The effect of balance training intervention on postural stability in children with asthma

A review of upper airway physiology relevant to the delivery and deposition of inhalation aerosols

Developing effective oral inhaled drug delivery treatment strategies for respiratory diseases necessitates a thorough knowledge of the respiratory system physiology, such as the differences in the airway channel's structure and geometry in health and diseases, their surface properties, and mechanisms that maintain their patency. While respiratory diseases, such as chronic obstructive pulmonary disease (COPD) and asthma and their implications on the lower airways have been the core focus of most of the current research, the role of the upper airway in these diseases is less known, especially in the context of inhaled drug delivery. This is despite the fact that the upper airway is the passageway for inhaled drugs to be delivered to the lower airways, and their replicas are indispensable in current standards, such as the cascade impactor experiments for testing inhaled drug delivery technology. This review provides an overview of upper airway collapsibility and their mechanical properties, the effects of age and gender on upper airway geometry, and surface properties. The review also discusses how COPD and asthma affect the upper airway and the typical inhalation flow characteristics exhibited by the patients with these diseases.

Impacts of aerobic exercise on children with asthma diagnosis: integrative review

Objective: To identify the impacts of aerobic exercise on the health of children with asthma, seeking to know protocols of rehabilitation programs and their impacts. Methods: Clinical trials published from 2010 to 2020 were selected, filtered by the descriptors: 'asthma', 'exercise' or 'physical training', 'children' OR 'adolescents' AND 'quality of life'. Results: Nineteen articles were included; the duration of the programs ranged from 4 to 24 weeks, 2 to 6 times/week, with the sessions varying from 30 min to 1h10min and intensity from 40% to 100% of the Maximum Heart Rate. The studies evaluated strength, lung capacity and function, inflammatory mediators, quality of life, and asthma control. Aerobic interventions made it possible to improve cardiorespiratory capacity, intracellular action of antioxidants, quality of life, and disease control. Significant results were found in protocols with playful exercises performed for 60 minutes, three times a week, and at least 12 weeks. Conclusion: The ease of reproducing the protocols can provide greater coverage of care and rehabilitation, which in the long term can help to reduce the hospitalization rate, cost, and hospital demand for severe exacerbations.

The effects of core stabilization training on dynamic balance and pulmonary parameters in patients with asthma

BACKGROUND

In the literature, novel physiotherapy and rehabilitation approaches are getting significant attention as a way to cope with secondary complications in the management of asthma.

OBJECTIVE

To investigate the effectiveness of core stabilization exercises combined with the Asthma Education Program (AEP) and breathing exercises in patients with asthma.

METHODS

The study sample consists of 40 asthmatic patients (age 52.25 ± 11.51 years) who were randomly divided into a Training Group (TG) (n= 20) and a Control Group (CG) (n= 20). All subjects were included in the AEP, and both groups were trained in breathing retraining exercises (2 times/wk, 6-week duration in the clinic). The core stabilization exercise program was also applied in the TG. Respiratory muscle strength (maximum inspiratory and expiratory pressures), physical activity level (International Physical Activity Questionnaire Short Form (IPAQ)), health-related quality of life (Asthma Quality of Life Questionnaire (AQOL)), functional exercise capacity (six-minute walking test (6MWT)), and dynamic balance (Prokin PK200) were assessed before and after the interventions.

RESULTS

The TG showed more significant improvements in MIP (ΔTG:4.55 cmH2O, ΔCG:0.95 cmH2O), IPAQ (ΔTG:334.15 MET-min/wk., ΔCG:99 MET-min/wk.), 6MWT (ΔTG:24.50 m, ΔCG:11.50 m), and dynamic balance sub-parameters compared to the mean difference between the initial assessment and after a 6-week intervention program, which included twelve exercise sessions (p< 0.01).

CONCLUSIONS

The findings present greater improvements in inspiratory muscle strength, physical activity level, functional exercise capacity, and dynamic balance when core stabilization exercises are included in the pulmonary rehabilitation program for the management of asthma.

[Medical rehabilitation of children with bronchial asthma]

Medical rehabilitation of children suffering from bronchial asthma is based on the complex use of natural therapeutic factors, drug, non-drug therapy and other methods in order to achieve control over the disease and long-term remission. The use of non-drug technologies is necessary taking into account the pathogenesis of the bronchial asthma development and is aimed at relieving bronchospasm, reducing the activity of allergic inflammation in the bronchi, improving their drainage function, strengthening the respiratory muscles and increasing exercise tolerance. When carrying out rehabilitation measures it is important to observe the basic principles of medical rehabilitation. An individual medical rehabilitation program is drawn up taking into account the assessment of the child's clinical condition at each stage with the diagnosis of the initial rehabilitation status, the establishment of a rehabilitation diagnosis and an assessment of the rehabilitation potential. The article presents the data of the analysis of scientific publications and our own research allowing to draw up an algorithm for the formation of an individual program of medical rehabilitation for children with bronchial asthma.

Pseudomonas aeruginosa-derived exosomes ameliorates allergic reactions via inducing the Treg response in asthma

BACKGROUND

Exosomes are nanovesicles originating from multivesicular bodies that have complex functions and significant therapeutic effects in many diseases. In the present study, we successfully extracted exosomes from Pseudomonas aeruginosa and assessed the effect of those exosomes on the development of the allergic response in two types of classic asthma models.

METHODS

Female BALB/c mice were administrated with P. aeruginosa-derived exosomes 1 week before ovalbumin (OVA) or house dust mite (HDM) sensitization. Bronchoalveolar lavage fluid, serums and lung tissues were collected and analyzed for pathophysiology and immune responses.

RESULTS

Our results demonstrated that P. aeruginosa-derived exosomes inhibited the development of airway hyper-responsiveness (AHR), peribronchial and perivascular inflammation in lung tissues and the level of serum IgE. Moreover, this protective effect was associated with an increase in the regulatory T cell (T_reg) response and a concomitant decreased T_h2 response.

CONCLUSIONS

In conclusion, these observations demonstrated that P. aeruginosa-derived exosomes could induce protection against allergic sensitization in asthma mice, and our study provided a new insight to prevent allergic diseases.