A Breath of Opportunity
Working with asthmatic clients
Asthma is a common condition that personal trainers come across in the fitness environment. In many cases asthma is viewed as a non-condition and ignored, this should not be the case. Personal trainers should be aware of the implications of asthma and how to make sure that their clients are screened effectively prior to the start of an exercise routine. This screening should then form the basis of any exercise programs generated, to make sure it is not just effective but safe.
Asthma is a condition in which there is a temporary and reversible narrowing of the airways.
Symptoms
• shortness of breath
• wheezing (a tightening in the chest)
• coughing
The cause of asthma attacks is normally an allergic reaction; common allergens for asthmatics include:
• pollen
• cigarette smoke
• dust
• viral infection
• animals
• a wide range of chemicals
Attacks can also be sparked off by stress and psychological factors.
The causative factor is known as a trigger, and all asthmatics have a single or multiple triggers that will initiate an attack. In some cases, however, asthmatics are unaware of their triggers, this makes them less able to predict the onset of an attack.
It is very important for an exercise professional to be aware of the triggers that their clients have, and minimise any exposure to them. This will reduce the frequency of attacks and ensure that the client remains safe during an exercise session.
Exercise-Induced Asthma
Yes, exercise can bring on an asthma attack; even though it also serves as an important method for reliving asthma—being that it helps to strengthen the accessory respiratory muscles making breathing an easier process. Not to mention, exercise also improves general cardiovascular function and improves the ability of the body to expire air.
• Type: Aerobic
• Frequency: 3 -7 times per week
• Duration: Building up to 30 minutes
• Intensity: appropriate to the client’s level and does not cause an asthma attack
• Type: Resistance Training (full body)
• Frequency: 2-3 times per week
• Intensity: Alternate manner between upper and lower body exercises at 70%1RM
• Zone: Hypertrophy – a single set of 8-12 reps
Breathlessness Scale
In early stages of exercise, it may be necessary to split the training time across two sessions in the day.
It is very important to monitor the level of exertion using the RPE scale and heart rate, but also it is important to use the dyspnoea (breathlessness) scale.
This is a scale that works in a similar manner to the RPE scale with 0 being not out of breath at all and 10 being unable to breathe. The most worrying signal would be if a client was at a very low intensity according to RPE and heart rate but experiencing an 8 on the dyspnoea scale, this would result in cessation of the exercise session.
• Do not exercise on days when wheezing, allergies are troubling, weather is very cold, peak flow shows a decline in lung function
• Extend warm ups
• Consider interval training may be more appropriate for exercise induced asthma
• Use exertion and breathlessness scales to monitor intensity
• Avoid too much upper body CV exertion
• Start with resistance after a severe flare up and gradually introduce CV
• Consider the use of a bronchodilator prior to exercise
• Ensure medication is always available
• Exercise mid to late morning
• Avoid extreme temperature and high humidity
Tom Godwin (@TomForesight) is the managing director of Foresight Fitness Services. He specialises in exercise referral and corrective exercise and helping other personal trainers improve their business. He is also involved with personal trainer education as a tutor/assessor, course developer and IQA. http://www.TomGodwin.co.uk
