What is bronchial asthma?
Asthma is a chronic disease in whichdevelops inflammation in the walls of small bronchi. This inflammation leads to swelling of the mucous membrane, the appearance of viscous mucus in the lumen, a periodic spasm of smooth muscles of the bronchi. These changes cause narrowing of the lumen of small bronchi (bronchial obstruction) and the main symptoms of asthma: shortness of breath or even choking, cough with hard-to-separate sputum, wheezing in the chest. Often the causes of the development of inflammation in asthma are: allergy to microscopic home dust mites, animal hair, pollen of plants; hereditary predisposition, taking certain medicines. Sometimes the cause of asthma is difficult to establish. It is well known that infection is not the cause of chronic bronchial inflammation in asthma, so asthma is not treated with antibiotics; for this purpose there are special anti-inflammatory drugs. For bronchial tubes with bronchial asthma is characterized by a state of increased reactivity (hyperreactivity). They react spasm to any external stimulus: dust, smoke, cold air, a sharp smell, contact with allergens. These stimuli are called triggers of asthma and can lead to an attack of suffocation or coughing. Asthma can get sick at any age, but more often children and young people are ill. 
Physiotherapy: a role in the treatment of asthma
Because asthma is inflammatoryand the main direction of its treatment is anti-inflammatory and bronchodilating therapy, the role of exercise can be underestimated by the doctor and the patient. But even the most modern drug therapy without sufficient physical training with asthma with age will lead to a worsening of lung function. Physiotherapy is a system of physical exercises that stimulate the vital functions of the human body. Physical training in many diseases develops endurance, muscle strength, coordination of movements, increases adaptation. Medical gymnastics with bronchial asthma can be useful to patients of any age, with different forms and stages of the disease. The main thing is the correct selection of the complex of exercises, taking into account the individual characteristics and preferences of the patient. Physical exercises with asthma help to increase lung ventilation and improve gas exchange. Physical training helps improve blood circulation in the lungs, prevents the development of emphysema, helps restore elasticity and mobility of the chest, improves the drainage function of the bronchi. It is known that in bronchial asthma, as a result of the disturbance of the mechanics of respiration and chronic lack of oxygen, the function of other organs, primarily the cardiovascular system, is disrupted. Regular physical training has a normalizing effect on blood circulation, increases the utilization of oxygen by tissues. Therapeutic physical education in asthma pursues the main goals:
- improvement of the function of the respiratory muscles and the mobility of the chest;
- normalization of breathing mechanics;
- improvement of bronchial drainage with increased production of bronchial mucus;
- general aerobic training, increasing physical endurance;
- improvement of the patient's psychological state and quality of life.
To strengthen the respiratory muscles, improve the ventilation of different parts of the lungs and drainage function of the bronchi apply a special set of breathing exercises.
An approximate set of breathing exercises
- Standing position standing. Perform leans forward, freely dangling hands. Breathe through the nose, exhale through the mouth, through the folded lips during the tilt. Exhalation should be 2-3 times longer than inhalation.
- The starting position is standing, hands should be lowered along the trunk. Taking a breath, raise the brush to the axillary hollows. On exhalation, they stretch their arms up, and then relax them down.
- The starting position is standing, hands are lowered. They take a deep breath, flex their right leg as they exhale, and, helping themselves with their hands, pull their knees to their chests. Repeat for the left foot.
- The starting position sitting on a chair, the back should be kept straight, pressed to the back, hands along the trunk. They inhale, on exhalation they make a slope to the side, sliding their hands down. Repeat in the other direction.
Physical exercises of this complex perform5-6 times, it is necessary to follow the depth and rhythm of breathing, the duration of exhalation is 2-3 times greater than the inspiration. There are special author's methods of breathing exercises with bronchial asthma. The most famous of them are the gymnastics of KP Buteyko and AN Strelnikova. To master them, especially Buteyko's gymnastics, is better under the supervision of an experienced instructor. These exercises are mainly aimed at improving the mechanics of breathing. Not only exercise can improve the drainage function of the bronchi - this is promoted by special breathing trainers, for example, Frolov's simulator. Contraindication for respiratory gymnastics with asthma is only asthmatic status. Even a severe exacerbation of the disease should not be an obstacle to the available physical activity. As you know, in intensive care units and intensive care hospitals, after removing the patient from a life-threatening condition, they begin to "activate", starting with breathing exercises. Naturally, it is necessary to do this under the supervision of a physician and an experienced LFK instructor. 
An approximate set of exercises for exacerbation of the disease and sparing semi-fast treatment
Exercises are repeated 5-6 times, not allowingoverwork of the patient. As the condition improves, the complex includes physical exercises for small groups of limb muscles, then more active movements involving medium and large muscle groups. Necessarily pauses for rest and relaxation of muscles, observe the patient's condition. Any exercise should be performed on exhalation (flexion and extension of arms, torso of the trunk). Physiotherapy exercises for exacerbation of asthma should not include exercises associated with straining and prolonged respiratory arrest. The optimal ratio of respiratory and general strengthening exercises is 1: 1. After recovery of lung function indicators, exercise therapy includes general developmental exercises that improve blood circulation, strengthen the muscles of the back, legs and hands. During the period of remission, it is possible to use physical exercises with dosed resistance, small weights, with projectiles and on projectiles. In addition, aerobic workouts are mandatory: walking, jogging, biking, swimming, depending on the patient's preferences and load tolerance. During the remission, the complex of respiratory exercises is recommended to be performed daily, aerobic training and general physical training 3-4 times a week. Aerobic exercise should preferably be conducted outdoors, while avoiding contact with triggers of asthma. So, people with pollen allergies can not be trained outdoors during the flowering of allergen plants, people with increased sensitivity to cold should not go for a run in dank, windy weather. In some patients, bronchospasm causes a smell of chlorine in the pool. Therefore, a specific type of aerobic training for each patient should be selected individually, with a possible replacement, depending on the season, weather and other conditions. Patients in whom bronchospasm is provoked by physical exertion or by inhalation of cold air, a bronchodilator inhaler can be used 20 minutes prior to exercise. If the need for an inhaler occurs during each workout, a review of the overall treatment plan and the intensity of the exercise during physical exercise is necessary. Correctly selected medicinal treatment of bronchial asthma allows the patient to maintain an active lifestyle and to tolerate well-proportioned physical activities. It should be remembered that regular exercise is a necessary condition for well-being and lung function in patients with asthma.
