New Asthma Treatment for Severe Asthma

The National Institute for Health and Care Excellence (NICE), are consulting again on the safety and efficacy of a new asthma treatment. The new treatment, bronchial thermoplasty, is likely to be offered to adults with severe asthma. The procedure involves applying thermal energy (heat) to the inside walls of the airways.

New asthma treatment

Bronchial thermoplasty will take place under sedation or general anaesthetic. Short pulses of radiofrequency energy are applied to the airway wall. Following that, patients will need to attend an additional two sessions, with 3-week intervals, to complete the procedure.

The aim of this new treatment is to reduce the smooth muscle mass lining the airways, decreasing their ability to constrict. Hopes are that by having this procedure, the severity and frequency of severe asthma attacks may decrease. NICE is currently in the process of considering the evidence for this treatment. Additionally, it’s listening to the views of specialist advisers with knowledge of the procedure.

Furthermore, to ensure safety, NICE is recommending that only a multidisciplinary team treat patients. In addition, they recommend that only specialist centres with on-site access to intensive care should carry out the procedure. Finally, they are proposing that only clinicians with experience of bronchial thermoplasty and managing severe asthma should perform the procedure.

As it stands, NICE believe there is adequate evidence to support the use of this new asthma treatment.

Severe asthma

In their consultation document, NICE say that in severe asthma, the lining of the airways becomes inflamed and narrow. Furthermore, this narrows the airways, making it harder for air to pass through. This makes it harder to breathe. And it is this that bronchial thermoplasty aims to tackle.

Complementary treatment for asthma

Research shows there to be an alternative, complimentary asthma treatment for opening up the airways and assist in easier breathing. This treatment is Inspiratory Muscle Training (IMT). Simply put, it is breathing muscle training, such as with the POWERbreathe IMT device. It too is clinically proven. Furthermore, it is drug-free.

The research reaches the conclusion that six-months of specific inspiratory muscle training improves inspiratory muscle strength and endurance. It also results in improvement in asthma symptoms, hospitalisations for asthma, visits to the emergency department, absence from school or work, and medication consumption in patients with asthma.

Alternative treatment for asthma – IMT

Inspiratory Muscle Training, such as with POWERbreathe IMT, is easy to use, straight out of the box. Because it is drug-free, there are only minimal precautions and contraindications that the Healthcare Professional needs to be aware of before prescribing IMT.

POWERbreathe IMT is an evidence-based, non-invasive asthma treatment. In fact, it is the amount of medical research behind the rigorous assessment that led to the POWERbreathe Medic being made available for prescription on the NHS. It offers people with asthma a clinically-proven method of reducing symptoms and putting them in control of their asthma.

Research shows that after only 3-weeks of IMT, asthma symptoms improve by up to 75%. Furthermore, patients with asthma experience improvement of symptoms, quality of life and a reduction in the consumption of medication of up to 79%.

In fact, three separate studies show an average 51% reduction in β2-agonist consumption (from 3.9 to 1.6 puffs per day) after IMT. One study also shows a decrease in corticosteroid use ~80%.

Finally, longer observations show that 6-months of IMT reduces absence from school/work (by ~95%) and use of healthcare resources (by ~75%).

What is World Asthma Day

Every year the Global Initiative for Asthma (GINA) organises World Asthma Day. The aim of this awareness day is to reduce asthma prevalence, morbidity and mortality in every corner of the globe. Their first awareness day was held in 1998. And so this year they are celebrating the 20th annual World Asthma Day. And every year they have a theme. The theme for 2018 is “Never too early, never too late. It’s always the right time to address airways disease.”

World Asthma Day 2018

This year’s theme asks both patients and healthcare providers to evaluate asthma symptoms, regardless of the time in that person’s life. In addition, they ask for actions to be taken to ensure a person’s asthma is controlled. For example, writing an Asthma Plan that contains all you need to help control your asthma, such as a list of asthma triggers, is a core part of asthma management.

Asthma triggers

There are many things that may trigger an asthma attack. In fact, anything that irritates the airways and sets off symptoms is considered an asthma trigger. Exercise is one such trigger. Yet evidence shows that people with asthma will benefit from exercise. In fact, there are many world-class athletes, including Paula Radcliffe MBE, that have asthma.

Asthma and exercise

As long as your asthma symptoms are under control then asthma shouldn’t stop you from enjoying these benefits of exercise:

  • Boosts the immune system, reducing the possibility of coughs and colds triggering symptoms
  • Increases bone and muscle strength
  • Improves overall health
  • Improves how well the lungs work, reducing the feeling of being breathless

Asthma treatment

The National Heart, Lung and Blood Institute explain that asthma is a long-term disease that requires managing. And because there is no cure, the purpose of asthma treatment is to control the disease. This includes two types of medicines:

  1. Long-term control medicines – these help reduce airway inflammation and prevent asthma symptoms.
  2. Quick-relief, or ‘rescue’ medicines – these relieve asthma symptoms that have the potential to flare up.

However, there is also a drug-free therapy that is clinically proven to help reduce asthma symptoms – Inspiratory Muscle Training (IMT). Always speak to a medical professional about your medical issues or concerns first.

Natural asthma treatment without drugs

Inspiratory muscle training is a drug-free breathing training intervention for people with dyspnoea (difficult or laboured breathing). It’s not surprising, therefore, that clinical trials are unanimously supportive of IMT in the management of asthma.

In trials, patients with asthma experienced a reduction in their laboured breathing in as little as 3 weeks’ inspiratory muscle training. Furthermore, they felt improvements in their quality of life. In addition, longer-term observations following 3 weeks of IMT were also impressive:

  • Reduces absence from school/work (by ~95%)
  • Reduces the consumption of medication (by ~79%)
  • Symptoms improve by up to 75%

WHO asthma statistics

  • Asthma is a major noncommunicable disease
  • Approximately 235 million people suffer from asthma (2017) which is common among children
  • Medication can control asthma symptoms
  • Asthma management helps people with asthma to enjoy a quality of life
  • Many people have undiagnosed asthma

Asthma – how it affects breathing

Asthma is a long-term breathing condition that affects the airways. These are the small tubes that transport air in and out of the lungs. It’s these tubes that become inflamed when they come into contact with something that ‘irritates’ them. Consequently, the airways become narrower. And it’s for this reason that people with asthma feel breathless and wheezy. But these symptoms will vary in severity from person to person.

What causes asthma

In the general population, asthma affects approximately 235 million people. And here in the UK, one in every 12 adults is receiving treatment for it.

Asthma tends to run in families, so genetic predisposition is one risk factor. Another factor is environmental. For instance, exposure to particles that may irritate the airways or give rise to an allergic reaction. Such irritants may include tobacco smoke, house dust mites, pet dander, pollen or air pollution.

In addition to genetic predisposition and environmental irritants, there are also other triggers. These can include physical exercise and cold air. So, it’s no surprise to discover that exercise-induced asthma (EIA) is the most common medical issue among winter Olympic athletes. In fact, almost 50% of cross-country skiers in the 2018 Winter Olympics have EIA. But it isn’t only the cross-country skiers who’re suffering. Short-track speed skaters (43%), figure skaters (21%) and ice hockey player (15%) also suffer.

What is EIA

Exercise-induced asthma (EIA) is a condition where exercise itself becomes the trigger for an asthma event. Symptoms will surface only while exercising, or immediately following exercise. And the symptoms feel worst of all after exercise and then start to gradually improve. Treatment for EIA is the same, with long-term medicines that are taken daily. But there is also a natural treatment that is drug-free that can be used alongside medication. And that is Inspiratory Muscle Training (IMT).

Natural asthma treatment without drugs

Data exists from five randomised controlled trials that are unanimously supportive of the use of IMT with POWERbreathe in the management of asthma. In fact, the POWERbreathe Medic is clinically proven by a wealth of research, as well as, the first non-pharmacological treatment for respiratory disease and the only product of its kind on the drug tariff. It is a non-invasive treatment that is drug-free, with no side effects or drug interactions.

POWERbreathe IMT is not suitable for patients with certain conditions so please first consult your specialist respiratory health doctor.

How asthma affects exercise

Breathlessness is a common feature of exercise. Shortness of breath, coughing and wheezing are also symptoms of asthma. So, imagine being an Olympic athlete performing high-intensity training above your lactate threshold. Then imagine being a winter Olympic athlete, with asthma. Breathing moves out of its comfort zone and increases steeply. And with the breathing muscles weakening and tiring, breathing feels harder still. It would be beneficial therefore to improve the state of the inspiratory muscles, mainly the diaphragm and intercostal.

It is possible to exercise specifically the inspiratory muscles with an inspiratory muscle training (IMT) device, such as POWERbreathe IMT. Such a device provides the inspiratory muscles with a resistance to breathe in against. This resistance training makes the inspiratory muscles work harder, improving breathing strength and stamina and reducing breathing fatigue.

What exercise helps asthma

Any form of exercise is good for you and will help keep heart and lungs healthy. In fact, many well-known, world-class athletes have this condition, such as runner Paula Radcliffe and cyclist Laura Trott.

If your symptoms are well managed, and your GP gives the go-ahead, then there’s no reason to limit your choice of exercise.

Practical tips for exercising with asthma

  • Warm-up first, including an inspiratory muscle warm-up with an IMT device
  • Make sure you have your inhaler with you
  • Ensure people around you know that you have asthma
  • If you feel your symptoms coming on during exercise, take your reliever inhaler and wait until symptoms subside

POWERbreathe IMT is Beneficial for Patients with Asthma

POWERbreathe Inspiratory Muscle Training is clinically proven to be beneficial for patients with asthma.

POWERbreathe Medic IMT available for prescription in the UK

After 20 months of rigorous assessment, the POWERbreathe Medic IMT device was made available in the UK for prescription in the National Health Service (NHS) Drug Tariff: PIP 232-1040. It found that the POWERbreathe Medic offers people with asthma a drug-free and clinically-proven method to reduce symptoms and put them in control of their asthma.

POWERbreathe Medic IMT rigorously assessed

Although the role of IMT in the management of asthma has been less widely studied than in COPD, data exists from five randomised controlled trials that are unanimously supportive of IMT in the management of asthma.

Asthma patients benefit from POWERbreathe Medic IMT

After as little as 3 weeks’ POWERbreathe training, patients experience a reduction in dyspnoea, the medical term for breathlessness or shortness of breath, as well as improvements in quality of life. Most striking however are the observations that longer-term IMT (6 months) reduces absence from school/work (by ~95%), use of healthcare resources (by ~75%), and the consumption of medication (by ~79%).

The five randomised controlled clinical trials in support of POWERbreathe IMT

  1. Inspiratory muscle training improves lung function and reduces exertional dyspnoea in mild/moderate asthmatics – McConnell, A. K., M. P. Caine, et al. (1998). Clinical Science 95(2): 4P.
  2. Inspiratory muscle training in patients with bronchial asthma 
  3. Specific inspiratory muscle training in patients with mild asthma with high consumption of inhaled beta(2)-agonists
  4. The relationship among inspiratory muscle strength, the perception of dyspnea and inhaled beta2-agonist use in patients with asthma
  5. Influence of gender and inspiratory muscle training on the perception of dyspnea in patients with asthma

Phlegm in lungs – clear naturally with drug-free Shaker

You will usually find phlegm in the back of the throat or in the lungs. It is produced by the lower airways. Mucus on the other hand will normally be found in the mucous membranes inside the nose. It acts like a filter protecting your lungs as you inhale. To clear it you simply blow your nose. Phlegm however is thicker and more viscous. You usually only notice it when you cough it up. An excess of this secretion can be a symptom of a respiratory problem such as bronchitis.

Why you should cough up phlegm

Although unpleasant, you can safely swallow mucus. This is because your body can safely reabsorb it. Phlegm however must be expelled from the body. Advice from healthcare professionals is to cough it up. This is because it will contain virus and dead bacteria. As you cough it up you are helping your body to get rid of the infection.

What to do when phlegm is problematic

Secretions will be more of a problem at night. This is simply because of gravity. These secretions will feel heavy in your chest. This can bring on coughing. You can allieviate this by elevating your sleeping position. Simply prop yourself up more with a pillow. Coughing is actually your body’s natural way of expelling the phlegm. This will help you to get better.

Expel phlegm with drugs – or drug-free

Expectorants can be prescribed to help increase bronchial secretion. They are intended to help make it easier to cough it up. But expectorants are medicines. Shaker by POWERbreathe however is an effective drug-free alternative.

Expel phlegm naturally with the Shaker

The Shaker by POWERbreathe literally ‘shakes’ secretions in your chest to make them more mobile. The shaking breaks these secretions down and makes it easier for you to cough it up.

How the Shaker works

Inside the Shaker device is a weighted ball. As you breathe in through the device the ball rises and then falls again under its own weight. This happens quickly and feels like vibrations. This vibration and gentle resistance dislodges and thins phlegm. You’re then more able to expel it by coughing.

Who can use the Shaker

Because the Shaker is drug-free and easy-to-use, children and adults can use it. And because it shakes up phlegm, it is ideal for people with respiratory problems. These include Chronic Bronchitis, Bronchiectasis, Emphysema, Asthma and Cystic Fibrosis. There are however some precautions which you will find on the Shaker Classic, Shaker Deluxe and Shaker Plus product pages.

Persistent childhood asthma linked to COPD later

A study published in the New England Journal of Medicine, Patterns of Growth and Decline in Lung Function in Persistent Childhood Asthma, has suggested that although most children with persistent asthma improve as they get older, longitudinal measurements of growth and decline in lung function have revealed links between asthma and subsequent chronic airflow obstruction. Seven hundred children in a Childhood Asthma Management Program who were between the ages of 5 and 12 took part in the study and they were followed until they were at least 23. At the end of the study, 11% of the young adults suffered from Chronic Obstructive Pulmonary Disorder (COPD). Other than persistent asthma, risks for COPD included being male and having poor lung function at the start of the study. And by the time children with persistent asthma reached early adulthood, 75% showed an early decline in lung function or reduced lung growth. POWERbreathe is an Inspiratory Muscle Training device (IMT) which means it trains the muscles used to breathe in, your inspiratory muscles, and inspiratory muscle training has been shown to relieve the symptoms of asthma by improving lung function, resulting in reduction of medication and a fall in hospitalisations. POWERbreathe IMT may be used by children over the age of 7 (the Plus is more comfortable for children) who are old enough to understand how to effectively perform the breathing exercises under the supervision of an adult. And because POWERbreathe IMT is drug-free it won’t interfere with asthma medication.  Always check with your GP first before undertaking any form of training. In summary, IMT was shown to generate:

  • A reduction in the consumption of asthma medication of up to 79%
  • A reduction of ß2-agonists consumption by up to 79%
  • An improvement in asthma symptoms by up to 75% in 3 weeks

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POWERbreathe Medic helps patients with breathing problems AND saves NHS money and resources

Health bosses announced back in October 2014 that the NHS in England needed extra money and an overhaul to services in order for patient care not to suffer.

When it comes to respiratory care the NHS could save both money and resources if they prescribed POWERbreathe Medic Respiratory Muscle Training (RMT) for patients with medical conditions such as COPD, Heart Failure, Asthma, Thoracic Surgery, Ventilator Weaning, Cystic Fibrosis and Neuromuscular Disease.

In a 2005 study of the benefits of a 12-month programme of POWERbreathe RMT, researchers observed significant reductions in the use of healthcare resources.1

POWERbreathe RMT for COPD

Accordingly to Professor Peter Calverley (Lung Report III. British Lung Foundation), in the average PCT serving 250,000 people, there would be 14,200 GP consultations per year for chronic obstructive pulmonary disease (COPD), and 9,600 inpatient bed days. Reducing length of hospital stay is an NHS productivity indicator.

POWERbreathe reduced hospital bed days by 29% and GP consultations by 23% compared with placebo (see table above).

POWERbreathe RMT for Asthma

In another study, Weiner et al2 observed an 86% reduction in hospitalisations/emergency room visits following respiratory muscle training in moderate/severe asthmatics (from 1.4 to 0.2 per 3 months per patient).

And in three separate studies, Weiner et al. observed an average 51% reduction in β2-agonist consumption (from 3.9 to 1.6 puffs per day)2,3,4 after respiratory muscle training, and in one study3, corticosteroid use decreased ~80%.

How POWERbreathe Medic could save NHS money & resources

In 2005 when this study was conducted, the total potential annual savings derived from POWERbreathe Medic prescription per average PCT due to reduced hospital bed days and medication consumption (not including savings due to reduction in GP consultations) were substantial.

The POWERbreathe Medic offers an evidence-based, drug-free treatment for patients with medical conditions such as COPD, Heart Failure, Asthma, Thoracic Surgery, Ventilator Weaning, Cystic Fibrosis and Neuromuscular Disease. It is the only Inspiratory Muscle Training device for RMT available for prescription that has been used in research into the benefits of IMT for a variety of medical conditions and prescribed by medical professionals as either a standalone intervention or as part of a rehabilitation programme.

For respiratory care professionals there is a POWERbreathe Medic Try-Before-You-Prescribe demonstration kit; an educational tool designed to help healthcare professionals and patients understand and experience the effect POWERbreathe Medic has on the respiratory muscles.

Since the approval of the POWERbreathe Medic for prescription in 2006, POWERbreathe has introduced the revolutionary, electronic POWERbreathe KH1, intended for use by healthcare professionals for respiratory muscle training and assessment in patients with dyspnoea, including patients with asthma, COPD, bronchitis, cystic fibrosis, emphysema, heart disease, neuromuscular disease, Parkinson’s disease and spinal injury.

The POWERbreathe KH1 is also suitable for use with disposable TrySafe filters and can be used bedside, on the ward, as part of a pulmonary program, or for single patient use at home under medical supervision.

Launched after the POWERbreathe Medic, following the latest technological advances in research and design, is the next generation POWERbreathe Medic: the POWERbreathe Medic Plus for patients to use at home, straight out of the box, with improved airflow dynamics and a more comfortable user experience. And for healthcare professionals (and their patients), is the new POWERbreathe KH2 with Breathe-Link Medic Live Feedback Software.

References:

  1. Beckerman M, Magadle R, Weiner M, Weiner P. The effects of 1 year of specific inspiratory muscle training in patients with COPD. Chest. 2005 Nov;128(5):3177-82.
  2. Weiner P, Azgad Y, Ganam R, Weiner M. Inspiratory muscle training in patients with bronchial asthma. Chest. 1992;102(5):1357-61.
  3. Weiner P, Berar-Yanay N, Davidovich A, Magadle R, Weiner M. Specific inspiratory muscle training in patients with mild asthma with high consumption of inhaled beta(2)-agonists. Chest. 2000;117(3):722-7.
  4. Weiner P, Magadle R, Massarwa F, Beckerman M, Berar-Yanay N. Influence of gender and inspiratory muscle training on the perception of dyspnea in patients with asthma. Chest. 2002;122(1):197-201.

Asthma In Older Women

Physician’s Weekly recently reported that older women are more likely to report having asthma than older men, and also have a 30% higher asthma-related mortality rate.

To discover why, Dr. Alan P. Baptist (MD,MPH) conducted a literature review in which he found data suggesting that hormonal changes during the menstrual cycle often play a large role in asthma symptoms. Other risk factors were also identified.

As a result of his review, Dr. Baptist recommended that physicians use Peak Flow Meters to assess asthma in older women because this particular group has a decreased perception of breathlessness.

There have been other scientific studies showing that women’s breathing does indeed differ to that of men’s and results in women feeling more out of breath. One study showed that the diaphragm in women had to work harder to compensate for smaller lungs and therefore narrower airways.

Another study found that the respiratory muscles in women used more energy when breathing, consuming a greater amount of oxygen.

One very recent study that was conducted on physically active young adults also showed that even in this younger and more active age group subjective differences appear which may partly be due to underlying differences in breathing patterns and operating lung volumes during exercise.

Women of any age therefore could benefit from exercising their breathing muscles, the inspiratory muscles (mainly the diaphragm and intercostals), with POWERbreathe to make them stronger and more resistant to fatigue. And because POWERbreathe is drug-free, it has no side effects or drug interactions.

Heartening Words From A POWERbreathe User

We’d like to thank Karl Coan for emailing us with this, his POWERbreathe story…

To whomever it may concern.

This may not be the correct way to contact you. I’m a 35year old man, who for all of my life has struggled with asthma. Bear with me, at school I could never run much further than 200m. I was put into a 400m race by an encouraging PE teacher, made it to the finishing line but collapsed.

I felt held back all my school life and this continued into my adult life. Although my asthma had faded in as far as how much it affected me as I got older, I still couldn’t do anything that involved anything too much in the way of cardiovascular activity. So I turned to weight training and lower cardio activities.

There have been many things I would have liked to have done in both my school and adult life, one thing I wanted to do was join the army. Asthma has stopped me from doing this. It embarrassed me if I’m honest.

Last year I hurt my back, injuring my L5. I had to take time off of work and felt useless. I read a book about a guy who climbed Kilimanjaro even though he was asthmatic and how great it was for him mentally. I thought it was great that he summited Kili, and have always thought even as a child how great it would be to climb a mountain. I decided it was something I needed to do.

I started researching asthma and breathing aids, this led me online to your company. I bought a POWERbreathe K3. I started using it and tried to start running. I ran 0.7mile to start, which I found hard; I spent the next few months slowly building my distances and by the end of last year was running up to 4miles! This meant a lot to me. I had also been walking/hiking in Wales.

I then decided 2015 would be my year, I took on a white collar boxing match in February, for this I had to train very hard cardiovascularly, I won my fight, though very hard. Next on the list was a half marathon which I completed, couldn’t believe I could run this far, dreamt as a child that one day I might be able to. Then I wanted to complete the Welsh 3000’s or 15 peaks challenge. I did this in June this year, all 15 3000ft peaks completed in 13hrs20mins, a very respectable time. All of this building fitness and strength for a mountain.

I didn’t want to do Kilimanjaro, but instead I wanted to climb Europe’s highest peak, the Elbrus in Russia. I said that if I managed to do it I would contact you. I did it!

Nothing that I have done has been easy and I’m not saying it was any harder for me than for anyone else, but it has been tough and being stubborn has helped no end.

I believe the POWERbreathe unit I used is the thing that made the difference and enabled me to complete my challenges; that and hard work. I’ve pushed my body to limits I thought I could never reach. I’m not stopping here. I want to reach my full potential. Next year I hope to head to the Himalayas to challenge myself with a tougher, larger mountain…. and who knows what else. I wish this product was available to me as a child, or that I had better guidance, maybe things would have been much different for me in terms of fitness and career.

Anyway to someone I feel I owe a huge thanks to, you opened up my world and are helping me reach my dreams.

Regards,

Karl Coan

Exercise-Induced Asthma – and POWERbreathe

Pip Windsor from Phsyio2Breathe is an expert with over 20 years’ experience in the treatment of Breathing Pattern Disorders (BPD) and Asthma Education and is an MDT Certified BradCliff Method® Practitioner (a structured research-based physiotherapy assessment and treatment programme for breathing pattern disorders).

Pip has written this article about Exercise-Induced Asthma (EIA) for Evolved Physiotherapy & Performance, a clinic specialising in injury recovery, strength and conditioning, sports psychology and endurance coaching.

Pip begins by asking ‘what is asthma’ and suggests a few solutions that could help; one of which is strengthening the breathing muscles with POWERbreathe to make them more efficient and less prone to fatigue. Pip then offers 3 tips on how best to breathe.

Read the full article Exercise-Induced Asthma >