Asthma – disease, therapy and rehabilitation
Asthma (bronchial asthma) is a chronic lung disease. The associated breathing difficulties can be alleviated by treatment, but only rarely cured completely. In addition, rehabilitation (rehabilitation) with individually adapted diagnostic and therapeutic measures can support the healing process and improve the quality of life. Find out everything here about the disease, the therapy and the options for a cure or rehabilitation.
Photo: Training inhalation techniques during a rehabilitation measure helps asthma sufferers to optimally use different types of inhalers in order to achieve the best possible effect. – © panthermedia.net / Wavebreakmedia
Asthma (or bronchial asthma) is a respiratory disease. When breathing, air first flows through the trachea and finally reaches the alveoli via increasingly finely branching bronchi and bronchioles, where oxygen is absorbed into the blood from the air we breathe. In asthmatics, the bronchi narrow due to permanent (chronic) inflammation, which leads to coughing and difficulty breathing.
Asthma diseases are becoming more common. Every tenth child is affected, but the disease often improves during puberty. In Germany, 6.9 percent of the population has bronchial asthma, in Austria it is 5.8 percent. The frontrunners are countries like England and Scotland with over 15 percent asthmatics (1). Boys are more affected than girls in childhood, while more adults than men suffer from bronchial asthma.
The exact cause of asthma has not yet been determined. Doctors assume that a genetic disposition and certain risk factors contribute to the development. There are two medical forms of asthma: allergic asthma occurs in connection with allergies (2). In all other cases one speaks of non-allergic asthma (or endogenous asthma).
Asthma attacks can be triggered by allergy sufferers from pollen, mold or other allergens. The non-specific, i.e. allergy-independent stimuli that can trigger an asthma attack include physical exertion, environmental influences such as high ozone levels, cold, tobacco smoke and fragrances (perfume).
Asthma: appearance / symptoms
In asthma, phases with no severe symptoms alternate with asthma attacks and shortness of breath. Symptoms of asthma include cough (often at night), shortness of breath, shortness of breath, chest tightness and wheezing. These symptoms are caused by inflammation and narrowing of the bronchi. Exhaling is typically a particular problem.
In addition, asthmatics are often sensitive to certain stimuli such as cold, dust, strong smells or smoke. When stimulated, the bronchial mucosa swells and breathing becomes more difficult. During an acute asthma attack, further symptoms such as cyanosis (blue staining of the skin, lips, fingernails), severe shortness of breath, feelings of fear, inability to speak, exhaustion and an accelerated heartbeat may occur.
Asthma: examinations & diagnosis
Initial examination and anamnesis
In the case of breathing difficulties, the doctor’s first measure is usually a comprehensive survey (anamnesis). It is clarified which symptoms occur in which situations. In addition, the personal medical history and the occurrence of respiratory diseases in the family are queried. During a physical examination, the lungs are listened to and tapped. This initial examination gives one suspicion of Asthma, referral to a pulmonologist (pneumologist) for further examinations.
Special diagnostics and lung function tests
Special diagnostics can take place either at a pulmonologist or in specialized clinics. In addition to blood tests and X-rays of the lungs, this includes above all various lung function tests in which, among other things, the lung volume and the air flow during exhalation (peak flow) are measured. If these values improve in a second measurement after administration of a bronchodilator, this is an indication of an asthma disease. In addition, allergy tests in allergic asthma show which allergen the trigger can be.
Diagnostic examinations in rehab
Comprehensive diagnostic measures can be carried out in a specialized health clinic or rehabilitation clinic (rehabilitation clinic). Patients have the opportunity to have the disease examined again during rehabilitation. This means that treatments and measures to improve the quality of life can be individually planned for the patient.
Asthma: therapy & Reha
Medicinal therapy for asthma
The basic therapy for asthma primarily includes medications that relieve symptoms and prevent the disease from progressing. These active ingredients are usually inhaled because they are located directly at the place of the desired effect. Among other things, cortisone (or other glucocorticoids) are used against inflammation or active ingredients that extend the bronchial tubes. At a acute asthma attack it is important to solve the shortness of breath as soon as possible. This usually happens with fast-acting medications that lead to an expansion of the bronchi within a few minutes. For more severe seizures, medication can also be given as tablets or intravenously. In the event of very severe seizures, emergency transportation to the hospital should always take place, as life-threatening conditions are possible.
Rehabilitation for asthma
In asthma, therapeutic measures for rehabilitation (rehab) include drug therapy as well as various applications and patient training. The aim is to curb the inflammation and hypersensitivity of the respiratory tract, to reduce the severity and frequency of asthma attacks, to increase physical resilience and thus to improve the quality of life in the long term. A study by the Hannover Medical School and the Bad Reichenhall Clinic (3) showed that after three weeks of rehabilitation, the measurable lung function and physical capacity of the asthmatics examined increased. One year after rehab, the self-assessment of the quality of life was significantly higher than before in more than half of the patients.
What does a rehabilitation clinic offer?
Spa clinics or rehabilitation clinics that specialize in lung diseases offer a whole range of advantages for asthmatics: Specially trained staff, specialists and state-of-the-art facilities ensure a variety of treatment options. This includes not only all important medical applications, but also physiotherapy, inhalation therapy, fango-, warmth– or massage treatments and alternative therapies. Special asthma clinics are often located in locations that are known for their good lung climate. A low-pollutant and low-allergen environment, medicinal water resources, thermal / brine baths or near the sea with salty air optimally support the applications carried out there.
Therapeutic measures in rehab
Therapeutic measures in rehab initially include specialist medical diagnostics and, based on this (if necessary), optimization of previous treatment and medication. There are also numerous additional therapeutic applications such as physiotherapy, breathing exercises and physiotherapy. Adapted endurance training increases physical resilience. Inhalation therapies and balneophysical measures (including medical baths, heat treatments and massages) can also help to relax the respiratory muscles and prevent infections.
Advice and training
The Advice and training is also an important key point in rehabilitation. Asthmatics receive extensive patient training that specializes in bronchial asthma during their stay in the spa clinic or rehabilitation clinic. This can include a wide range of topics: Specially trained specialist staff provides nutritional advice, advises on the important points in sports or exercise training and trains those affected to avoid asthma triggers. The training of inhalation techniques helps to ensure that different types of inhalers are used optimally and that the active ingredients can work in the best possible way.
Also psychological support, relaxation and social counseling are part of a rehab. During rehabilitation, asthmatics often have the opportunity to have psychological conversations in the appropriate clinic or to take courses in relaxation procedures. Social counseling and asthma-specific career counseling are also possible. If certain points are particularly important to you, inform yourself in advance at the clinics whether they are offered there. For example, smokers can also get help with smoking cessation.
Rehabilitation clinics for Children and adolescents offer young asthmatics and their families specially adapted children’s pneumological diagnostics, treatments and training to achieve an unrestricted quality of life in the long term. Children and adolescents learn how to deal independently with asthma in age-appropriate training. This includes behavior when breathlessness occurs, breathing techniques, inhalation techniques, strategies to avoid shortness of breath, and much more. Depending on the clinic, children and adolescents will find playgrounds and lots of space to run around, as well as additional facilities and activities for games, sports and fun.
about the author
Dr. Silvia Nold has a doctorate in biology with several years of experience in medical-scientific diagnostics.
(1) Kozyrskyj AL, et al. Increased risk of childhood asthma from antibiotic use in early life. Chest 2007; 131 (6): 1753-9.
(2) Gerd Herold: Internal Medicine. 2016. ISBN-10: 3981466063
(3) Lingner H, et al. Asthma control and health-related quality of life one year after inpatient pulmonary rehabilitation: the ProKAR Study. J Asthma 2015, 52 (6): 614-21.
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