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Asthma is a respiratory condition characterised by sudden swelling, narrowing and the production of excess mucus in the airway passage in response to specific triggers such as cold and dry air, pollution, pollens, pet dander, etc. This can lead to an asthma attack or exacerbation characterised by breathlessness, coughing, wheezing, chest pain and trouble sleeping. Asthma can also impact a person's daily activities and is associated with a poor quality of life in patients. Asthma patients, especially children report daytime tiredness, poor concentration and an increased number of missed days at school and work. About 49 per cent of school children with asthma miss one or more days at school every year. In severe cases, patients may need hospitalization to prevent death.
At present, there is no cure for the condition. Management is primarily focused on the management of symptoms, avoiding triggers and prevention of exacerbation through lifestyle changes and medications.
According to the report published by the World Health Organization, asthma affected nearly 262 million people globally in 2019, accounting for 4,61,000 deaths. A family history of asthma and the presence of other allergic conditions such as eczema and hay fever are associated with an increased risk of asthma. Low-birth weight, premature birth, exposure to smoke, air pollution and viral infections affecting the respiratory system are some of the important risk factors in children. Mounting evidence also suggests that rapid urbanization and lifestyle changes are important contributors to the rising asthma cases globally. As obesity is an independent risk factor of asthma, its increasing prevalence is translating to higher asthma cases globally. Moreover, industrialization leading to increased air pollution and occupational exposure to chemicals, fumes and dust are also driving high asthma cases over the last few decades.
Asthma affects about 6 per cent of children and 2 per cent of the adult population in India. Studies carried out in the Indian population suggests that the use of firewood for cooking, pet animals, obesity and the absence of ventilator measures such as chimney at home were associated with a higher risk of asthma.
Asthma tends to get worse during the winters due to several factors, namely, cold and dry weather, increased risk of chest infections, higher risk of exposure to moulds, dust mites and indoor pollution such as wood-burning stoves. The cold, dry air tends to irritate the airways and constricts respiratory muscles. Chest infections increase the risk of asthma exacerbation. Apart from getting a flu shot, avoiding stepping out in the cold weather and taking precautions to keep respiratory infections at bay, regular physical exercising can a crucial role in reducing the risk of an asthma attack.
In many patients with uncontrolled asthma, vigorous physical activity or strenuous exercises may lead to exacerbation of symptoms. This may lead the patient to stop exercising completely and adopt a sedentary lifestyle. For example, a study has established that only 24 per cent of children with asthma exercise regularly for 60 minutes as recommended in children for optimal growth. Routine exercising is safe in children with adequate asthma control. Mounting evidence in asthma patients suggests that moderate physical activity is linked with better asthma control and a lesser number of exacerbations. Based on the findings on these pieces of evidence, the international guidelines of asthma management-The Global Initiative for Asthma (GINA) recommends regular physical activity in asthma to improve their general health. Regular moderate-intensity physical activity of about 30-45 minutes every day in adult patients with asthma not only helps to build good immunity against fighting infections but also helps to keep obesity at bay, an important risk factor for uncontrolled asthma.
For example, a large population-based study in Denmark showed moderate to high physical activity to be associated with better asthma control among smokers. Similarly, another study showed that mild to moderate aerobic exercise at least 3 times a week for 30 minutes or more in addition to muscle training and stretching improved asthma control by 23 per cent, including shortness of breath by 30 per cent among patients. Several studies among children with asthma also confirm that exercising training led to significant improvement in days without asthma symptoms.
To avoid a sudden asthma attack, it is important to follow a routine while exercising.
All patients should have a written asthma action plan appropriate for their level of asthma control and health literacy, so they know how to recognize and respond to worsening asthma.
The article is authored by Dr Divyashree, Consultant Pulmonology, Manipal Hospital Jayanagar.
Disclaimer: The views expressed in this article belong to the author. Readers are advised to exercise discretion and try out the mentioned tips/remedies only under the supervision and advice of a doctor.