Asthma is a chronic disease affecting the airways of the lung. In people with asthma, the airways are sensitive to stimuli. Therefore, those who have asthma experience recurrent and reversible flare-ups (attacks) of airway narrowing and inflammation. Asthma usually begins in childhood but can affect people of any age. During a flare-up of asthma, the symptoms can include wheeze, breathlessness, cough and chest tightness.    

What causes asthma?

The actual cause and pathology behind asthma is not well-understood, but it is thought that a trigger causes airway inflammation, airway narrowing and mucous secretions. A person who has asthma will experience recurrent flare-ups (attacks) that are reversible. These flare-ups are usually triggered by exposure to some sort of stimuli or allergen, such as dust, dog or cat hair, pollen, mould, chemicals, tobacco smoke, air pollution, exercise in the cold and some types of food or drink. The symptoms of a flare-up are usually reversed by taking reliever medication, a blue or grey ‘puffer’).

How do I know if I have asthma?

During an asthma attack, common symptoms are wheeze, breathlessness, cough and chest tightness. Asthma Australia recommends that during an asthma attack, it is important to stop and rest, sit upright in a chair, and take four puffs of your asthma medication, with a spacer if you have one. If the symptoms are not relieved after four minutes, take the puffer four times again. If there is still no improvement, call 0-0-0. People with asthma who have the disease under control may not experience any symptoms normally outside of flare-ups. Refer to Asthma Australia for more information.

A GP will help diagnose asthma. They may do a variety of breathing tests to try to determine if you have asthma and how severe it is, and may then send you to a specialist medical doctor (respiratory physician) for assessment and treatment. Asthma is diagnosed based on a history of recurrent flare-ups (especially if the flare-ups occur after exposure to an allergen), reversal of symptoms and improvement in breathing immediately after taking asthma-relief medication. Because asthma cannot be cured, the treatment is focused on managing the condition and preventing flare-ups. The main component of treatment for asthma is medication (preventers and relievers) prescribed by a medical doctor. 

How can physiotherapy help with asthma?

Physiotherapy is important in the management of asthma. Your physiotherapist will help educate you about your condition. They will teach you to use and clean your asthma medication devices correctly to ensure you are getting the correct dose. There are many different types of devices, such as puffers, Turbuhalers, Autohalers and tablet devices. They each work slightly differently.

Your physiotherapist can also help prescribe and supervise exercise training for you. Sometimes exercise can induce an asthma attack, so your physiotherapist will help to assess your exercise ability, your breathing and the presence of any wheeze before you commence. They can develop an appropriate exercise program for you to do at home or in a group setting, and will teach you what to do before and during exercise sessions to prevent a flare-up induced by exercise. Your physiotherapist may also teach you breathing exercises to help with your asthma.

How effective is physiotherapy for asthma?

There is growing evidence for exercise training and breathing techniques in the management of asthma. Exercise training, such as running, cycling, swimming, walking, gymnastics and weight training, can improve fitness levels and quality of life. Breathing techniques may also help reduce symptoms and improve quality of life. Both exercise training and breathing techniques are well-tolerated and safe for people with asthma when done correctly.

What can I do at home?

Managing your asthma at home is important. Discuss with your GP or physiotherapist about having an asthma action plan. This involves having a plan for what medication to take when you are stable, how to detect if your asthma is getting worse, and what medications to take if your asthma is getting worse. An important part of your management at home is measuring your ‘peak flow’ every morning. This measures how fast you can breathe air out of your lungs and helps you keep track of your asthma severity over time. Maintaining a physically active lifestyle is also important to keep you fit and healthy.

How long until I feel better?

The symptoms of asthma during a flare-up should be relieved within four to five minutes of taking relief medication. However, other longer-term ongoing benefits are slower to occur.

The effects of exercise training will be seen after at least one month of regular training. Evidence showing the beneficial effects of exercise training for people with asthma was seen in people exercising for a minimum of four weeks and training at least twice per week.