Eficacia de la fisioterapia respiratoria en el asma: técnicas respiratorias

Jordi Vilaró, Elena Gimeno-Santos

Resumen


El asma es una enfermedad que se caracteriza por hiperreactividad bronquial y obstrucción parcialmente reversible de las vías aéreas. Un grupo importante de estos pacientes tiene dificultades en el control de los síntomas y padece exacerbaciones frecuentes. En la última década, se han incorporado técnicas de fisioterapia respiratoria como tratamiento complementario al farmacológico. Estos han observado esencialmente, mejorías importantes en la reducción de los síntomas y mejoría en la calidad de vida de los pacientes. Además, en función del tipo de técnica utilizada, algunos estudios han obtenido cambios significativos en la reducción de la medicación de alivio, la hiperventilación o el ETCO2.

A pesar de estos resultados, el rol de las técnicas respiratorias está todavía controvertido por parte de algunas guías clínicas y revisiones sistemáticas por la necesidad de mejora en la calidad metodológica. Sin embargo, todas coinciden en que pueden ser una buena opción como tratamiento coadyuvante al farmacológico sobretodo, en aquellos pacientes peor controlados.

Texto completo:

PDF HTML

Referencias


Reddel HK, Bateman ED, Becker A, Boulet LP, Cruz AA, Drazen JM, et al. A summary of the new GINA strategy: a roadmap to asthma control. Eur Respir J. 2015;46:622–39.

Plaza V, Álvarez FJ, Casan P, Cobos N, López Viña A, Llauger MA, et al. Guía Española para el Manejo del Asma (GEMA 2003). Arch Bronconeumol. 2003;39 Supl 5:1–42.

Arden-Close E, Teasdale E, Tonkin-Crine S, Pitre N, Stafford-Watson M, Gibson D, et al. Patients’ perceptions of the potential of breathing training for asthma: a qualitative study. Prim Care Respir J. 2013;22:449–53.

British Thoracic Society; Scottish Intercollegiate Guidelines Network. British guideline on the management of asthma. Thorax. 2014;69 Supl 1:1–192.

Burgess J, Ekanayake B, Lowe A, Dunt D, Thien F, Dharmage SC. Systematic review of the effectiveness of breathing retraining in asthma management. Expert Rev Respir Med. 2011;5:789–807.

Freitas DA, Holloway EA, Bruno SS, Chaves GS, Fregonezi GA, Mendonça KP. Breathing exercises for adults with asthma. Cochrane Database Syst Rev. 2013;10:CD001277.

Bruurs ML, Van der Giessen LJ, Moed H. The effectiveness of physiotherapy in patients with asthma: a systematic review of the literature. Respir Med. 2013;107:483–94.

Breathing exercises for adults with asthma. Drug Ther Bull. 2015;53:126–9.

Slader CA, Reddel HK, Spencer LM, Belousova EG, Armour CL, Bosnic-Anticevich SZ, et al. Double blind randomised controlled trial of two different breathing techniques in the management of asthma. Thorax. 2006;61:651–6.

Holloway EA, West RJ. Integrated breathing and relaxation training (the Papworth method) for adults with asthma in primary care: a randomised controlled trial. Thorax. 2007;62:1039–42.

Jeter AM, Kim HC, Simon E, Ritz T, Meuret AE. Hypoventilation training for asthma: a case illustration. Appl Psychophysiol Biofeedback. 2012;37:63–72.

Meuret AE, Ritz T, Wilhelm FH, Roth WT. Targeting pCO(2) in asthma: pilot evaluation of a capnometry-assisted breathing training. Appl Psychophysiol Biofeedback. 2007;32:99–109.

Cowie RL, Conley DP, Underwood MF, Reader PG. A randomised controlled trial of the Buteyko technique as an adjunct to conventional management of asthma. Respir Med. 2008;102:726–32.

Grammatopoulou EP, Skordilis EK, Stavrou N, Myrianthefs P, Karteroliotis K, Baltopoulos G, et al. The effect of physiotherapy-based breathing retraining on asthma control. J Asthma. 2011;48:593–601.

Lima EV, Lima WL, Nobre A, Dos Santos AM, Brito LM, Costa Mdo R. Inspiratory muscle training and respiratory exercises in children with asthma. J Bras Pneumol. 2008;34:552–8.

Sodhi C, Singh S, Dandona PK. A study of the effect of yoga training on pulmonary functions in patients with bronchial asthma. Indian J Physiol Pharmacol. 2009;53:169–74.

Thomas M, McKinley RK, Mellor S, Watkin G, Holloway E, Scullion J, et al. Breathing exercises for asthma: a randomised controlled trial. Thorax. 2009;64:55–61.

Cooper S, Oborne J, Newton S, Harrison V, Thompson Coon J, Lewis S, et al. Effect of two breathing exercises (Buteyko and pranayama) in asthma: a randomised controlled trial. Thorax. 2003;58:674–9.

Vempati R, Bijlani RL, Deepak KK. The efficacy of a comprehensive lifestyle modification programme based on yoga in the management of bronchial asthma: a randomized controlled trial. BMC Pulm Med. 2009;9:37.

Hagman C, Janson C, Emtner M. Breathing retraining – a five-year follow-up of patients with dysfunctional breathing. Respir Med. 2011;105:1153–9.

Saxena T, Saxena M. The effect of various breathing exercises (pranayama) in patients with bronchial asthma of mild to moderate severity. Int J Yoga. 2009;2:22–5.

Prem V, Sahoo RC, Adhikari P. Comparison of the effects of Buteyko and pranayama breathing techniques on quality of life in patients with asthma – a randomized controlled trial. Clin Rehabil. 2012;27:133–41.

Manocha R, Marks GB, Kenchington P, Peters D, Salome CM. Sahaja yoga in the management of moderate to severe asthma: a randomised controlled trial. Thorax. 2002;57:110–5.

Kligler B, Homel P, Blank AE, Kenney J, Levenson H, Merrell W. Randomized trial of the effect of an integrative medicine approach to the management of asthma in adults on disease-related quality of life and pulmonary function. Altern Ther Health Med. 2011;17:10–5.

Opat AJ, Cohen MM, Bailey MJ, Abramson MJ. A clinical trial of the Buteyko Breathing Technique in asthma as taught by a video. J Asthma. 2000;37:557–64.

Thomas M. Breathing exercises and asthma. Thorax. 2003;58:649–50.

Sabina AB, Williams AL, Wall HK, Bansal S, Chupp G, Katz DL. Yoga intervention for adults with mild-to-moderate asthma: a pilot study. Ann Allergy Asthma Immunol. 2005;94:543–8.

Ritz T, Rosenfield D, Steele AM, Millard MW, Meuret AE. Controlling asthma by training of Capnometry-Assisted Hypoventilation (CATCH) vs slow breathing: a randomized controlled trial. Chest. 2014;146:1237–47.

Laurino RA, Barnabé V, Saraiva-Romanholo BM, Stelmach R, Cukier A, Nunes Mdo PT. Respiratory rehabilitation: a physiotherapy approach to the control of asthma symptoms and anxiety. Clinics (São Paulo). 2012;67:1291–7.

Gomieiro LTY, Nascimento A, Tanno LK, Agondi R, Kalil J, Giavina-Bianchi P. Respiratory exercise program for elderly individuals with asthma. Clinics (São Paulo). 2011;66:1163–9.

Agency for Healthcare Research and Quality. U.S. Department of Health and Human Services. Breathing Exercises and/or Retraining Techniques in the Treatment of Asthma: Comparative Effectiveness. Compar Eff Rev. 2012;71:1-219.


Enlaces refback

  • No hay ningún enlace refback.