GUIDED EXERCISE PROGRAMME FOR ASTHMATIC PATIENT DURING COVID-19 PANDEMIC

GUIDED EXERCISE PROGRAMME FOR ASTHMATIC PATIENT DURING COVID-19 PANDEMIC Medical History Ms. X is a 18 years old young lady. Throughout secondary school she was active in competitive sports in her school. On occasion throughout secondary school she would develop an increase in shortness of breath and a cough. Her doctor told her that she had bronchitis and that she should not worry about this. After a year she started with another symptoms of chest tightness, abdominal pain and shortness of breath. Her doctor prescribed medication for her and to monitor her to recognise another signs. After two months she was directed to me to give guided regular exercise that can help the lungs to work more efficiently. Diagnosis and Test Results A simple lung test called peak flow measurement and spirometry was conducted immediately measures the amount of air in lungs and how fast they can blow it out. I told her parents to go for X-ray, blood tests, skin test and test for allergies in order to assist me. Treatment and Exercise prescription Spirometry was performed at 15,30,and60 minutes following the exercise test. Maximal oxygen consumption was 3.18L.min.The patient was started on a short -acting albuterol sulfate administered 30minutes before exercise. She was instructed to warm up for 15 minutes with low to moderate intensity exercise or swimming before starting a high intensity swimming practice. Exercise tolerance subsequently improved while exercise associated symptoms became rare. Exercise Recommendation Comprehensive supervised rehabilitation is helpful for patients with asthma. Control of airway inflammation and bronchoconstriction by use of an appropriate medical regimen is of primary importance for each person. Without adequate control of these pathological processes, exercise capabilities will not improve significantly. Improvements in aerobic capacity, muscle strength, and endurance are important goals achieved through an appropriate exercise prescription. The exercise prescription should be based on objective measurements of the exercise capabilities and individualized for each patient. This comprehensive approach can often improve exercise tolerance and quality of life for each patient. Depending on the coexisting medical and orthopedic conditions, patients can undertake exercise training through a variety of modalities, such as stationary cycling, treadmill, walking, and swimming. In addition, if weakness of a specific muscle group is noted, then exercises addressing that weakness should be undertaken for example :for weakness of the trapezius or biceps, specific weight training targeted at this muscle group. Note for Exercise Prescription 1 Assess patient's underlying respiratory status and goals for exercise. 2 Assess maximum level of exercise. 3. If maximum level of exercise has been determined by measurement of oxygen consumption and carbon dioxide production (cardiopulmonary exercise testing), begin exercise prescription at an initial intensity level just below the anaerobic threshold. 4. If such measurements are unavailable, begin exercise at a level of exercise at which the patient is comfortable performing for 5minutes. 5 Instruct the patient to continue exercise for 20 to 60 minutes per session. 6. Have the patient perform sessions three to five times per week. 7. Increase exercise intensity by 5% with each session. 8. When maximal level of intensity is attained, increase exercise duration by 5%. Question for all the students. Are we ready to follow this example of Exercise prescription. Yes No

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