There are numerous theories about the potential benefits of massage therapy, although there are few studies on how it works. Preliminary evidence suggests promising that massage might be beneficial for lung function of children with asthma. However, the data are inconclusive.

In a new study, 60 children with asthma were randomized to receive either daily 20 minutes of massage therapy by their parents at home for five weeks in addition to usual care for asthma, or a control group would receive only the care normal (without massage). Several tests were performed lung function in the first and last day of treatment, including spirometry, which measures the volume of air that can be inhaled or exhaled, and forced expiratory volume in one second, which measures the speed of air leaving of the lungs.

The researchers found that at the end of the study, forced expiratory flow was significantly higher for children in the massage therapy group, compared with the control group. There was also a significant improvement to the relationship between forced expiratory flow and forced vital capacity (ie the volume of air that can be forced out after a full inspiration or inhalation). There were no other significant improvements in pulmonary function tests, including peak expiratory flow.

The study authors concluded that massage therapy can improve lung function in children with asthma. However, further studies are well designed to confirm these findings.

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There is an increased incidence of asthma by 10% over the last twenty years. In 2001, asthma affected more than 100 million people worldwide. In France, the incidence and severity of the disease are rising steadily since 1960. According to the survey Health and Welfare 1998 (ESPS 98), nearly 3.5 million French are concerned, and 5 million French have had asthma at some time or another in their life. Asthma is a chronic disease of children the most common, with 6-10% of school children affected. It is also the leading cause of school absenteeism.

Between 1979 and 1995 and despite the availability of effective treatments, deaths increased by 30%.
How to assess asthma control?

The main therapeutic goal is the control of symptoms. But conventional DMARDs are sometimes inadequate. Monitoring the effectiveness of treatment can be done by simply measuring periodic FEV (forced expiratory volume in one second) but must incorporate the impact of disease on quality of life. This recent concept should improve the overall care. Various studies have shown that there is no linear relationship between the measurement of FEV and quality life.1. The perception of good asthma control is very discordant between patient and doctor, the first tends to minimize symptoms by frequently “used disability” (study ASHAIR).

Today through appropriate questionnaires professionals have more tools to assess overall as the percentage of days on which asthma has been well controlled or AQLQ for “Asthma Quality of Life Questionnaire. In thirty issues, activity, symptoms, well-being and the patient environment are evaluated. Presented at the MEDEC 2003, the preliminary results of a survey on the perception of this new approach (survey ASTEQ2 for Asthma and Quality of Life) show an interest from the patient but also the physician for consideration quality of life.

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Differences medical patients

The results of the GAPP Survey for France are clear, highlighting two main obstacles to effective management: lack of communication between physicians and their patients and the occurrence of adverse reactions related to treatment with inhaled corticosteroids.

* Patients and doctors: misunderstandings persist

* Patients and doctors have differing opinions on information about adverse reactions:

* More than half of patients following their treatment, claiming he never spoke of adverse short-term (63%) and long (60%) with their doctor.

* However, 87% of physicians said they sometimes or always speak of adverse short-term and 32% said they sometimes or always speak of adverse long-term.

* The perception of patient education in practice varies considerably

* 62% of doctors say spent more than a quarter of the time from consultation to discuss techniques to ensure the success of treatment, against only 23% of patients.

* 26% of physicians state that they offer to their patients during consultations in the office, keep a daily log of symptoms, while only 7% of patients reported having such a conversation with their doctor.

* The occurrence of side effects influence adherence to treatment:

* 21% of patients having undergone anti-asthma report having been victims of adverse short-term and 11% of adverse long-term.

* Patients who experienced adverse events were 50% report that they have considered reducing the dosage, and 29% said they have reduced.

The survey results Gapp provide unique insights into the current state of asthma in France, both in terms of doctors that adult patients. In addition to caring for adults, the investigation Gapp was also interested in treating children with asthma. The results confirm the need to improve both the safety of proposed treatments and information for parents.

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Respiratory acidosis is a condition that occurs when the lungs can not remove all the carbon dioxide produced by the body. This makes the interference in the body, which is not a balance between acid-base. Body fluids become very acidic.

Respiratory acidosis can be caused by lung diseases such as chronic obstructive pulmonary disease (COPD) and severe asthma. Other conditions that can cause Respiratory acidosis include:
* Obesity
* Excessive fatigue or weakness of the muscles of the rib cage
* Severe defects of the spine and ribs as severe scoliosis
* Airway obstruction

Symptoms may include shortness of breath, easy fatigue, chronic cough, or wheezing.
When Respiratory acidosis is getting worse, the symptoms related to confusion, irritability, or lethargy.

Respiratory acidosis occurs over a long period of time. This leads to a stable situation. This is because the kidneys increase chemicals that help restore the body’s acid-base balance.

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Benefits of exercise in children with asthma:

• Improved child development
• Improved physical fitness and exercise tolerance itself
• The attacks caused by stress are reduced or are less strong
• The crisis is best handled
• Helps reduce the nervousness caused by the attacks.

But keep in mind that at least 80% of children with asthma may have a bronchoconstriction with sports, unless appropriate measures are taken). However, given the benefit of sport psycho and integrator, is a great error overprotect the asthmatic child and prevent a normal level of exercise.

When we begin a physical activity for the first time we all get tired, feel fatigue and breathlessness. In the asthmatic child who has done sports before, these feelings are even stronger. Therefore, the adaptation of the child with asthma sports activity should be very gradual, so that eventually learn to distinguish between normal breathlessness by intense exercise and breathlessness by an asthma attack.

Asthma and Sport

Except for diving with air bottles, a child with asthma can play sports. But there are a number of sports less likely to trigger asthma than others.

The free running, which is the basis of the running, athletics, and sports like football or basketball, is the activity which can produce bronchospasm. As there is usually a refractory period of 2 to 4 hours’ duration in the exercise-induced asthma during which no bronchospasm occurs again, however much they continue to exercise, so running causes an intense and continuous more bronchospasm that perform the exercise intermittently.

Activities that cause exercise-induced asthma

In order of severity are:

1. Free Race
2. Career treadmill
3. Cycling
4. Swimming

In addition, sports like swimming in warm pool (hot and humid air), gymnastics, walking, golf, hiking and biking on level ground are much less likely to trigger asthma. The tennis and ball games, but require much free running, usually take the form of intermittent heavy exertion, so are also good, like the martial arts (judo, karate, taekwondo), fencing, etc..

The deep diving with compressed air cylinders is not an activity recommended by the pressure changes involved, and unable to cope with an asthma attack at a certain depth: In the midst of a crisis of dyspnea, it may be very difficult to carry out maneuvers required for decompression to the surface without risk of barotrauma.

The mountain sports in asthmatics (mountaineering, alpine skiing and background, etc.) only have the problem of breathing cold, dry air, which can be minimized by the use of masks or helmets.

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