What is asthma?

Asthma is a medical condition which affects the bronchial tubes (airways) via inflammation and obstruction. During an exacerbation, the thin layer of muscle on the walls of the bronchial tubes contract causing them to become inflamed, making it harder for air and mucus to pass through. The symptoms to look out for when experiencing an exacerbation of asthma are:

• Wheezing
• Coughing
• Short of breath
• Fast or irregular breathing
• Chest tightness

Some risk factors which may flare up certain people’s asthma are some of the following:

• Cold air / hot air
• Exercise
• Air pollution
• Dust

Due to these certain risk factors, people with asthma may flare up which causes the airways to become narrow making it difficult for them to breath. A person with asthma may describe a flare up as breathing through a straw or someone sitting on their chest.

There is no cure for asthma so this is to be controlled via medicines such as inhalers, regular medical check-ups with GP’s, and controlled exercise.

Times have changed how we manage asthma compared to years ago. A few years ago, you could have been told to rest and not move your body excessively. However, in more recent years, research shows that exercise is very beneficial for improving lung function, increase quality of life, decreases the number of exacerbations, and decreases airway inflammation.

Recommended duration and frequency of exercise

It is recommended for people with asthma to engage in exercise to help with improving their health and fitness. There are even some famous athletes who are able to excel in their sport while managing the health condition of asthma. (For example, English former football player David Beckam was able to dominate his sport while dealing with asthma). However, elite athletes who have asthma will require additional care and management from their medical team due to their chronic exposure to high intensity activity.

The recommendation of the amount of exercise volume per week would vary from person to person depending on multiple factors. Exercise and Sport Science Australia has provided the below recommendation as an outline for exercise targets to reach for long-term health benefits:

It is suggested that exercise should start off at a low intensity and then gradually increase to moderate -high as fitness levels improve over time.

It is recommended for exercise to last between 20-60 minutes. Initially starting at 20 minutes, while slowly building up to 60 minutes. This should be done approximately 3-5 times a week to gain long term benefits. You will gain greater improvement with increased frequency throughout the week. Some great examples of cardio exercises include: swimming (non-chlorinated is recommended), jogging and cycling.

Some pointers to reduce exacerbations during exercise include:

• Follow your “Asthma Action Plan” as set out by your GP
• Participating in a pre-exercise warm up (example: light walk or jog)
• Taking your pre-exercise medication
• Having your reliever medication with you during exercise in case an exacerbation occurs.
• Reducing exposure to unfavourable environmental conditions (i.e. very cold climates)

What are some simple home exercises that I could be doing if I have asthma?

• Diaphragmatic breathing
• Lie down on the floor and get yourself comfortable.
• Place one hand on your chest and one hand on your stomach.
• Inhale through your nose for approximately 4 seconds, expanding your stomach.
• Hold your breath for approximately 2 seconds.
• Exhale through your mouth with pursed lips for approximately 6 seconds.
• Repeat this 4-6 times.

Breathing exercises have been show in research to improve quality of life, lung function and assist when someone is hyperventilating.

• Sit to stand

This increases strengthen in the lower limbs, balance, proprioception and cardiovascular fitness. The research shows this is a reliable outcome measure for pulmonary rehabilitation and can be used as a good strengthening exercise as well.

• Cobra yoga pose

This exercise helps strengthen the back, open up the chest and encourages deep breathing.

• Walking tolerance

Start off taking a 5-10 minute walk, and slowly build up increase tolerance throughout a number of weeks. This could progress to a walk-jog protocol for additional health benefits.

This will allow your aerobic fitness levels to increase at a safe and steady pace.

If you are living with asthma and you are unsure on how to start a training program that is related to your fitness goals, feel free to speak with one of our physiotherapists or exercise physiologists to get the support that you need.

References

Mims,J. (2015) Asthma: definitions and pathophysiology. International forum of allergy and rhinology. 5. PP 1923-3783.

Santino, T et al. (2020) Breathing exercises for adults with asthma. The cochrane database of systematic reviews. 25. 3(3) PP 1277.

Burner et al. (2022) Exercised induced asthma. StatPearls. https://pubmed.ncbi.nlm.nih.gov/32491486/#:~:text=Exercise%20has%20paradoxically%20been%20shown,people%20with%20asthma%20and%20EIB.

Morton, A. et al. (2011) Australian Association for Exercise and Sports Science position statement on exercise and asthma. Journal of science and medicine in sport. 14, PP: 312-316