Evaluation of effects of Nebulization and Breathing Control in Asthmatic Patients

Background: Asthma is a disease characterized by airflow limitation that is either fully or partially reversible. There is a growing realization that in asthma the airflow limitation leads to further mechanical consequences that result in dyspnea which is also a very important domain along-with airflow limitation to build up strategies to effectively cope up with asthma. To treat asthma effectively means to achieve a better level of control of asthma. Various strategies have been adopted by the patients themselves to keep their asthma level in control and avoid frequent exacerbations. Asthma has many dimensions to it rather than only airway obstruction. Asthma is affected by anxiety, cold, emotional quotient & also by the level to which other non- pharmacological means to control asthma adopted by the patient like yoga, meditation and various breathing strategies. It was seen that pharmacological measures though were very essential to treat asthma, but along-with its long term use; factors like adverse effects of medications, patient's non-compliance, cost effectiveness of treatment, patients sense of satisfaction of their disease control came into focus. Hence, various non-pharmacological measures were researched in the past trials, of which breathing control was one of the measures used.

Purpose: The purpose of our study was to evaluate the effects of nebulization and breathing control (N+B combination) as against only breathing control(B) on airway obstruction [by measuring peak expiratory flow rate(PEFR), forced expiratory volume in 1st second(FEV1) and dyspnea [by measuring respiratory rate (RR) and rate of perceived exertion (RPE)] in asthmatic patients.

Method: In total, 60 patients were selected according to the inclusion and exclusion criteria. Written informed consent was taken from the patients and asthmatic patients were randomly allocated to two groups either N+B or only B. Parameters PEFR, FEV1, RR and RPE on Borg's modified 10 point category ratio scale were obtained before and after the treatment session. Data was analyzed using SPSS 15. For statistical significance, p value of

Results: There was a statistically significant improvement in PEFR, FEV1, RR and RPE in both the groups. However, there was no statistically significant difference in PEFR and FEV1 i.e. airway obstruction between the two groups. But, there was a statistically significant difference in RR and RPE i.e. dyspnea between the two groups, with breathing control showing greater improvement in dyspnea.

Conclusion: Thus, asthmatic patients not only could reverse their airway obstruction (PEFR, FEV1) with Breathing control but also improved in terms of dyspnea (RR, RPE) as compared for Nebulization and Breathing control group. Nebulization and Breathing control group though it showed statistical significant improvement in airway obstruction(PEFR,FEV1) than only Breathing control; but the overall energy expenditure and thermogenic effect of nebulization with salbutamol did not help reverse dyspnea(RR and RPE)to the effect the breathing control could to.