Asthma is a chronic inflammatory disease of the bronchi, in which increased sensitivity of the airways develops, which leads to spasm of the bronchi and bronchioles and obstructed air flow. Bronchial asthma is one of the most common childhood chronic diseases. The risk of getting the disease is increased among children who are overweight and have low levels of physical activity. Typical symptoms of asthma are shortness of breath, coughing and wheezing, which develop during an attack. Patients also tend to react with broncho-obstruction (bronchial spasm) during illness with viral infections, when inhaling cigarette smoke, cold air, contact with allergens, taking certain medications, emotional stress, and when engaging in physical exercise. Physical activity and excessive emotionality are triggers (provocateurs) of bronchospasm, without having an effect on the current inflammatory process.
There is also the concept of “exercise-induced asthma” (EIA). Most patients with asthma and about half of those suffering from allergic rhinitis are familiar with exercise-induced bronchial asthma. In children, an attack triggered by exercise may be the primary manifestation of asthma.
As a rule, in patients suffering from bronchial asthma of physical exertion, bronchospasm develops 10-15 minutes after the start of physical exercise and disappears within an hour. The provoking moment may be running and other cardio exercise, less often swimming. One of the popular hypotheses explaining the development of bronchial asthma due to physical stress is the drying out of the mucous membrane of the respiratory tract due to intense breathing during physical activity.
In order to effectively treat asthma and control attacks, it is first necessary to assess the severity of the disease, identify the main triggers, and then develop a detailed treatment plan, personalized lifestyle recommendations and a recovery program. Patients with recurrent attacks, symptoms of bronchial obstruction persisting during the interictal period, require long-term planned anti-inflammatory treatment. In emergency cases, special medications (beta-2 adrenergic agonists) in the form of a spray are used to relieve bronchospasm. These same drugs are prescribed shortly before the start of training to those patients in whom physical activity may be a provoking factor. Children with mild exercise-induced bronchial obstruction may benefit from warm-up exercises before exercise, breathing through the nose, and the use of a beta-2 adrenergic agonist spray before physical activity. Children participating in prolonged exercise should take long-acting medications. The medication is taken 15-30 minutes before the start of physical activity.
Parents whose children suffer from bronchial asthma need to know that with proper correction, this disease does not affect the physical activity of their children, who can play outdoor games and exercise in the same way as their healthy peers. As a rule, asthmatic children, with the exception of the most severe cases of the disease, do not feel sick, and their physical activity is limited only due to the concern and anxiety of adults.
Potential benefits of exercise
The benefits of exercise for the health and well-being of children susceptible to asthma attacks are clear. Bronchial hyperreactivity increases with a reduction in the hours allocated for physical activity per week. Swimming has been proven to increase aerobic endurance and reduce the severity of symptoms of the disease. Physical exercise can reduce the number and severity of attacks by blocking excessive bronchial reactivity. About half of the patients demonstrate temporary “unexcitability” of the bronchi within 4 hours after the start of physical activity. To reduce the risk of developing bronchospasm, athletes with bronchial asthma need to do a warm-up warm-up lasting 45-60 minutes before starting a full workout.
Possible risks of training
High-intensity physical activity can provoke an attack of bronchospasm due to increased ventilation of the lungs and loss of heat and water during breathing. Some sports expose asthmatic athletes to dry, cold air contaminated with dust and allergens, which can trigger a sudden flare-up of the disease. Most often, such complaints are made by track and field athletes, cyclists and athletes involved in winter sports. Inhaling moist air while swimming can have beneficial effects, but there are potential risks of chlorine irritating the airways, which can also cause bronchospasm in some cases. The issue of increased risk for asthmatics when scuba diving remains controversial. On the one hand, the ability to control your breathing and hypoxic training have a beneficial effect on the course of bronchial asthma, on the other hand, breathing an insufficiently humidified air mixture through scuba gear and the risk of developing bronchospasm at depth force specialists to be extremely careful about diving with bronchial asthma.
Recommendations for children with asthma:
• Can participate in any sport if symptoms are well controlled. Parents should be aware that swimming is less likely to cause exercise-induced asthma than running.
• It is necessary to carefully monitor the symptoms of bronchospasm and clearly identify the factors that provoke the attack. You should not deviate from the prescribed course of treatment and recovery after episodes of bronchospasm.
• It is necessary to undergo respiratory functional diagnostics (spirography with stress), which is performed before the start of physical activity and after a 6-8 minute test on a treadmill or exercise bike in order to exclude the development of exercise asthma while taking beta-2 adrenergic agonists and a positive response to use of the drug. They must carefully follow the course of treatment, while trying not to abuse the use of short-acting inhaled drugs. Let us remind you that the necessary inhalation of beta-2 adrenergic agonists should be carried out 15-30 minutes before the start of physical activity.
• It is not recommended to scuba dive if you have asthma symptoms or unsatisfactory breathing test results.
• Those who take part in national or international competitions must provide a certificate of chronic asthma and/or exercise asthma to authorize the use of certain medications. We recommend consulting with a sports medicine physician.
You can make an appointment with a sports medicine doctor by calling +7495 1200107. The appointment is led by Klimenty Yurievich Golovin.