Physiotherapy in दमा (Breathlessness) - Pulmonary Rehabilitation

Many times patient come to mi complaining that “मला दम लागतो”, मुझे दम लगता है ”, "मेरी सास फूलती है ”, "I get breathless"....

The reason for this breathlessness can be many. It can be because of less haemoglobin, it can be because of lung problems, it can be because of heart problems, it can be because of muscle problem etc.  A good physician will find the root cause of the problem.

This post is on breathlessness because of lung problems and how physiotherapy can help in lung conditions.

There are many lung conditions as Asthma, COPD, Bronchiectasis Cystic Fibrosis etc. These conditions lead to symptoms as cough, breathlessness, fatigue etc.

Lungs are the organ in our body through which oxygen is given to body and carbondioxide is removed from our body.

With damage to this  exchange system at any stage of the  above cycle, appropriate amount of oxygen can’t reach body parts as brain, muscle etc.

The movement of oxygen is hampered. So as our motto says “ Keep moving for healthy living”, physiotherapy helps movement of oxygen such that adequate amount reaches body parts. 

Physiotherapy helps at two levels

1^st - at level of lungs

2^nd- at level of muscles

1^st – at level of lungs

Due to the disease activity in lungs, various symptom’s appear as,

• Increase in cough (खोकला, ख़ासी )
• Thick sputum (बल्गम)
• Breathlessness (दम)
• Wheezing (श्वास घ्यायला कठिन होणे , स्वासाचा आवाज़ येणे) etc.

With the help of physiotherapy, these symptoms are relieved. Physiotherapy uses various methods as,

 

• Different kinds of breathing exercise.
•  Positioning of body such that it helps drain excess mucus (बल्गम) out
• Improving mobility of chest so that movement of lungs improves
• Improves strength of muscles of respiration
• Relaxation (specific to lung condition) etc.

2^nd- at level of muscles

Physiotherapy focuses on improving muscles in such a way that they can do there maximal activity with minimal oxygen. This means that muscle are improved so that they will require less oxygen.

For this various exercise of upper body and lower body are done. But in Pulmonary Rehabilitation, Upper body is focused as upper body is close to lungs which helps lungs to function better.

These exercise includes stretching, aerobic exercise, strength exercise etc.

During the whole course of Pulmonary Rehabilitation, care is taken that the present symptoms are not aggrevated.

In this way Physiotherapy will help in lung condition to reduce the damage to the lungs and help to cope with the symptoms of the condition.

 

“Keep Moving But when …. why …. where?” Answer to "Where"

 

So we answered “When” and “Why” from “Keep Moving But when …. why …. where?”

Now let us get to answer of “Where”...

After the injury and initial rest period, mobilization should always be under observation of a Physiotherapist.

But what is this mobilization?

Mobilization is movement of any part whose movement is restricted. The question is, "For such a movement do I need a physiotherapist?"

Let’s  consider our door example. I came back to open my door. But the hinges are too  stuck, so I try a bit of force but the door won’t open. With less force door won't open. So I increase my force.  Due to more force, the door opens but the hinges break. So do we really want to break our hinges with more force???

In our knee example, if we put undue stress on the joint to increase movement there can be internal damage to the knee.  But if the force is negligible there won’t be any change in movement. There has to balanced force which will cause improvement in knee. 

Such a balanced force by a skilful and experienced physiotherapist will help to improve the knee.

This force can be in a kind of exercise, manual therapy, etc.

So to answer “Where”, it has to be at a Physiotherapy clinic by an experienced physiotherapist.