Journal Information
Vol. 46. Issue 11.
Pages 600-606 (January 2010)
Share
Share
Download PDF
More article options
Vol. 46. Issue 11.
Pages 600-606 (January 2010)
Review Article
Full text access
Effectiveness of Therapeutic Education and Respiratory Rehabilitation Programs for the Patient with Asthma
Eficacia de los programas de educación terapéutica y de rehabilitación respiratoria en el paciente con asma
Visits
7008
Roberto Cano-De La Cuerda
Corresponding author
roberto.cano@urjc.es

Corresponding author.
, Ana Isabel Useros-Olmo, Elena Muñoz-Hellín
Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
This item has received
Article information
Abstract
Bibliography
Download PDF
Statistics
Abstract

Asthma is a chronic complex and heterogeneous disease, with great variability and has a huge impact, not only on patients who suffer the disease but also their families and society in general. Educating asthmatic patients and their families is essential for therapeutic intervention. Through continuous, dynamic and adaptive education, changes in attitudes and behaviours of the patient and family can be achieved, and will undoubtedly lead to an improvement in their quality of life. Among other non-pharmacological interventions, respiratory rehabilitation is an alternative treatment, and is primarily aimed at patients with moderate to severe asthma. Although the latest clinical practice guidelines published in scientific literature recommend two strategies for treatment, the results of relevant publications are diverse. The objective of this study was to describe the effectiveness of therapeutic and educational programs in respiratory rehabilitation of the asthmatic patient.

Keywords:
Asthma
Therapeutic education
Physiotherapy
Respiratory rehabilitation
Treatment
Resumen

El asma es una enfermedad crónica compleja, heterogénea, con una gran variabilidad y que tiene un enorme impacto, no sólo en los pacientes que la padecen sino también en sus familias y en la sociedad en general. La educación del paciente asmático y su familia son el elemento esencial para la intervención terapéutica. A través de la educación, entendida como un proceso continuo, dinámico y adaptado, se van a poder conseguir cambios en las actitudes y conductas del paciente y su familia, que habrán de llevar, sin duda, a mejorar la calidad de vida de los mismos. Entre otras intervenciones no farmacológicas, la rehabilitación respiratoria representa una alternativa de tratamiento, y está dirigida fundamentalmente a los pacientes que padecen asma moderada y severa. Puesto que las últimas guías de práctica clínica publicadas en la literatura científica recomiendan ambas estrategias de tratamiento, pero los resultados de las publicaciones al respecto son diversos, el objetivo del presente trabajo fue describir la eficacia de los programas de educación terapéutica y el papel de la rehabilitación respiratoria en el tratamiento del paciente asmático.

Palabras clave:
Asma bronquial
Educación terapéutica
Fisioterapia
Rehabilitación respiratoria
Tratamiento
Full text is only aviable in PDF
References
[1.]
Global Iniciative for Asthma. Global Strategy for Asthma Management and Prevention NHLBI/WHO Workshop Report; 2002.
[2.]
Sociedad Española de Neumología y Cirugía Torácica (SEPAR).Guía Española para el Manejo del Asma GEMA. SEPAR. 2003.
[3.]
A. Tuffaha, J.E. Gern, R.F. Lemanske.
The role of respiratory viruses in acute and chronic asthma.
Clin Chest Med, 21 (2002), pp. 289-300
[4.]
F.D. Martínez, A.L. Wright, L.M. Taussig, C.J. Holberg, M. Jalonen, W.J. Morgan.
Asthma and wheezing in the first six years of life. The Group Health Medical Associates.
N Engl J Med, 332 (1995), pp. 133-138
[5.]
D.E. Elder, R. Hagan, S.F. Evans, H.R. Benninger, N.P. French.
Recurrent wheezing in very preterminfants.
ArchDisChild, 74 (1996), pp. F165-F171
[6.]
J.M. Román-Piñana.
Educando en asma.
An Pediatr (Barc), 66 (2007), pp. 447-452
[7.]
K.F. Rabe, P.A. Vermiere, J.B. Soriano, W.C. Maier.
Clinical management of asthma in 1999: The Asthma Insights and Reality in Europe (AIRE) Study.
Eur Respir J, 16 (2000), pp. 802-807
[8.]
Children & Asthma in America. [accessed on 22/3/2007]. Available: http://www.asthmainamerica.com/children_index.html.
[9.]
A. López Viña, J.E. Cimas, C. Días Sánchez, G. Coria, O. Vegazo, C. Picado, On behalf of Scientific Comitee of ASES study.
A comparison of primary care physicians and pneumologists in the management of asthma in Spain: ASES study.
Respir Med, 97 (2003), pp. 872-881
[10.]
National Institutes of Health. National Asthma Education and Prevention Program Expert Report 2(NAEPEPR-2) Guidelines for the Diagnosis and Management of Asthma 2002. Available: http://www.nhlbi.nih.gov/guidelines/asthma/asthmafullrpt.pdf.
[11.]
Becker A, Bérubé D, Chad Z, Dolovich M, Ducharme F, D’Urzo T,et al. CMAJ. 2005;173: S12-S55. Canadian Pediatric Asthma Consensus Guidelines, 2003. [updated on 12/2004; accessed on 3/3/2010]. Available: http://www.cmaj.ca/cgi/reprint/173/6_suppl/S51.
[12.]
Nacional Asthma Council Australia (NAC).Asthma Management Handbook Available: http://www.natinalasthma.org/publications/amh/amhcont.htm.
[13.]
British Guideline on the management of asthma (SIGN Updated November 2005). A national clinical guideline. British Thoracic Society. Scottish Intercollegiate Guidelines Network [updated in 2005; accessed on 8/2/2010]. Available: http://www.sign.ac.uk/pdf/sign63.pdf.
[14.]
Grupo Español para el Manejo del Asma. (GEMA).Guía Española para el Manejo del Asma Arch Bronconeumol. 2003;39(Supl5):1-42.
[15.]
R.M. Busquets, A. Escribano, M. Fernández, L. García-Marcos, J. Garde, M. Ibero, et al.
Consenso sobre tratamiento del asma en pediatría.
An Pediatr (Barc), 64 (2006), pp. 365-378
[16.]
A. Escribano, A. Ibero, J. Garde, S. Gartner, J. Villa Asensi, J. Pérez Frías.
Protocolos terapéuticos enasta infantil.
Protocolos Diagnóstico-terapéuticos AEP. Neumología y Alergia, Asociación Española de Pediatría, (2003),
[17.]
Guía de Práctica Clínica sobre Asma. Osakidetza/Servicio Vasco de Salud. [accessed on 15/3/2007]. Available: http://www.avpag.org.
[18.]
Global Initiative for Asthma (GINA).Global Strategy for Asthma Management and Prevention.[accessed on 15/3/2007]. Available: http://www.ginasthma.com/
[19.]
British Guideline on the Management of Asthma. A national clinical guideline. Scottish Intercollegiate Guidelines Network. British Thoracic Society. Mayo 2009.
[20.]
Román JM. Interés de la Educación Terapéutica en el manejo del asma. In: Javier Korta Murua, Grupo de Asma y Educación (SENP), editors. Monografía Asma y Educación. Donostia: San Sebastián: 2006.p.65-73.
[21.]
P.G. Gibson, H. Powel, J. Coughlan, A.J. Wilson, M. Abramson, P. Haywood, et al.
Self-management education and regular practitioner review for adults with asthma (Cochrane Review).
The Cochrane Library, Issue 4, John Wiley & Sons, (2003),
[22.]
F.M. Wolf, J.P. Guevara, C.M. Grum, N.M. Clark, C.J. Cates.
Educational interventions for asthma in children. (Cochrane Review).
The Cochrane Library, Issue 4, John Wiley & Sons, (2003),
[23.]
P.G. Gibson, H. Powell.
Written action plans for asthma: an evidence-based review of the key components.
Thorax, 59 (2004), pp. 94-99
[24.]
J. Korta, J. Valverde, M. Praena, J. Figuerola, C.R. Rodríguez, S. Rueda, et al.
La educación terapéutica en el asma.
An Pediatr (Barc), 66 (2007), pp. 496-517
[25.]
American Journal of Respiratory and Critical Care Medicine.
American Thoracic Society Documents, 173 (2006), pp. 1390-1413
[26.]
C. Wallis, A. Prasad.
Who needs chest physiotherapy? Moving from anecdote to evidence.
Arch Dis Child, 80 (1999), pp. 393-397
[27.]
P. Casán, C. Sotomayor.
Rehabilitación respiratoria en el asma.
Rehabilitación respiratoria,
[28.]
C. Dubreuil, D. Pignier.
Asrhme et Kinésitheérapie. Kinésitheérapie.
Scientifique, 369 (1997), pp. 17-28
[29.]
V. González, P. Rada, M. Moreno.
Tratamiento fisioterápico en el asma infantil: a propósito de un caso clínico.
Fisioterapia, 30 (2008), pp. 49-54
[30.]
J.G. Martin, E. Powell, S. Shore, J. Emrich, A. EngelL.
The role of respiratory muscles in the hyperinflation of bronchial asthma.
Am RevRespir Dis, 121 (1980), pp. 441-447
[31.]
J.R. Jardim, A.F. Mayer, A. Camelier.
Músculos respiratorios y rehabilitación pulmonar en asmáticos.
Arch Bronconeumol, 38 (2002), pp. 181-188
[32.]
M. Thomas, R.K. McKinley, E. Freeman, C. Foy, P. Prodger, D. Price.
Breathing retraining for dysfunctional breathing in asthma: a randomized controlled trial.
Thorax, 58 (2003), pp. 110-115
[33.]
P.K. Vedanthan, L.N. Kesavalu, K.C. Murthy, K. Duvall, M.J. Hall, S. Baker, et al.
Clinical study of yoga techniques In university students with asthma: a controlled study.
Allergy Asthma Proc, 19 (1998), pp. 3-9
[34.]
R. Nagarathna, H.R. Nagendra.
Yoga for bronchial asthma: a controlled study.
Br Med J (Clin Res Ed), 291 (1985), pp. 1077-1079
[35.]
T. Fluge, H. Ritcher, H. Fabel, E. Zysno, E. Wehner, U.F. WagnerI.
Long term effects of breathing exercises and yoga in patients with asthma.
Pneumologie, 48 (1994), pp. 485-490
[36.]
T.K. Lim, S.M. Ang, T.H. Rossing, E.P. Ingenito, R.H. Ingram.
The effects of deep inhalation on maximal expiratory flow during intensive treatment of spontaneous asthmatic episodes.
Am Rev Respir Dis, 140 (1989), pp. 340-343
[37.]
A. Hough.
Physiotherapy in Respiratory Care An evidence-based approach to respiratory and cardiac management, third ed.
Nelson Thomas Ltd., (2001),
[38.]
M. Girodo, K.A. Ekstrand, G.J. Metivier.
Deep diaphragmatic breathing: rehabilitation exercises for the asthmatic patient.
Arch Phys Med Rehabil, 73 (1992), pp. 1992-1993
[39.]
E. Ernst.
Breathing techniques-adjunctive treatment modalities for asthma? A systematic review.
Eur Respir J, 15 (2000), pp. 969-972
[40.]
J. Marks, H. Pasterkamp, A. Tal, F. Leahy.
Relationship between respiratory muscle strength, nutritional status, and lung volume in cystic fibrosis and asthma.
Am Rev Respir Dis, 133 (1986), pp. 414-417
[41.]
F.S. Ram, S.R. Wellington, N.C. Barnes.
Inspiratory muscle training for asthma.
Cochrane Database of Systematic Reviews, (2003),
[42.]
P. Weiner, Y. Azgad, R. Ganam, M. Weiner.
Inspiratory muscle trainingin patients with bronchial asthma.
Chest, 102 (1992), pp. 1357-1361
[43.]
C.G. Tsai, J.J. Tsai.
Effectiveness of appositive expiratory pressure device in conjunction with beta 2-agonist nebulisation therapy for bronchial asthma.
J Microbiol Immunol, 34 (2001), pp. 92-96
[44.]
J.P. Girard, N. Terki.
The flutter VRP1: A new personal pocket therapeutic device used as an adjunct to drug therapy in the management of bronchial asthma.
J Investing Allergol Clin Immunol, 4 (1994), pp. 23-27
[45.]
G.L. Swift, T. Rainer, R. Saran, I.A. Campbell, R.J. Prescott.
Use of flutter VRP1 in the management of patients with steroid-dependent asthma.
Respiration, 61 (1994), pp. 126-129
[46.]
R. Samransamruajkit, T.W. Chin, A. Yuengsrigul, T. Newton, E. Nussbaum.
Possible Beneficial effect of Chest Physical Therapy in Hospitalized Asthmatic Children.
Pediatric Asthma, Allergy and Immunology (PAAI), 16 (2003), pp. 295-303
[47.]
Holloway E, Ram FSF. Breathing exercise for asthma (Cochrane Review).In: The Cochrane Library, Issue 3,2001. London: John Wiley & Sons Ltd.
[48.]
Ram FSF, Robinson SM, Black PN, Picot J. Entrenamiento físico para el asma (translated Cochrane Review).In: La Biblioteca Cochrane Plus, 2008 Número 4. Oxford: Update Software Ltd.[accessed on 15/3/2010]. Available: http:// www.update-software.com.
[49.]
Linde K, Jobst K, Panton J. Acupunture for chronic asthma (Cochrane Review). In: The Cochrane Library, Issue 3, 2001. London: John Wiley & Sonds Ltd.
[50.]
J. Martin, A.N. Donaldson, R. Villamrroel, M.K. Parmar, E. Ernst, J. HigginsonI.
Efficacy of acupuncture in asthma: systematic review and meta-analysis of published data from11 randomised controlled trials.
Eur RespirJ, 20 (2002), pp. 846-852
[51.]
W. Gruber, E. Eber, D. Malle-Scheid, A. Pfleger, E. Weinhand, L. Dorfer, et al.
Laser acupuncture in children and adolescents with exercise induced asthma.
Thorax, 57 (2002), pp. 222-225
[52.]
M. Malmstrom, J. Ahlner, C. Carlsson, B. Schmekel.
No effect of Chinese acupuncture on isocapnic hyperventilation with cold air in asthmatics, measured with impulse oscillometry.
Acupuncture in Medicine, 20 (2002), pp. 66-73
[53.]
A. Huntley, A.R. White, E. Ernst.
Relaxation therapies for asthma: a systematic review.
Thorax, 57 (2002), pp. 127-131
[54.]
Hondras MA, Linde K, Jones AP. Manual therapy for asthma (Cochrane Review). In: The Cochrane Library, Issue 3, 2001. London: John Wiley & Sons Ltd.
[55.]
Dennis J. Técnica de Alexander para el asma crónica (translated Cochrane review). In: La Biblioteca Cochrane Plus, 2008. Número 2. Oxford: Update Software Ltd.[accessed on 22/2/2010]. Available: http://www.update-software.com.
Copyright © 2010. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?