Respiratory rehabilitation: a physiotherapy approach to the control of asthma symptoms and anxiety

Abstract

Objectives: The objectives of this study were to verify the degree of anxiety, respiratory distress, and health-related quality of life in a group of asthmatic patients who have experienced previous panic attacks. Additionally, we evaluated if a respiratory physiotherapy program (breathing retraining) improved both asthma and panic disorder symptoms, resulting in an improvement in the health-related quality of life of asthmatics.

Methods: Asthmatic individuals were assigned to a chest physiotherapy group that included a breathing retraining program held once a week for three months or a paired control group that included a Subtle Touch program. All patients were assessed using the Diagnostic and Statistical Manual of Mental Disorders IV, the Sheehan Anxiety Scale, the Quality of Life Questionnaire, and spirometry parameter measurements.

Results: Both groups had high marks for panic disorder and agoraphobia, which limited their quality of life. The Breathing Retraining Group program improved the clinical control of asthma, reduced panic symptoms and agoraphobia, decreased patient scores on the Sheehan Anxiety Scale, and improved their quality of life. Spirometry parameters were unchanged.

Conclusion: Breathing retraining improves the clinical control of asthma and anxiety symptoms and the health-related quality of life in asthmatic patients.

Figure 1

Study design.

Figure 2

At the end of the study, the scores for agoraphobia and panic disorder symptoms (Figure 2A) were significantly reduced only in the BRG group (p<0.05). According to the Sheehan scale, panic scores (Figure 2B), were significantly decreased for both the BRG and the STG (p<0.05). There were no differences in the same parameters when multiple analyses were performed comparing the BRG with the STG.

Figure 3

Weekly peak flow rate measurements (3A) and daily use of β₂ agonist (3B) were monitored over three months. Peak flow rate progressively and significantly increased in the BRG (p<0.05) but remained stable in the STG (Figure 3A). In the BRG, the use of β₂ agonist (salbutamol) as a relief medication (Figure 3B) decreased over time, particularly after the sixth week (p<0.05).