Rehabilitation therapy in asthma: focus on high-resistance breathing exercises
Authors:   Kuban State Medical University, Krasnodar, Russian Federation, Alekseenko S.N. , Churyukina E.V. ,   Kuban State Medical University, Krasnodar, Russian Federation,   Rostov State Medical University, Rostov-on-Don, Russian Federation, Ukhanova O.P. ,   Stavropol State Medical University, Stavropol, Russian Federation,   North Caucasian Federal Scientific Clinical Center of the Federal Medical Biological Agency, Essentuki, Russian Federation, Kas'yanova T.R. ,   Astrakhan State Medical University, Astrakhan, Russian Federation, Kotieva I.M. ,   Rostov State Medical University, Rostov-on-Don, Russian Federation, Kokova L.N. ,   Kuban State Medical University, Krasnodar, Russian Federation, Dodokhova M.A. ,   Rostov State Medical University, Rostov-on-Don, Russian Federation, Andreeva V.O. ,   Rostov State Medical University, Rostov-on-Don, Russian Federation, Puzikova O.Z. ,   Rostov State Medical University, Rostov-on-Don, Russian Federation, Popova V.A. ,   Rostov State Medical University, Rostov-on-Don, Russian Federation, Sozaeva D.I. ,   Rostov State Medical University, Rostov-on-Don, Russian Federation
Published: May 2024

Aim: to evaluate the effectiveness of high-resistance breathing exercises using flutter as a method of rehabilitation therapy for asthma. Patients and Methods: the patients with asthma were divided into two groups. Group 1 (n=40) received breathing exercises as part of their treatment, which consisted of quiet inhalation through the nose and exhalation into the flutter for 3–5 minutes daily, for a total of 14 procedures per course, in addition to their baseline therapy. In group 2 (n=40), patients received similar drug therapy without performing breathing exercises. The control group (n=40) consisted of healthy volunteers who performed breathing exercises as in group 1. We analyzed changes in clinical and functional parameters over time after a single application of the rehabilitation technique, as well as at baseline and after completing treatment (after 14 days). Results: showed a significant increase (p<0.05) in external respiration indices, specifically forced expiratory volume in the 1st second, forced vital capacity (FVC), and expiratory reserve volume in groups 1 and 2. Furthermore, group 1 reported a significant increase (p<0.05) in the time to hold breath, as well as an increase in peak expiratory flow, peak expiratory flow rate (PEFR), and a decrease in the daily variation of PEFR and minute ventilation. After two weeks of treatment, group 1 showed significant improvement. The study showed a decrease in choking incidents, reduced need for bronchodilators, and improvement in symptoms such as cough, dyspnea, expectoration of sputum, its character, and wheezing. Additionally, there was an improvement in disease control and exercise tolerance as demonstrated by the results of the 6-minute walk test. Group 2 showed a stable disease course during the follow-up, but no significant changes in clinical manifestations or pharmacological therapy were reported. In this study, it was found that flutter therapy had a significant and moderate favorable effect on 80% and 20% of patients with asthma, respectively. However, this effect was only maintained in patients who regularly practiced high-resistance breathing exercises. No adverse events were reported. Conclusion: high-resistance breathing exercises can reduce hyperventilation and improve bronchial patency in patients with asthma. Additionally, flutter therapy can decrease the doses of bronchodilators, improve FVC, and positively impact the disease course. KEYWORDS: asthma, breathing exercises, expiratory resistance, flutter therapy. FOR CITATION: Alekseenko S.N., Churyukina E.V., Ukhanova O.P., Kas'yanova T.R., Kotieva I.M., Kokova L.N., Dodokhova M.A., AndreevaV.O., Puzikova O.Z., Popova V.A., Sozaeva D.I. Rehabilitation therapy in asthma: focus on high-resistance breathing exercises. Russian Medical Inquiry. 2024;8(3):143–149 (in Russ.). DOI: 10.32364/2587-6821-2024-8-3-4.