Asthma

Overview of Asthma

This is a chronic inflammatory disease, which produces a reversible obstructive lung condition during exacerbation episodes. Asthma can be triggered by numerous environmental causes, which include exercise activities. Inflammation of airways produces edema, mucous production, and smooth muscle spasms that obstruct the airway, thus making breathing difficult. Bronchospasms produce wheezing, with prolonged expirations, a nonproductive cough, and tachypnea. Progression of the disease can lead to permanent changes in the airway similar to those of other chronic obstructive pulmonary diseases.¹ Individuals with this condition may experience exercise-induced asthma, especially in cold weather conditions. These attacks can be unpredictable and may cause the individual to limit exercise activities to avoid these episodes. Clients with asthma can improve their aerobic fitness and breathing reserve without increasing the occurrence of asthma and may improve their ability to recover from an asthmatic episode.^2,3

Comorbidities to Consider

• Clients who are obese have a greater risk for developing asthma. The effects of obesity make asthma difficult to control.

Client Examination

Keys to Examination of Clients

• Ask clients if they have had pulmonary function studies, arterial blood gas analysis, and chest radiographs to assess the severity of their disease.

• Assess for breathing patterns, proper use of inhaler medication, and postures during exercise activities.⁴

• Counsel clients who smoke or use tobacco on the effects of smoke and nicotine on their medical condition.

• Discuss with younger clients their beliefs about physical activities and their asthma. Many adolescents avoid activities that could bring on asthmatic episodes to avoid appearing different from their peers and as an excuse for sedentary behaviors.^5,6

Recommended Baseline Testing of Fitness Levels

• Choose aerobic tests of walking, running, or cycling will allow for baseline measurements of aerobic capacity, ventilation measures, and airway tolerance of exercise activities.

• Document the types of activities and the environmental triggers that have caused the onset of their asthmatic episodes to determine a baseline for their tolerance to activities.

Exercise Prescription

Type: A variety of recreational and competitive activities

Intensity: 50% of peak oxygen uptake or at limits tolerated by symptoms⁷

Duration: 20–30 minutes

Frequency: Three to five times per week

Getting Started

Clients with severe forms of asthma will need to modify their participation to avoid asthmatic episodes.² Swimming has been considered the least likely activity to promote an asthmatic episode, due to the benefits of breathing warm, humid air.⁸ Clients should learn how to use perceived exertion, breathlessness levels, and other symptoms to control their level of exercise intensity to avoid developing an asthmatic episode. Clients need to recognize when they begin to ...