Lennon, Marley and the paediatric asthma physiotherapist: all things we lost in the 1980s

Published:January 08, 2022DOI:https://doi.org/10.1016/j.paed.2021.12.006

      Abstract

      The management of asthma in children and young people changed dramatically in the 1980s, with the advent of inhaled corticosteroids and long-acting beta-2 agonists. The focus on these revolutionary new pharmaceuticals eclipsed previous therapy approaches that helped people with poorly controlled asthma, including physiotherapy. The number of deaths due to asthma initially fell, before plateauing, and despite a second revolution of targeted biological drugs, asthma deaths remain at an unacceptably high level. With this comes the realisation that asthma is much more complex than just the pathophysiological process; there are identifiable treatable traits, co-morbidity components and socioeconomic factors, meaning that an individualised approach, targeting the multidimensional components around asthma, has the biggest impact on symptoms and quality-of-life. Small pockets of excellence around the UK are leading the way in demonstrating the benefits of physiotherapist-led interventions, such as exercise and breathing retraining for dysfunctional breathing, in improving the health and wellbeing of young people with asthma. However, despite physiotherapy being recommended for children and adolescents with asthma, services remain sparse, under-resourced and under-used. This article provides a potted history of the demise and rebuilding of specialist physiotherapy provision within services for asthma. We review the innovations and research across the UK and suggest how we can break down barriers to accessing specialist physiotherapy within this new era of a modern, digitised NHS.

      Keywords

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      Further reading

        • Barker N.
        • Thevasagayam R.
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        Paediatric Dysfunctional Breathing: proposed components, mechanisms, diagnosis, and management.
        Front Paediatr. 2020; 8: 379https://doi.org/10.3389/fped.2020.00379
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