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ผลลัพธ์ (อังกฤษ) 1:

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ผลลัพธ์ (อังกฤษ) 3:

IntroductionAsthma is an inflammatory disorder with airway hyper- responsiveness leading to recurrent episodes of wheezing, breathlessness, chest tightness and coughing, especially during the night and the early morning.1,2 Asthma develops primarily at a young age, but may also occur in adulthood. The prevalence of asthma is about 5e10% in children1 and approximately 3% in adults.3Asthma has a significant impact on individuals in terms of quality of life, it affects school or work attendance and performance and reduces activity levels. The treatment of asthma consists of both medical, primarily through inhala- tion medication, and non-medical therapy. The aim of treatment is to achieve a normal lifestyle with a normal exercise capacity, the avoidance of serious asthma attacks and the achievement of an optimal lung function with as few symptoms as possible.1,3 Since the introduction of medical therapy for asthma, interest in non-medical treatments deteriorated.Non-medical treatment of asthma may consist of several aspects including education, guidance of patients and var- ious forms of physiotherapy. Physiotherapy may have ben- eficial effects since most asthmatics have a dysfunctional breathing pattern and poor physical condition. As a con- sequence, this may cause problems in participation in sports, school gymnastics and playing outside.Cochrane reviews concerning physiotherapyIn the last decade five Cochrane reviews4e8 were pub- lished concerning physiotherapy in children and adults with asthma. These reviews examined the effect of vari- ous treatments (namely Alexander technique,4 breathing exercises,5 manual therapy,6 physical training,7 and inspiratory muscle training (IMT)8) in patients with asthma. For two reviews, the number of included studies were too small to draw conclusions.4,6 The other three reviews5,7,8 did find several significant results, but due to the small number of included studies, the small patient numbers per study and the different methods and out- come measures, the reliability of these results is limited. From these five Cochrane reviews it can be concluded that too little reliable studies have been performed to draw a conclusion on the effectiveness of physiotherapy in asthma. Furthermore, literature searches for these re- views took place up to 2002 (IMT), 2003 (breathing exer- cise), 2004 (manual therapy) 2005 (physical training) and 2010 (Alexander), which underlines the need for an up- date of the literature.Despite the limitations of the Cochrane reviews, espe- cially the three physiotherapy techniques breathing exer- cises, IMT and physical training are techniques which are promising in asthmatics and which are practiced by various patients.