10 points of care during physical exercise in Asthma

Physical exercise in asthma is important for both fitness and lung function.

Asthma and Physical Activity

Physical activity (PA) and exercise in asthma, are integral to health, and to maintain and improve treatment outcomes. However, exercise is one of the known triggers of an asthma attack. Therefore, it is important to keep the following points in mind while including physical exercise in one’s daily routine if suffering from asthma or any other bronchial disease:

1. Aerobic exercises, such as walking and yoga or exercises that use large muscle groups, are recommended instead of running or cycling.
2. Always consult your treating physician before starting on any exercise regime as well as timing your inhaler medication before the start of PA (usually 15 minutes prior). Take all your medications regularly and keep rescue inhaler medication prescribed to you, handy during PA.
3. All exercises should be done only 2 hours after meals, or in the morning before breakfast.
4. Perform an aerobic warm-up and cool-down of 10-15 minutes each (with light stretching, slower walking speed, or activity at low intensity).
5. Never start or stop intense exercise suddenly. Stop to rest whenever shortness of breath is experienced.
6. Breathe through the nose as much as possible when exercising.
7. The optimal daily duration of exercise is around 20-30 minutes of continuous activity (excluding warmup-cooldowns), however, when starting an exercise program this duration goal needs to be achieved very gradually. Start with reduced duration twice or thrice a week, increasing over a month to an alternate day regime (for example increase walking distance little by little every day), and then to a stable regular daily schedule over 2-3 months.
8. On poor air quality days, avoid outdoor PA and exercise. PA should always be avoided in high pollution areas, such as within 50 feet of a road, factory, or field, and when pollution levels tend to be highest, (in midday or afternoon). When exercising indoors, keep windows and doors closed to reduce allergen and irritant exposure.
9. PA should not be undertaken if asthma symptoms are not well controlled or if you have a cold or respiratory infection.
10. Wear appropriate footwear and adequate protection for weather, and avoid extreme weather conditions, including windy, rainy, icy, or cold days for outdoor PA.

Asthma and Swimming

This is often an area of confusion and most people with asthma think they should avoid swimming. Swimming is a preferred activity for many children and adults with asthma and is has physical and mental health benefits like improving general fitness and lung function, and reducing stress-induced triggers. Based on current research, there is no strong evidence to suggest that recreational swimming can worsen asthma that is well controlled. Here are 10 tips for those with asthma who want to take up swimming:

1. Learning to regulate breathing is crucial for people with asthma sufferers, and therefore training in swimming can help to pace breathing to do regular laps. Avoid untrained and self-taught swimming. Initially swim under the guidance of a trained instructor.
2. Warm air in a cool pool is a combination that is actually in favor of asthma, and reduces bronchoconstriction. So do not be anxious in the pool that your asthma will worsen or you may get an attack. This will help in relaxed and enjoyable swimming and more health benefits..
3. Always shower before and after entering the pool, with the shower water temperature similar to that of the pool water.
4. Warm-up and cool-down slowly with a few slow laps and stretching exercises, before going for regular speed swimming and laps.
5. Always keep your reliever inhaler and a towel at the pool-side. You could consider taking reliever medicine 10 minutes before the swim or as advised by your physician.
6. Wear a well-fitting swimsuit that covers the chest, with a cap and goggles.
7. Avoid pools with strong a chemical smell that suggests too much chlorine use or suspended chlorine in air. Consider the standard of pool hygiene. Swim only in well-maintained recreational pools.
8. Different climates may affect one’s usual asthma control like changes in humidity, pollen, or air quality. Check with your physician when swimming on such days if inhaler use needs to be modified. This is especially true during travel.
9. Do not swim on days when asthma symptoms are present or you have a cold or respiratory infection.
10. Check the local medical policy when swimming as a tourist in natural waters like beaches and lakes. Sea salty water is considered appropriate for people with asthma, however, be careful not to swim too deep, and that your reliever medicines are well accessible.

For a detailed understanding read:

Asthma and COPD – Understanding Airway Diseases

3 Effective Techniques to improve Breathing capacity and control