Physiotherapy for bronchial asthma

Bronchial asthma is a chronic respiratory disease characterized by changes in the sensitivity and reactivity of the bronchi and manifested by an attack of suffocation (expiratory dyspnea), asthmatic status, or, in the absence of such, symptoms of respiratory discomfort (paroxysmal cough, distant wheezing, and dyspnea). It is characterized by reversible bronchial obstruction against the background of a hereditary predisposition to allergic diseases, extrapulmonary signs of allergy, blood eosinophilia and/or eosinophils in sputum.

In case of exacerbation of bronchial asthma, patients are treated in a hospital setting. The following methods of physiotherapeutic influence are implemented there in various combinations and with appropriate alternation of procedures.

1. Medicinal electrophoresis of necessary medications.
2. The impact of sinusoidal modulated currents (amplipulse therapy) on the corresponding areas.
3. Ultrasound therapy, UHF therapy and inductothermy of the adrenal gland area.
4. Laser (magnetolaser) therapy by means of cutaneous irradiation of the corresponding fields and intravenous laser irradiation of blood.
5. Normobaric hypoxic therapy.
6. Carbon dioxide baths.
7. Electrosleep procedures.

It is again necessary to emphasize the need for persistence of the family doctor in explaining to hospital doctors the advisability of using UHF therapy and inductothermy on the projection area of the adrenal glands and other organs in an athermic mode of action.

In the absence of asthmatic status or increased frequency of asthma attacks, the general practitioner (family doctor) carries out anti-relapse measures in an outpatient-polyclinic setting or at home. In this case, the most important physiotherapeutic method is inhalation therapy at the time of the asthma attack. The widespread introduction of a pocket metered dose inhaler (PMDI) into practice has significantly reduced the importance of this method using physiotherapeutic inhalation equipment. However, this equipment is not excluded from the arsenal of physiotherapy methods for these patients. The family doctor must have a portable inhaler for treatment with bronchodilators (2.4% euphyllin solution or 3% ephedrine solution, 5-6 ml at a temperature of 38 °C) on an alternating basis with the use of a PMDI or in case the patient does not have one.

Pathogenetically conditioned methods of physiotherapy at home in the inter-relapse period include laser (magnetolaser) therapy. They use devices that generate red (wavelength 0.63 μm) and infrared spectrum (wavelength 0.8 - 0.9 μm) OR in continuous or frequency-modulated radiation mode.

The method of exposure ILI is contact, stable. The exposed skin of the body is exposed to two fields with a matrix emitter: - to the area of the middle third of the sternum; II - to the interscapular area along the line of the spinous processes of the vertebrae. Using devices with an irradiation area of about 1 cm2, the interscapular area is exposed to four fields paravertebrally, two fields on the right and left at the level of ThV - ThVI.

PPM NLI 10 - 50 mW/cm2. Optimum NLI modulation frequency is 10 Hz. However, the use of exposure in continuous radiation generation mode is also effective. Magnetic nozzle induction is 50 - 150 mT. Duration of exposure to one field is 5 min once a day in the morning (before 12 noon), for a course of treatment 7 - 10 daily procedures.

During the inter-relapse period, courses of laser therapy are recommended to be carried out once every 3 months, so that they coincide with the spring and autumn periods.

An alternative method of laser therapy is the use of information-wave exposure using the Azor-IK device. The technique and fields of exposure are identical to those of laser therapy. The modulation frequency of the EMI is 10 Hz, the exposure time per field is 20 minutes, the course of anti-relapse treatment is 10-15 daily procedures once a day in the morning. The frequency of the courses of information-wave exposure also corresponds to the frequency of laser therapy.

If necessary, psychological rehabilitation methods using the Azor-IK device are very effective, which are carried out with two fields simultaneously on the projection of the frontal lobes of the patient's head, contact, stable. The procedures are carried out 2 times a day. The frequency of EMI modulation in the morning hours after waking up is 21 Hz and before sleep at night - 2 Hz. The exposure time on the field is 20 minutes, for a course of 10 - 15 daily procedures.

During the period of absence of relapses of the disease, it is recommended to regularly perform long-term (up to 3 months or more) daily procedures in the evening (1 hour after dinner) on the Frolov breathing simulator (TDI-01) according to the methods attached to this inhaler.

It is possible to carry out procedures sequentially on the same day for bronchial asthma in outpatient and home settings (the interval between procedures is not less than 30 minutes):

• inhalation + laser (magnetic laser) therapy;
• inhalation + information-wave exposure using the Azor-IK device;
• laser (magnetic laser) therapy + psychological rehabilitation using the Azor-IK device + procedures on the Frolov breathing simulator;
• information-wave impact using the Azor-IK device + psychological rehabilitation using the Azor-IK device + procedures on the Frolov breathing simulator.

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