Respiratory diseases have a major epidemiological impact.
According to the Guidelines of the various pathologies, the treatment of acute forms is primarily drug-based
In the treatment of chronic forms, which are an impairment for ill people, drug therapy may be associated with respiratory rehabilitation programs, customized to individual patients.
Respiratory rehabilitation is particularly suitable for chronic and stabilized diseases, and it can reduce symptoms (dyspnoea), improve exercise tolerance and allow a better quality of life (social, family, work). It is a therapy that needs to be included into the general treatment of the patient and should not disregard the optimization of the drug therapy.
As a multidisciplinary treatment (personalized on the individual clinical case), it involves various aspects of Medicine (physiatry, respiratory, general, internal medicine, cardiovascular, physiotherapy, nursing, dietary, psychology). It consists of different interventions, such as physical exercise training, training of the respiratory muscles, training of limb muscles and other muscle groups, and respiratory physiotherapy for bronchial clearing. It also includes diagnostic definition, therapeutic optimization, behavioural and educational interventions and prevention programs.
Respiratory rehabilitation is a multidisciplinary and personalized therapeutic treatment. It starts with the general clinical, respiratory and cardiology tests, to formulate recommendations and rule out contraindications.
After going through the outpatient treatment program, selected and stabilized patients can be offered a home-based program. To maintain the achieved results, treatment may continue at home, under the supervision of the General Practitioner and with tele monitoring coordinated by physiotherapists.
Limitation of exercise tolerance
Bronchial hyper secretion
Patients with chronic obstructive respiratory disease, who are clinically stable, who can breathe spontaneously, who have respiratory symptoms, reduced tolerance to exercise-stress and are limited in their everyday physical activities (chronic obstructive respiratory disease, chronic respiratory disease with respiratory insufficiency, pulmonary emphysema, chronic bronchitis, bronchiectasis, bronchial asthma – in selected cases)
Patients with chronic respiratory disease of the restrictive type, both primary and secondary (primary and secondary interstitial diseases with chronic respiratory failure), non-primitive lung conditions, caused by serious neurological or muscular disorders (including diaphragmatic), conditions related to chest diseases (e.g. kyphoscoliosis)
Patients with other conditions, such as:
– respiratory disorders linked to obesity
– breathing disorders in sleep (obstructive sleep apnoea, OSAS)
– ventilation impairment due to previous chest operations (e.g. lung cancer, mediastinal tumours)
– neurological diseases
In patients with chronic respiratory disorders, respiratory rehabilitation is designed to:
improve ventilation capacity and hence increase overall motor physical activity
reduce dyspnoea by improving overall muscle function
improve independence (from the physical and psychological point of view)
reduce the number of relapses and admissions to hospital
improve social, family and work life while the chronic respiratory disease is in progress
OUTPATIENT REHABILITATION TREATMENT IS NOT POSSIBLE IN THE FOLLOWING CASES:
acute and sub-acute respiratory conditions, unstable chronic respiratory diseases treated on an inpatient basis.
Gymnastics prevent and correct skeletal and muscular disorders such as changes in thoracic and shoulder-humeral joint statics, the alterations of the muscular trophism of the chest wall and diaphragm, the functional limitations and movement of the upper limb and shoulder movement; it improves bronchial secretion by increasing the lung expansion and elasticity, it strengthens the diaphragm movement of the ribs and there is a greater oxygenation of blood that tends to decrease in the elderly compared to the young.
The objectives and content of RESPIRATORY GYMNASTICS are:
Awareness of the respiratory act and its range of modulation and control of the breathing phases, apnea, chest breathing, abdominal breathing etc.
Awareness, flexing and control of respiratory muscles
Mobilization of articular districts involved in breathing
Relaxation (respiratory control causes relaxation, relaxation occurs through respiratory control)
Stimulation of the respiratory function with exercises that bring modifications and therefore adaptations of the normal respiratory rhythm (brisk walking, running a gentle pace, dancing, etc.)