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Asthma in a Fitness/School Setting

For some, the agony of asthma may be an affliction only during childhood; for others, the illness persists throughout adulthood. The least fortunate are those who fall mortal victims. Asthma can kill. Medical science can offer only temporary relief at best. The deviousness of the disease defies almost all attempts at discovering a cure. Asthma can be mild; it can be devastating. Sometimes the symptoms disappear for many years but surface again with even greater severity.

In an asthmatic attack the diameter of the small bronchi is diminished as a result of spasm of the muscular coat, active congestion of the mucous membrane and excessive secretion of tough mucus. In inspiration the small bronchi are pulled open and the obstruction is thereby reduced. On the other hand, forced expiration tends to compress bronchi and increase the obstruction. Consequently inspiration is much easier than expiration; the difficult breathing of asthma differs in fact from all other forms of difficult breathing, in being mainly expiratory in character (Mezei, 188). Not to be confused with asthma is a similar, but less intense, tightening of the bronchial muscles that occurs in people who are exposed to large amounts of noxious fumes, tobacco smoke, and other pollutants. The body attempts to protect itself against invasion by dangerous substances flowing into the lungs. The asthma victim, however, usually hypersensitive, overreacts with severe symptoms (Renard, 16).

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Asthma deaths in the country are steadily rising at an ever-increasing rate. Statistics indicated that about 4,000 Americans died from the disease in 185, more than double the number only a decade ago. Society became more involved into the process of


determining why asthma death were increasing. A task force of immunology, chemistry, pulmonary medicine, and epidemiological researchers were charged with finding an answer, but their preliminary report only raised more questions. The rise in asthma deaths during the past decade has puzzled scientists and physicians. But while the severity of the disease appears to be increasing, many asthmatics are unwilling to lead the sedentary lives that some say their condition requires (Asthmatics, 1XX).

As seen in many studies and research done in the past exercise can be both beneficial and deleterious to an asthma patient. New research showed that a health and fitness program called, The Eagles Circle improved flexibility, strength, aerobic fitness and quality of life for children with asthma involved in the program. Although children with asthma often avoid physical activity for fear that it will trigger an asthma attack. Studies have shown that regular, moderate exercise can actually be helpful to children with asthma in addition to controlling weight problems. Lack of exercise can lead to physical de-conditioning as well as obesity, in turn, can cause asthma to worsen (Amsterdam News, 18).

For some asthma sufferers, a proper diet is more than a wishful goal, its a necessary step in leading a normal life. In addition to common triggers, food-triggers asthma affect in 6%-8% of asthmatic children but less than % of asthmatic adults. Often the triggers is sulfites, sulfite additives or a food allergen such as milk, eggs, peanuts, tree nuts, soy, wheat, fish or shellfish. Dr. Ron Simon of Scripps Clinic and Research Foundation in La Jolla, CA, stated, sulfites in or added to food can cause potentially life-threatening reactions for asthmatics (Medical Information, 18). Further research by


Harvard Medical School have found that instead of being a by-product of asthma, extra pounds could make people more vulnerable to developing the disease (Tufts Diet, 18).

Even though physical activity has been found to be beneficial to asthmatics. Exercise-induced asthma have been prevalent in our society. As Arateus, in the second century, stated, If from running, gymnastics exercises, or other work the breathing becomes difficult, it is called asthma. The phenomenon of shortness of breath after vigorous exercise has been recognized for centuries and for decades; it has been recognized that bronchi-constriction occurs after exercise, it most likely occurs after running. Many athletes and non-athletes have dealt with E.I.A. About 70-0% of asthma suffers discover that exercise and sometimes only exercise can trigger an attack. Before research began, many E.I.A. prone people were unaware of why they were having trouble breathing during exercise, and not inform about treatments. The symptoms, which usually begin after three-eight minutes of a strenuous workout, may include, coughing, wheezing, limited endurance, etc. No one is certain why exercise triggers asthma. In the end, if there is no exercise there will be no exercise induced asthma, but there will be none of the benefits of exercise (Mezei, 18).

In healthy individuals exercise programs and lifestyle initiatives have major benefit in reducing the risk of cardiovascular diseases. There is no reason to believe that this should not occur in patients with respiratory diseases, such as asthma. Many people with asthma of different severity have sufficient ventilatory reserve to allow tolerance of

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training routines. Improvements in fitness ranging from 10% to % have been reported (A.C.E., 16).

Most studies failed to identify any significant changes in the degree of bronchial responsiveness with various aerobic conditioning programs, the potential benefits are valuable and include 1) improved fitness, ) decreased frequency and severity of acute attacks, ) decreased medication usage, 4) decreased school absenteeism, 5) improved self image. Recommendations for evaluation of level of physical activity 1) Educate the patients about exercise induced asthma, the prophylactic use of drugs, the overall value of exercise, ) Prescribe drugs to prevent E.I.A. and monitor their effectiveness, ) Question the patient concerning his/her level of activity and capacity to keep up with peers, 4) Make repeated efforts to determine that there really are no limitations of physical activity, 5) If limitations in capacity to exercise are reported by the patient, consider testing, 6) Design rehabilitation program based on the results of the physical fitness (Mezei, 18).

While physical activities are good for children with asthma, as they bring them into contact with other children and improve their physical fitness, there are contradicting evidence of the specific effects on asthma. Not to denigrate the value of exercise, but rather to ensure the persons involved are aware that it is something to be enjoyed rather than as part of medical treatment (Dennis, 185).

Many questions need to be answered when dealing with an asthmatic person in a fitness setting. They are, 1) Can persons with asthma exercise normally? ) Are they fit as other people with similar exercise habits? ) What sort of exercise is needed to

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make the patient fitter? 4) What effect might regular exercise have on their disease as opposed to their fitness (Mezei, 18)?

When a disease is in remission and a person have been treated to prevent E.I.A., exercise can proceed normally. There is now enormous amounts of evidence than many asthmatic persons have reduced cardio-respiratory fitness, compared to a control with a similar pattern of physical activity. In other words, the study showed that asthma persons can exercise to a similar intensity as other people, but their overall fitness is reduced. The type of activity an asthmatic performs is not a critical factor but the exercise preferably should be conducted indoors in conditions of warmth and controlled humidity with appropriate warm up and cool down components to reduce likelihood of breakthrough exercise induced asthma. Supervision of exercise prescription is critical, such as in the aspects of progressive increments of intensity and the capacity (A.C.E., 16).

Some groups have used progressive incremental exercise around the anaerobic threshold but without routine a more empirical trial and error approach may be effective. This consists of evaluating the tolerability of submaximal exercise at the intensity that will be required during training which expressed in terms of the target heart rate. The persons either will achieve the target heart rate and tolerate steady state exercise during one of these stages or alternatively will show an inability to continue at the required work intensity owing to the breathlessness. If symptoms have remained stable with mild but tolerable breathlessness, the persons may be expected to participate in

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aerobic exercise program with the achievement of improved cardiovascular fitness (Mezei, 18).

For persons who cannot sustain exercise of sufficient intensity to improve aerobic fitness because of breathlessness, they require techniques to condition peripheral muscles with the objective of improving mobility and stamina. Persons with moderate to severe chronic airflow limitation can undertake low intensity isotonic training of individual muscle groups to improve the strength and endurance of these muscles and increase overall exercise tolerance. Additional components of this second approach include calisthenics, breathing retraining exercises and walking at the maximum tolerable rate. One can also take a person pulse as a simple method of identifying the few patients who have arterial oxygen desaturation during exercise. Everyone should be supervised, and the exercise prescription should be reviewed periodically (Mezei, 18).

Strong motivation is required because variations in the disease may interrupt an exercise program and so make the goal of increased fitness difficult to attain. It is important for exercise to be habitual, it should be easily accessible and without adverse sequel. Ideally it should also be dynamic, interesting, fun, and varied. Asthma to run or not to run (Dennis, 185)?

A widely accepted prescriptions of exercise intensity for healthy individuals to improve their fitness are exercise of 15-0 minutes, three times a week, to a level at which oxygen uptake (VO ) is about 70-80% of maximum heart rate. This exercise prescription is highly recommended for all asthmatic persons except those with moderate to severe chronic airflow limitation (Dennis, 185).

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In a studies done in the past, persons showed a significant increase in both VO and O after a 4-month exercise program, indicating an improvement in physical fitness. However, it did not provide any evidence that the exercise program alter indices of asthma severity. These results suggest that patients with asthma may underestimate their capacity and if the disease is well controlled, they can be encouraged to undertake vigorous exercise. There is no cost benefit study available on exercise programs (Mezei, 18).

Despite the fact that patients with asthma have often excluded themselves from normal activities of childhood, it has long been thought that activity was likely to benefit them. Like persons with cystic fibrosis, children with asthma can increase their work capacity. The 184, Olympic saw 67 of 57 athletes on the U. S. teams with E. I. A. The rewards of participation in competitive sports for the asthmatic can be tremendous. Building individual skills, working with others as a team, character enhancement, and improved fitness with less respiratory distress can result from involvement in competitive athletics. The coach, teacher, and parents should share a common philosophy with the child, regarding competition. They should make the child aware that winning for an asthmatic does not necessarily mean coming in first place or having more points than the opposition. For an asthmatic, winning is wheeze-free participation (Dennis, 185).

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Works Cited

Asthma & Food Know the facts. (18, May). Executive Healths Good Health, 4, 8, .

Asthma deaths rising, but asthmatics dont have to give up exercise. (1XX). Aerobics for Asthmatics, Inc.

Dennis, Warren. (185). What Every Physical Educator should know about Asthma. American Lung Association.

Excess pounds may lead to asthma. (18, Jun). Tufts University Health & Nutritional Letter, 16, .

Exercise and Asthma. (16). A.C.E. Fitness Matters,

Mezei, Gyorgyi. (18). Physiotherapy of Asthma. Acta Microbiological et Immunological Hungarica, 45, 157-166.

Research shows exercise program benefits children with asthma. (18, June 11). The New York Amsterdam News, 14.

William, Renard Jr. (16). Asthma. Nutrition Health Review, 78, 10.


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