CLINICAL CONDITIONS

EXERCISE IN THE MANAGEMENT OF ASTHMA IN CHILDREN

WHAT IS ASTHMA? Asthma is an obstructive lung disease, which is reversible either spontaneously or with treatment. The disease is char- acterised by cough, wheeze and breathlessness and will vary in severity from episodic or occa- sional asthma to persistent severe disease.

Effects on the

airways can result in constric- tion (bronchoconstriction) and inflammatory changes. Unless appropriately and adequately treated permanent changes in the airway structures can occur. In children coughing, especially at night with subsequent dis- turbed sleep, may be the only presenting symptom.

Asthma trigger factors Asthma can be triggered by many factors. In children the most common trigger factor is a viral infection. Other triggers include: ● smoking, both passive and active ● house dust mites ● animal dander (especially cat and dog) ● cold weather ● pollens ● moulds ● feathers ● emotions ● exertional activities (inc. exercise)

Asthma management Drug therapy Drug therapy is both effective and safe. Inhaled bronchodilator therapy, which gives symptomatic relief by increasing air- way diameter, and inhaled corticosteroids, which control and prevent inflammation within the airways, are the main therapeu- tic options available to treat asthma. The

1997 British Asthma Management guide- lines recommend a stepped approach to management with treatment starting at a level that depends on the disease severity. In addition to drug therapy, asthma can also be controlled by minimising exposure to potential allergens.

Benefits of exercise The respiratory improvements reaped by exercise not only boost self-esteem and confidence, an important issue in child- hood, but also enable children to do more with less effort and lead a more normal and less compromised lifestyle.

Research suggests that physicians treating children with asthma should ‘strongly encourage physical activity and not permit asthma to limit exercise in all but the most severe cases’ (2). Breathlessness leads to reluctance and/or avoidance of exercise which in turn can lead to reduced exercise

SportEX 13