Not acute asthma attack

In the case of a non-acute asthma attack, the main focus is on experiencing the stress limit and perception of one’s own body. Many patients are afraid to strain themselves too much and to do sports. The physiotherapy for asthma is based on this; the asthma patient is led to his or her stress limit.

At this limit it is important to perform the above mentioned exercises to deepen breathing, as well as to consciously control breathing. Breathing in is done through the nose, while exhaling the air is slowly blown out of the minimally opened lips (lip brake). With lip-braking, the bronchial tubes are held wide and breathing is automatically deepened.

This has a calming effect on the patient and is therefore a good prevention of asthma attacks in asthma patients. It is also advisable for him to keep his breathing under control and above all not to increase his breathlessness. In order to feel the perception and to deepen the breathing, the patient lies down in a supine position and feels inside himself where the respiration flows to.

The physiotherapist then places his hands alternately on the sternum, the ribs and the abdomen. He asks the patient to breathe deeply in the places where the hand is lying. This leads to the lungs being completely filled with air, the gas exchange is improved and the stuck mucus can be loosened.This exercise (contact breathing) is the basis of breathing therapy in physiotherapy.

Furthermore, the exercise can be intensified or varied with different starting positions. The rotary-stretching position (the legs are tilted to the side in an upright position and the arm of the opposite side is put down stretched upwards) ensures that the breathing can flow especially in the stretched side and thus the thorax is stretched to its final length. The same applies to the C-stretch position, where the asthma patient lies like a banana to achieve the same success as with the rotary-stretch position.

Many patients tend to lose body tension due to the extreme coughing attacks or the constant fear of an asthma attack. This is countered with special mobilization exercises. These can be simple straightening and rotation exercises with a rod, Theraband or Pezzi ball, but also therapeutic body positions.

With the “giraffe” the patient kneels and turns backwards with one hand, grasps his foot and stretches the other arm upwards. With the “Cobra” the patient lies on the stomach, overstretches his spine by supporting his hands, the elbows remain slightly bent. The “cat” can be carried out in a four-footed position.

The asthma patient pushes the BWS towards the ceiling like a hump and then lets himself fall again. The patient is given these exercises as homework to keep his upper body mobile. Another aspect of physiotherapy for asthma in the late phase is the relaxation of the respiratory muscles.

As already mentioned above, an asthma attack causes tension in the entire body, which is the cause of limited mobility but can also lead to persistent pain in the back and neck. The physiotherapist uses soft tissue techniques, such as massage or passive stretching, to lower the tone of the muscles. But also strokes, as mentioned above, shaking – the patient lies relaxed on his back, the physiotherapist takes one arm, leg, pelvis after the other and shakes the body part carefully in a slow rhythm.

In addition, the physiotherapist combines the breathing therapy with so-called pack grips. This is usually done in a lateral or prone position. The physiotherapist lifts a skin fold and asks the patient to breathe away on the skin fold.

The physiotherapist can also roll the skin fold, which simultaneously loosens the fasciae in the area. Not only the superficial muscles are tense but also the muscles surrounding the deeper ribs. The physiotherapist uses his finger to trace the intercostal space from its origin to the base.

This treatment is very painful but very effective. An equally common form of treatment in respiratory therapy is the hot roll. A towel is rolled up tightly like a funnel and filled with hot water.

Then the roll is carefully dabbed onto the asthma patient’s back until it has cooled down a bit and rolling movements can be performed. The aim of the treatment, as well as releasing tissue resistance, is to promote bronchial cleansing, which can be supported by breathing out on sounds. In order to loosen the stuck mucus, tapping is performed in addition to shaking the chest area.

This is done in a sitting position, the physiotherapist taps with the hollow hand on the back of the asthma patient for several minutes. Here too, the patient can intensify the effect by breathing out on sounds. The sounds already mentioned above during exhalation work especially well on sounds like M, Br, S, because this causes a vibration of the vocal chords and thus has a positive effect on the transport of mucus. These articles may also be of interest to you.

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