Asthma is a common condition that personal trainers come across in the fitness environment. In many cases asthma is viewed as a non-condition and ignored, this should not be the case. Personal trainers should be aware of the implications of asthma and how to make sure that their clients are screened effectively prior to the start of an exercise routine. This screening should then form the basis of any exercise programmes generated to make sure the programme is not just effective but safe.
So what exactly is asthma, well it is a condition where there is a temporary and reversible narrowing of the airways. This is signalled by shortness of breath, wheezing a tightening in the chest and on some occasions a cough. Asthma attacks can vary massively in terms of severity, with extreme cases requiring an ambulance. Eventually the condition can lead to the onset of COPD (Chronic Obstructive Pulmonary Disorder) or become classed as chronic asthma.
The cause of asthma attacks is normally an allergic reaction; common allergens for asthmatics include pollen, dust, animals, cigarette smoke, viral infection, or a wide range of chemicals. But attacks can also be sparked off by stress and psychological factors. The causative factor is known as a trigger, and all asthmatics have a single or multiple triggers that will initiate an attack. In some cases however asthmatics are unaware of their triggers, this makes them less able to predict the onset of an attack.
It is very important for an exercise professional to be aware of the triggers that their clients have, and minimise any exposure to them. This will reduce the frequency of attacks and ensure that the client remains safe during an exercise session.
Some sufferers have exercise induced asthma, this is where the attack is brought on by exercising. These sufferers will be the ones that exercise professionals will need to show most care with, ensuring that they regularly check in on RPE and the breathlessness scale.
Exercise is an important method for reliving asthma as it helps to strengthen the accessory respiratory muscles making breathing an easier process. Exercise also improves general cardiovascular function and improves the ability of the body to expire air. This makes exercise an important part of an asthmatics lifestyle and vital that they receive qualified advice on how to exercise in the safest manner possible.
It is recommended that the asthmatic client takes part in aerobic activity on 3-7 days per week, for 20-30 minutes, at an intensity that is appropriate to the client’s level and does not cause an asthma attack. In early stages of exercise it may be necessary to split the training time across two sessions in the day. It is very important to monitor the level of exertion using the RPE scale and heart rate, but also it is important to use the dyspnoea (breathlessness) scale.
This is a scale that works in a similar manner to the RPE scale with 0 being not out of breath at all and 10 being unable to breathe. The most worrying signal would be if a client was at a very low intensity according to RPE and heart rate but experiencing a 8 on the dyspnoea scale, this would result in cessation of the exercise session.
In terms of resistance training a full body resistance programme should be implemented 2-3 times per week. Working in an alternate manner between upper and lower body exercises at 70%1RM, over 15 reputations for 1 set.
On top of this a proper programme of ADL (Activities of Daily Living) should be implemented that meet the minimum requirements of aerobic activity. A general full body flexibility routine should also be implemented that helps to stretch muscles across the body.
Generally the following precautions should be taken:-
- Do not exercise on days when wheezing, allergies are troubling, weather is very cold, peak flow shows a decline in lung function
- Extended warm ups
- Interval training may be more appropriate for exercise induced asthma
- Use exertion and breathlessness scales to monitor intensity
- Avoid too much upper body CV exertion
- Start with resistance after a severe flare up and gradually introduce CV
- Consider the use of a bronchodilator prior to exercise
- Ensure medication is always available
- Exercise mid to late morning
- Avoid extreme temperature and high humidity