Asthma (factors, testing, FITT) Flashcards
What is asthma
chronic inflammation that leads to airway hyperresponsiveness
What are some common symptoms of Asthma patients?
Wheezing
Dyspnea
Chest tightness
Coughing
What is the Primary issue with asthma, as it relates to physiology?
Inflammation
Where is inflammation most pronounced
Medium-sized bronchi
Airway thickening is caused by what to airway smooth muscle?
Hypertrophy and hyperplasia of the airway smooth muscle
Airway hyper-responsiveness causes
Airway narrowing and remodeling
Subendothelial Fibrosis is caused by
deposition of collagen fibers underneath the basement membrane
What is the progressive Pathology of Asthma?
-Walls become inflamed and thicken
-air becomes trapped in alveoli
-Smooth muscles tighten
Predisposing factors of Asthma
Genetics
Race
Gender
Age (10-11 yrs)
Precipitating “triggers”
Environmental pollutants
Chemicals
Allergens
Exercise
Stress
How do you differentiate between symptoms of Asthma and COPD?
Asthma = usually asymptomatic between episodes
COPD = usually symptomatic
FEV1 is ______ in obstructive disorders
Reduced
FEV1/FVC is ______ in obstructive disorders
Reduced
FVC is _______ with obstructive disorders
Normal
What does a normal Spirometry Flow-Volume Loop look like?
Will descend in a straight or convex line
Flow-Volume curve for COPD
Typically angled
What will the Loop Curve showcase in a Flow-Volume curve for Asthma?
Loop curve is smooth and concave
What will Bronchial provocation testing showcase & suggest
> 20% decline in FEV1 following administration of irritants is suggestive of asthma
Exercise benefits of asthma patients
-Increases cardiorespiratory fitness
-Increases work capacity
-Decreases dyspnea
Exercise training may reduce:
-Airway inflammation
-Asthma severity
-# of days with symptoms
-# of ER visits
-Symptoms of anxiety & depression
-And improve health–related QOL
Aerobic FIIT recommendations for Asthma
F: 3-5 days/week
I: Begin with moderate (40%-59% HRR)
T: Progressively increase to 30 to 40 minutes/day
T: Aerobic activities using large muscle groups brisk walking, running, cycling, swimming, or pool exercises
Aerobic progression for Asthma patients
After 1 month, if tolerated increase:
F: 5 days/week
I: 60%-70% HRR
Strength training FIIT for Asthma patients
F: 2-3 days/week
I:Strength: 60-70% of 1RM for beginners; >80% for experienced weight trainers
Endurance: <50% of 1RM
T: Strength: 2-4 x 8-12 | Endurance: 1-2 x 15-20
T: Weight machines, free weight, body weight exercises
FIIT flexibility: Asthma Patients
F: >2-3 days/week (daily most effective)
I: Stretch to point of feeling tightness or slight comfort
T: 2-4 x10-30 second holds for static stretching (ea. exercise)
T: Static, dynamic, and/or PNF stretching
What is an Exercise-Induced Bronchospasm (EIB)?
- Bronchodilation occurs in first 10 min of exercise
- Progressive bronchospasm peaking 10 minutes following completion of exercise
- Resolution of EIB over the next 60 min.
Cut off for EIB
> 20% decline in FEV1 following exercise
Prevention options for EIB
-Proper warm-up (15min)
-Cool-down (10min)
-Drink plenty of fluids
-Mask or scarf over mouth in cold temperatures
-swimming in non-chlorinated pool
-Pharmacologic intervention prior to exercise
Medications for asthma
-Short-acting bronchodilators
-prolonged oral corticosteroid use
Quick relief medications for asthma
Anticholinergics
Short-acting β2-agonists
Systemic corticosteroids
Long-term medication for control of asthma
-Corticosteroids
-Long-acting β2-agonists
-Immunomodulators
-Leukotriene modifiers
-Methylxanthines
How would you differentiate ashma from emphysema with Flow-Volume Tracings?
Asthma: Full Longitudinal Loop (pre)
Emphysema: Flat Loop (pre)
How is the 6-minute walk test administered & scored?
1.) Total # of completed labs (+ partial laps)
2.) Calculate Total Distance Walked (laps x 200ft)
3.) Calculate Speed in mph
4.) Calculate METs
