Pharmacy Today: Address breathing technique
Not addressing breathing patterns of asthmatics is negligent, Auckland physiotherapist and co-founder of Breathing Works clinic, Tania Clifton-Smith, says.
While Ms Clifton-Smith says asthma medication is essential, she believes little attention is paid to breathing techniques – leading to worsened outcomes for asthma sufferers.
“Curiously, since the advent of user-friendly inhalers 30-odd years ago and newer asthma ‘wonder drugs’, less attention has been paid by the medical profession to the business of breathing itself.
“Dependency on asthma medication is regarded as the norm and there is little encouragement for people with asthma to try alternative methods to control their breathing.”
She says pharmacists can encourage patients to address their breathing, in conjunction with taking medication.
“Pharmacists know any more than three puffs a week of Ventolin, excluding if it is for exercise, should be questioned.”
Ms Clifton-Smith says overuse of medication means the asthma may not be under control, and breathing patterns should be addressed.
In 1999, she founded Breathing Works – the first independent breathing pattern disorders clinic in Australasia – together with physiotherapist Dinah Bradley.
The two also established a method of breathing, focusing on respiratory and musculoskeletal steps – the BradCliff method.
There are nine steps to the SmithBradCliff method and these are tailor-made to individuals.
“There is a retraining, going from a faulty energy, poor pattern – consuming lots of energy – to one where you’ve got good physiology and good mechanics that allows balance and relaxation.”
Breathlessness often misinterpreted. A good pattern means people are less likely to be histamine riddled, which means people will be less likely to react to triggers, Ms Clifton-Smith says.
“When you breathe badly, you riddle your body with histamine, so therefore you’re much more susceptible to quittingtriggers. If you breathe well, the histamine is a lot lower.
“Many individuals misinterpret breathlessness or ‘air hunger’ as an asthma episode. Instead of immediately reaching for an inhaler, good breathing practice is what we advocate.
If this does not relieve symptoms, an action plan must be followed using medication,” Ms Clifton-Smith says.
In 2008, Mike Thomas’ large randomised controlled trial was published in Thorax (2009;64;55–61), showing physiotherapy-based breathing training programmes improved asthma control and reduced the impact of asthma on patients’ lives.
It improves quality of life, Ms Clifton-Smith says.
From 20 June, physiotherapists who have undergone specific training in the BradCliff method will be available in all the major centres of New Zealand.