack occurs in a reflex way, due to irritation of the pulmonary branches of the vagus nerve. It is known that in the vagus nerve there are fibers that narrow the bronchi and cause increased secretion, that is, mucus on the inner walls of the bronchi and bronchioles. In addition, increased excitability of the vagus nerve can cause various intoxications and infections, as well as allergization of the body. Attacks of bronchial asthma are sometimes not only reflex in nature, but also conditioned reflex; there were cases when an attack occurred not only after the patient inhaled the smell of a rose, but also when an artificial rose was shown to the patient.

In other words, with an attack of suffocation, the body, as it were, protects itself from the effects of external aggressive factors. For example, if even an absolutely healthy person enters a room with a sharply lower temperature, in relation to the one in which he was previously, then his bronchial tubes will constrict at a reflex level and the gap between the walls will sharply decrease. If a foreign body, such as dust, enters the respiratory tract, then in order to avoid it entering the alveoli, sputum will be released, which will absorb the foreign body and be able to go out with it through the respiratory tract without damaging the alveoli. In patients with bronchial asthma, the body also reacts to external changes, but has excessive sensitivity and hyperreaction, due to which the pulmonary fibers of the vagus nerve cause the bronchi and bronchioles to narrow several times more and secrete more sputum than in a healthy person.

Features of the action of exercise therapy in bronchial asthma

In the treatment of bronchial asthma, a set of physical exercises is used, which contribute to the normalization of cortical dynamics and nervous regulation of the respiratory act. As a result of the exercises, breathing slows down, motor-visceral reflexes are restored, which regulate the tone of the bronchi during physical work. Breathing exercises with the pronunciation of sounds help to reduce spasm of the bronchi and bronchioles. An increase in adrenaline in the blood under the influence of muscle activity also has a beneficial effect on the patient's condition. In addition, metabolic processes are enhanced, exercises help prevent emphysema. By strengthening the respiratory muscles, voluntary exhalation, and mastering various breathing techniques, the patient can control the onset of attacks and facilitate their course.

Exercise

therapeutic breathing asthma exercise

Therapeutic exercises are usually prescribed during periods of subsiding attacks, when the general condition of the patient improves, and there are no pronounced phenomena of circulatory failure.

Physiotherapy exercises are designed to solve the problems of general strengthening of the body, normalize the course of nervous processes, relieve bronchial spasms, and restore normal breathing. Therapeutic exercise also helps to strengthen the respiratory muscles, restore skills correct posture, normalization of chest excursion. The amount of load is determined depending on the age of the patient, the severity of the disease, the level of physical fitness.

People with bronchial asthma are contraindicated in exercises that entail straining, holding the breath. A set of exercises usually contains: general strengthening exercises, special exercises to increase the mobility of the chest, breathing exercises designed to instill in the patient the ability to control and manage their own respiratory act. Particular attention in the exercises is given to training diaphragmatic breathing and extended exhalation, strengthening the abdominal muscles. Recommended breathing exercises consist in the alternate pronunciation of vowels and consonants, which is combined with a contraction of facial muscles.

Exercise examples

Application of static breathing with arbitrary slowdown, duration 30-40 sec.

Squeeze your hands into a fist, bring your hands to your shoulders - take a breath. Take the starting position - exhale.

Bend the leg forward, clasp it with your hands and pull it to the stomach - exhale, take the starting position - inhale.

Perform a turn to the side with the abduction of the hand with the palm up - inhale, starting position - exhale.

Breathing exercise with lengthening the exhalation and pronunciation of the sounds "sh", "g".

Tilt to the side, the hand slides down the leg of the chair - exhale, return to the starting position - inhale.

Starting position - standing, legs apart, brushes are located on the lower ribs on the side. Take your elbows back, there is a compression of the chest - inhale. Bringing the elbows together and exhaling.

Starting position - standing, hands holding the back of the chair. We squat - exhale, starting position - inhale.

Starting position - legs apart, hands on the belt. We perform breathing exercises with lengthening the exhalation, while exhaling, stretching out the lips with a tube, we pronounce the sounds “a”, “o”.

Slow walking combined with breathing.

Starting position - legs apart, hands on the belt. Tilt forward, reach the seat of the chair with your hands, exhale, return to the starting position - take a breath.

Starting position - lying on your back. Raise your hand - inhale, relax your muscles, drop your hand on the bed - exhale.

The starting position is the same. Raise your leg and exhale. I.p. and inhale.

Same starting position. Applies diaphragmatic breathing with frequency reduction.

Walking combined with breathing.

Starting position - sitting, put your hands on your knees. Tilt forward, hands gently glide over the legs - exhale, take ip and inhale.

Starting position - sitting, put your hands on your belt. Take the left hand to the side, and the right hand forward, at the same time straighten the left leg. Repeat on the other side.

Starting position - sitting, put your hands on your knees. Bend and unbend the legs in ankle joints, at the same time we squeeze and unclench our fingers into a fist.

Conclusion

Physical therapy for bronchial asthma allows you to: relax the muscles of the neck, shoulder girdle, chest, neck; improve diaphragm function, facilitate expectoration, prevent emphysema, and increase chest elasticity, educate correct breathing. It should be noted that, despite the enormous benefits that physiotherapy exercises can provide to the patient's body, there are contraindications to it. Among the main contraindications are respiratory and heart failure.

Bibliography

Chuchalin A. G. "Bronchial asthma"

Epifanov V. A. "Therapeutic physical culture"

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The effect of exercise therapy on the body of a patient with bronchial asthma

Exercise therapy in bronchial asthma helps to restore the rhythm, depth and frequency of breathing. At the same time, ventilation of the lungs, gas exchange in them improves, blood oxygen saturation normalizes. As a result, the severity of respiratory failure decreases, and the body's adaptability to environmental conditions improves.

Breathing exercises help to increase the mobility of the chest. Reduces sensitivity to allergens and the tendency to bronchospasm. The balance of the processes of excitation and inhibition in the nervous system is restored.

Carrying out exercise therapy for bronchial asthma helps to reduce the frequency of exacerbations, reduce the need for drugs.

Modes of physiotherapy exercises

The complex of therapeutic physical culture for bronchial asthma includes general strengthening exercises, breathing, sound gymnastics.

First, the patient must master the so-called diaphragmatic breathing. At the same time, on inspiration, the diaphragm rises, the anterior abdominal wall protrudes. On exhalation, the diaphragm descends, the abdominal wall retracts. You need to learn how to take a deep breath and a long exhale.

When performing sound gymnastics, the patient pronounces various sounds on exhalation, which causes vibration of the vocal apparatus, which is transmitted to the lower respiratory tract. As a result, their relaxation occurs, spasm is relieved, and sputum clearance improves.

The duration of one lesson is 10 - 30 minutes. Conduct 1 to 3 classes per day.

The program of therapeutic physical culture for bronchial asthma begins with a course preparatory classes within 10 - 14 days. Then there are daily training sessions, walking, running, swimming, cycling are added.

It is done while sitting on a chair.

Diaphragmatic breathing.
Inhale: hands to the sides. Exhale: pull your knees to your stomach with your hands.
Inhale: take your right arm and leg to the side. Exhale: starting position. Repeat on the left.
Inhale: raise your shoulders, turn your head to the side. Exhale: starting position.
Inhale: bend, connecting the shoulder blades. Exhale: pull your knees to your stomach.
Inhale: Raise your hands. Exhale: lower your hands, pronouncing the sound "sh".
Inhale: hands on knees. Exhale: pronounce the sound "g".
Raise your hands in front of your chest, connect your fingers “in the lock”. Inhale: Raise your hands. Exhale: lower your hands, pronouncing the sound “pff”.

The ratio of the phases of breathing is regulated by counting: 1.2 - inhale, 3, 4, 5, 6 - exhale, 7, 8 - pause. The duration of the exhalation should be up to 30 - 40 seconds.

A set of exercises (preparatory mode)

Starting position - sitting.

Diaphragmatic breathing.
Hands on knees. Inhale: spread your knees. Exhale: starting position.
Hands on the belt. Inhale: turn the torso to the side. Exhale: starting position.
Inhale: raise your hands up. Exhale: lower your hands, pronouncing the sound “ha”.
Pose "coachman on the goats" (forearms lie on their knees, eyes are closed, muscles are relaxed).
Movements imitating rowing in a kayak, with turns of the torso to the sides (you can use a gymnastic stick).

Starting position - standing.

Inhale: raise your arms up through the sides, rise on your toes. Exhale: lower your arms down through the sides, swing from toe to heel.
Inhale: tilt to the side, hand slides over the thigh. Exhale: starting position.
Hands in front of the chest "in the lock." Inhale: raise your hands up. Exhale: lower your hands, pronouncing the sound "uff".
Walking in place with high knees, active hand movements.

In the training mode, 3-4 times a week are held physical training: running, swimming, exercise bike for 20 - 30 minutes. After such a training, it is necessary to carry out breathing exercises in accordance with the above sets of exercises.

Sound gymnastics for bronchial asthma

After inhaling through the nose, as you exhale, you should pronounce various vowels and consonants.

In the preparatory period, they begin with the pronunciation of the sounds u, i, e, o. In the training period, they begin to use the sounds z, r, s, and later - w, w, u.

Exhalation sounds must be pronounced for 5 seconds with a gradual lengthening during training up to 30 seconds

On the exhale, you can pronounce syllables using the sounds b, d, x, p (bang, bat, brohh, drruhh, etc.). Sound exercises are repeated for 2-3 minutes up to 5-6 times a day. Between exercises, you should pause for 30 seconds.

Article prepared

Kazarinova Victoria Vladimirovna

Specialist of UIA "CPPMiSP"

FC Instructor

"Therapeutic exercise for bronchial asthma"

The main symptoms of bronchial asthma are episodes of shortness of breath, wheezing, coughing, and chest congestion. The appearance of symptoms after exposure to the allergen, the seasonal variability of symptoms, and the presence of relatives with bronchial asthma or other atopic diseases are essential. When combined with rhinitis, asthma symptoms may either appear only at certain times of the year, or be present constantly with seasonal aggravations. In some patients, seasonal increases in airborne levels of certain aeroallergens (eg, Alternaria pollen, birch, grass, and ragweed) cause flare-ups.

Tasks of exercise therapy in bronchial asthma

The main objectives of therapeutic physical culture are:

Restoration of the balance of the processes of excitation and inhibition in the cerebral cortex, the repayment of pathological reflexes and the restoration of the normal stereotype of the regulation of the respiratory apparatus;

Reducing spasm of the bronchi and bronchioles; improvement of lung ventilation;

activation of trophic processes in tissues;

Teaching the patient to manage their breathing apparatus during an asthmatic attack in order to alleviate it;

learning to exhale.

Contraindications

Contraindications for exercise in bronchial asthma:

1. Any overload is contraindicated.

2. Exercises should be stopped if the first signs of an asthma attack are noticed: uneven breathing, spasm, coughing.

3. Intense running, performing exercises without a break to establish calm breathing are not allowed.

4. In the room where the physiotherapy session is held, wet cleaning and ventilation should be carried out in advance.

5. It is contraindicated to practice outdoors in adverse weather conditions (too cold weather, rain, wind), as any hypothermia can cause an asthma attack.

Features of the exercise therapy technique

A mistake is the generally accepted opinion that patients with bronchial asthma should be limited in physical activity, since physical activity is considered one of the factors provoking attacks of bronchospasm (bronchial asthma).

However, according to the literature, training under optimal conditions (temperature and humidity), on the contrary, reduces the frequency and severity of seizures. Such a load should be present in all patients with bronchial asthma.

Gymnastic exercises can help a patient with bronchial asthma cope with the first signs of an asthma attack and learn how to dose physical exercise to maintain muscle activity without harming your health.

In therapeutic exercises for patients with bronchial asthma, the simplest, easy-to-perform exercises should be included. Between breathing exercises with the pronunciation of sounds, it is necessary to include a pause for rest to relax the muscles. The dosage of exercises is 4-12, the pace is slow and medium.

Massage technique for bronchial asthma

Massage, as a rule, is carried out in the affected area and symmetrically to the lesion, in case of swelling and with sharp pains - above the affected area.

The massage course can be conditionally divided into three parts: 1) introductory - 1-3 procedures that are carried out to determine the body's reaction to massage; 2) main - about 20 procedures, which are carried out taking into account physiological state massaged and features of his disease; 3) final - 1-2 procedures.

As a rule, a massage course includes from 5 to 25 procedures, depending on the severity of the disease and the condition of the person being massaged.

Between courses, you can take breaks from 10 days to 2-3 months. The number of procedures and the duration of the break between them are selected individually and can be either reduced or increased.

Massage and self-massage procedures also consist of three stages: 1) introductory - 1–3 minutes, during which the massaged person is prepared with gentle techniques for the main part; 2) main - from 5 to 20 minutes; 3) final - 1-3 minutes, during which the intensity of exposure is reduced, normalizing body functions, and breathing exercises are performed.

The duration of the session can be from 3 minutes. up to an hour, depending on the indications. Massage is done daily or every other day, sometimes it is carried out 2-3 times a week, combined with other types of complex treatment.

Approximate set of exercises

Physical exercise is used between asthma attacks to improve well-being and performance, strengthen the respiratory muscles and improve lung ventilation, teach the ability to control the respiratory apparatus and develop full breath which makes it easier to endure asthmatic attacks.

Breathing exercises and exercises accompanied by the pronunciation of certain sounds and their combinations on the exhale (sound gymnastics) help to reduce spasm of the smooth muscles of the bronchi and bronchioles. Sound gymnastics acts on their walls like vibration massage, relaxing the bronchial muscles. This effect also gives relaxation of the muscles of the shoulder girdle.

Walk at a fast pace for 5 minutes before starting the exercises and after doing them. Gymnastics is best done in the morning, an hour after eating. The total walking and exercise time is 15–20 minutes. At the end - raising and relaxing lowering of the hands at the pace of calm breathing.

1. Sitting on a chair, hands on knees. Hands behind the head, bend over - inhale; return to the starting position - exhale (4-6 times).

2. Sitting on a chair, hands on the belt. After inhaling, pull your knee to your chest with your hands - exhale (alternately, 3-6 times).

3. Sitting on a chair, feet shoulder-width apart, hands down. Tilt to the left, try to touch the floor with your left hand, exhale with your right hand to the shoulder; return to the starting position - inhale. The same with the slope to the other side.

4. Sitting on a chair. Hands to the sides - inhale; cross your arms on the ribs, standing up and leaning forward - exhale (4-8 times).

5. Sitting on a chair, hands on knees. Taking your head back, bend - inhale; return to the starting position - an elongated exhalation through the mouth, pronounce the sound "zh-zh-zh" (4-6 times).

6. Normal walking - 1-2 minutes. Walking with arms raised to the sides while inhaling and lowering while exhaling - 1-2 minutes. Walking with a slowdown in pace and lengthening of the exhalation (30-60 s).

7. Standing, legs apart, hands down. Bend over, connecting straight arms behind your back - inhale; tilt your head forward, connect your straight arms below in front of you - an elongated exhalation, pronouncing the sound "oooo" (3-5 times).

8. Standing, legs apart, hands on the belt. Taking the left leg back to the toe, slightly turn the torso to the right, right hand to the side (look at it) - inhale; return to the starting position - exhale; the same in the other direction (3-4 times).

9. Legs apart, arms down. Tilt to the right, right hand on the belt, left up - inhale; return to the starting position - exhale; the same in the other direction (3-4 times).

Gymnastics activates the secretion of the adrenal hormone - adrenaline, which in turn causes the expansion of the bronchi. Regularly performed exercises of the complex increase the ventilation effect of breathing with less energy consumption.

No less significant is the fact that chest breathing, which is characteristic of the majority of those suffering from bronchial asthma, is replaced by a physiologically more appropriate - abdominal, as a result of which the ventilation of the lower parts of the lungs is significantly improved.

Increased breathing, excessive ventilation of the lungs sharply reduce the content of carbon dioxide in the body, which can increase bronchospasm. Make sure that during training the breath is calm, followed by a pause of 2-3 seconds.

Do not forget to control the degree of load on the pulse rate and breathing before and after exercise. The pulse rate after exercise should not exceed 100-110 beats, and breathing - 20-24 per minute.

Within 5 minutes after exercising, the pulse and breathing rates should be the same as before exercise.

Breathing exercises

Breathing exercises in one form or another are recommended for all patients with bronchial asthma. With this disease, it is necessary to learn how to breathe shallowly, not to take deep breaths, because they irritate the bronchial receptors, and this can increase the attack. In order to be able to calm them during an attack, you need to learn how to exhale moderately. After that, hold your breath for 4-5 seconds. The next breath should also be shallow. It is necessary to strive to eliminate forced exhalations so that exhalation occurs only under the influence of the elastic recoil of the lungs. At the same time, you need to monitor the lengthening of the breath.

The simplest method for generating more deep breathing is inflating balloons, to obtain maximum effect The balloon must be inflated until it bursts. It is enough to inflate two balloons daily. This breathing exercise will help deepen your breathing and strengthen your diaphragm.

In order to strengthen the diaphragm, you can perform other breathing exercises: put your hands on your stomach just under the ribs and take a slow, deep breath. During inhalation, you need to stick out your stomach; this will spread the arms a little to the sides, as the diaphragm will move forward. When exhaling, draw in the stomach - the diaphragm will go back and the hands will join again. Repeat no more than 3-4 times and then breathe normally.

In order to normalize the tone of the muscles of the bronchi, breathing exercises are performed with the pronunciation of sounds. Take a moderate breath and, squeezing the chest in the middle and lower sections with your palms, pronounce the following sounds with a slow exhalation: “pf”, “rrr”, “brrroh”, “brrrh”, “drrokh”, “drrakh”, “brruh”. Watch the duration of the exhalation with a stopwatch. In the first lessons, it should not exceed 4-5 seconds, but gradually it should be increased to 12-25 seconds. The sound “ppr” can be especially long: in the first days of classes - 5 seconds, then up to 30. The same exercises can be performed by clasping the chest with a towel: while slowly exhaling, pull off the ends of the towel, pronouncing the same sounds 6-10 times.