THE EFFICIENCY OF THE BUTEYKO METHOD IN IMPROVING THE FUNCTIONAL PARAMETERS IN THE BRONCHIAL ASTHMA-CASE STUDY

Abstract

This paper presents a case study concerning the efficiency of the Buteyco method in improving the functional parameters in the bronchial asthma. The basic principle for using this method is to maintain a constant level of carbon dioxide in the blood, by limiting the hyperventilation specific to the patients with asthma and by achieving a superficial nasal breathing associated to apnoea. Since the specialized studies show this method to be useful for the patients with bronchial asthma, in this case study we want to prove the practical efficiency of this method in limiting and even preventing the asthma crises. The results achieved support the hypothesis formulated, and by using this method we achieved: a decrease in the number of asthma attacks and of their severity, improved breathing dynamic and bronchial function by increasing the values of the VEMS (FEV1) and of the Tiffheau index (FEV1/FVC), as well as the control of the patient's state of panic. The Buteyko method offers an efficient and global approach for the disease. It can be used anywhere, at any given moment, offering a natural control over the symptoms of the bronchial asthma without using medication, supplements or inhalers. [PUBLICATION ABSTRACT]

Ochiana Gabriela1*,

Ochiana Nicolae2,

1,2Uiversity "Vasile Alecsandh", Marasesti 157, Bacau, 600115, Romania

Keywords: the Buteyco method, breathing, apnoea, obstructive respiratory dysfunction

Abstract

This paper presents a case study concerning the efficiency of the Buteyco method in improving the functional parameters in the bronchial asthma. The basic principle for using this method is to maintain a constant level of carbon dioxide in the blood, by limiting the hyperventilation specific to the patients with asthma and by achieving a superficial nasal breathing associated to apnoea. Since the specialized studies show this method to be useful for the patients with bronchial asthma, in this case study we want to prove the practical efficiency of this method in limiting and even preventing the asthma crises.

The results achieved support the hypothesis formulated, and by using this method we achieved: a decrease in the number of asthma attacks and of their severity, improved breathing dynamic and bronchial function by increasing the values of the VEMS (FEV1) and of the Tiffheau index (FEV1/FVC), as well as the control of the patient's state of panic.

The Buteyko method offers an efficient and global approach for the disease. It can be used anywhere, at any given moment, offering a natural control over the symptoms of the bronchial asthma without using medication, supplements or inhalers.

1. Introduction

The price of the asthma, paid by all the occidental countries, is huge, being quantified in money as well as in suffering.

The obstructive ventilatory dysfiinction (DVO) prevails in the acute and chronic bronchopulmonary affections which, due to their evolutionary potential, degrade continuously the breathing function, leading inevitably towards a respiratory insufficiency and a chronic pulmonary cord. The chronic bronchitis, the bronchiolitis (the obstructive disease of the small airways), the pulmonary emphysema, the bronchial asthma and the mucoviscidosis are nosological entities of the DVO, being classified in this group based on the reactions of the respiratory system face to the aggressive factors, and not according to certain aetiology (Cf. Hanson 2006). The bronchial asthma is distinctly defined due to its particular features, since it is an acute obstruction of the airflow. The chronic obstruction appears in time by associating elements of the chronic bronchitis or/and of the pulmonary emphysema. In this case, the recovery by means of physical therapy aims not actually at the disease, but at the functions disturbed (the dysfunctions).

The bronchial asthma affects people from different age groups, being a real burden for children as well as for their parents, fact which was statistically proved, since in most occidental countries the percentage of the asthma patients is of 25% in the case of children and 10% in the case of adults (Cf.Albu, C, Rascarachi, I., 2001). In my medical care activity, I have often met parents scared to see how their child chokes, coughs, is "thirsty for air" and has anxiety attacks and how his/her airways are obstructed by every breath he/she take. I have seen many times elderly people for whom the asthma attack was fatal (www.medscape.com).

Although at present there is a real industry devoted to inhalers, pills and mixtures that promise to relieve the pain, the asthma is the only chronic disease with a continually increasing morbidity rate. The medication can do nothing else but, in the best case scenario, reduce the severity of the symptoms, because even when the medicine is taken daily the symptoms continue to reappear, showing that there has been only a temporary improvement of the affection. (Cf. Sbenghe, T., 1996).

Ih our study, we started from the fact that the patients who experimented using the Buteyko method supported its efficiency, proving how the people affected by asthma can be helped and proving that in most cases the symptoms can be diminished or even eliminated and the need of medicine is reduced (www.buteykco.com).

The specialized medical literature quotes an impressive number of cases of bronchial asthma, thousands of cases, which were cured by Dr. Konstantin Pavlovich Buteyko by means of the method that got his name. This method has some advantages: the low cost and the adaptability according to the living space of each person.

The purpose of this study was to prove the relationship between the major symptoms of the asthma (bronchospasms, cough, blockage of the nose, etc) and the hyperventilation. By using the Buteyko breathing technique, known in the specialized literature as a therapy for the bronchial asthma, without using the specific medication, the life quality of the patients with bronchial asthma was improved by diminishing the symptoms and reducing the use of bronchodilator inhaled medication.

2. Material and methods

The assumption which was the starting point of this study is based on the fact that the bronchial asthma is caused by hyperventilation, the chronic hyperventilation leading to an imbalance between the levels of carbon dioxide and oxygen, thus causing asthma symptoms. The breathing of the asthma patients is usually deeper and more accelerated than usual, the patient is hyperventilated and thus the hypocapnia appears. According to the Bohr Effect, in which one of the vital roles of the carbon dioxide consists in freeing the oxygen into the tissue cells, when the level of carbon dioxide is low the haemoglobin retains more oxygen and as a consequence the amount of oxygen freed in the tissues is considerably lower. The low level of carbon dioxide causes many reactions such as: the contraction of the smooth muscles in the body (bronchoconstriction), the excessive production of histamine, tachycardia, SNC excitability and respiratory alkalosis.

Buteyko states that the hyperventilation is not only a consequence of the narrowing in the airway, but it is the very cause that leads to it.

This theory is also supported by the studies that proved that the asthma patients, even when they do not have the specific symptoms, breathe 10-15 litres of air per minute and not 4-6 litres as it is normal. Buteyko' s theory states that the narrowing of the airways (bronchoconstriction) is in fact a simple method by which the body tries to avoid losing a great amount of carbon dioxide. The main factor that stimulates the breathing is proper the level of carbon dioxide in the blood, the breathing being adjusted so as to maintain a constant level (www.buteykco.com).

The use of the Buteyko method in the case of asthma patients was based on the following hypithesis: if we use the Buteyko method in the recovery of the bronchial asthma, thus maintaining a constant level of carbon dioxide in the blood, then the bronchial asthma crises will be diminished or even stopped.

The research methods used - are the ones known in the specialized literature, and for the assessment we selected the most efficient tests used to determine the degree of bronchial obstruction, such as: the cyrtometric index, the VEMS (FEV1), the Tiffheau index (FEV1/FVC), the Seva score as well as the TA, FC and the FR

Content of the experiment

At frst, the research was carried out in a doctor's office and later at the subject's home, using only one subject, B.S., 37 years old, male, clinically diagnosed with: Therapeutically uncontrolled bronchial asthma. Moderate degree of obstructive ventilatory dysfunction. The duration of the physical therapy treatment using the Buteyko method was of 3 months, with a frequency of 5 sessions a week, the duration of a session being of approximately 30-45 minutes, 3 sessions a day.

Within the recovery programme, we focused on:

* Avoiding the polluted environment, avoiding the allergenic and infectious factors of any kind, administering the medication for the respiratory infections;

* The patient's relaxation in order to perform the correct breathing techniques. The most appropriate relaxation positions are: dorsal decubitus, with the upper limbs relaxed on the side of the body, knees flexed, the soles on the bed or in the position of the coachman on the coach box;

* Performing abdominal breathing exercises - which are initially taught in the dorsal decubitus position and later they will be performed in sitting position, in orthostatism or even while walking. The patient is taught how to fill his/her abdomen while inhaling, and while exhaling the abdominal wall is close to the spine, the movement being guided with the hand pressure.

* Application of the Buteyko method.

The Buteyko technique is actually an experimental method used with caution, based on the classical physical therapy breathing techniques, which are:

* Raising the patient's awareness concerning use of the airflow guiding technique on the level of the upper respiratory ways (inhaling through the nose);

* Explaining and understanding the breathing mechanism.

* Re-educating the breathing (rhythm, frequency), by lowering gradually the breathing frequency by 4-5 breaths for each stage.

Starting from the principle that the bronchial asthma is caused by hyperventilation, the defining element which customizes the Buteyko technique during the recovery is the rejection of the deep breathing.

The technique of the Buteyko method - includes several steps:

* The practice of slow breathing ("The Shallow Breathing Practice")The breathing is performed only through the nose, with the mouth closed, it is abdominal breathing, and superficially.

* Performance of the breathing - the patient is standing in vertical position and breathes superficially for 3 minutes.Is monitoring of the apnoea - Control Pause (CP). After a normal breathing cycle (inhaling/exhaling), the patient is asked to hold his/her nose and stop breathing. We record the period of time that the patient can hold his/her breath until he/she feels the slightest need for air. The patient breathes superficially for 3 minutes, after that follows a period of normal breathing He/she is asked to hold his/her nose and stop breathing again for 20 seconds, then 30 seconds and 40 seconds with breathes superficially for 3 minutes.

* The Buteyko technique used in the daily life consists in: - educating the patient to close his/her mouth during the sleep, the breathing being performed

3. Results and Discussions

The subject studied followed the physical therapy programme for 3 months, the focus being on the use of the Buteyko breathing technique. The physical therapy programme consisted in teaching the patient the correct way of performing the breathing technique and in performing it daily, at least once a day, respecting the parameters described: number of repetitions, duration, intensity, breaks, which finally led to the improvement of the functional deficiency, materialized through the improvement of the cyrtometric index by increasing the mobility of the thoracic cage, the difference between the inhalation and the exhalation increasing from 3 cm to 6 cm (figure 1).

After applying the Buteyko breathing technique, the obstructive breathing dysfunction came back to normal, the breathing volumes reaching values close to the normal ones, especially the maximum exhaling volume per second VEMS (FEV1)=100,2% and the Tifmeau index VEMS/CV (FEV1/FVC)=93,56%, diminished in the case of asthma because of the resistance of the airways to the exhalation flow, as it follows from figure 2.

In figure 3 is presented the score for the assessment of the airway obstruction, which corresponds to the value 0, as compared to the initial value 1 , materialized through the absence of bronchial sounds, cough, bronchial cast expectoration, rhinorrhea and dyspnoea.

Due to the use of the Buteyco method, we noticed:

* an improvement of the breathing dynamic and of the bronchial function by increasing the values of the VEMS (FEV1) and of the Tiffheau index (FEV1/FVC) as well as the improvement of the clinical symptoms (diminishing the cough, the quantity of sputum, the nasal congestion, the allergic reactions etc);

* the improvement in the patient's health was achieved immediately, after about one week of breathing exercise, the cough disappearing and the patient being able to breathe freely through the nose again;

* the limitation of the bronchodilating medication and of the inhaler.

4. Conclusions

After the study, we can state that the hypothesis was confirmed and we can draw a series of conclusions as follows:

* by applying the Buteyko method, we established the connection between the hyperventilation and the main symptoms of the bronchial asthma which diminished (bronchospasm, cough, expectoration, nasal congestion);

* the practice of this technique is based on raising the patient's awareness concerning the lowering of the breathing intensity and using the superficial breathing;

* the Buteyko breathing (the « Balance Volum Breathe » - BVB method) determines the decrease in the number of asthma attacks and their severity and also reduces the use of medicine;

* the method is efficient in periods of acute asthma, contributing to the improvement of the patient's general health and to the control of the patient's state of panic;

* the Buteyko method offers the patients an efficient and global approach for the disease. It can be used anywhere, at any given moment, offering a natural control over the symptoms of the bronchial asthma without using medication, supplements or inhalers.

* the Buteyko method or the Buteyko breathing technique is an alternative that suggests the re-teaching of breathing, as a treatment for asthma as well as for other affections: states of panic, cephalgia, anxiety, sleep apnoea, insomnia and dyspnoea, chronic obstructive pulmonary disorders - BPOC, pulmonary emphysema.

References

1. ALBU, C, RASCARACHI, I., ALBU, ?., RASCARACHI, G., ( 2001), §tifi sä respirati corect?, Edit. Polirom, Iasi

2. HARRISON, (2006), Principii de medicina interna - edi/ia a XIII-a, Edit. Teora, Bucuresti

3. OCHIANÄ, G., (2008), Kinetoterapia în afec/iuni respiratorii, Edit. Pirn Iasi

4. PLAS, F., HAGRON, E., (2001), Kinetoterapie activa, Edit. Polirom, Iasi

5. SBENGHE T., (1996), Recuperarea \a la domiciliul boina vului, Edit. Medicala- Bucuresti

6. www.buteyko.com

7. www.medscape.com

* E-mail: gabiochiana @yahoo.com, tel: [phone]

EFIGENIA METODEI BUTEYKO ÎN AMELIORAREA PARAMETRILOR FUNCJIONALI DIN ASTMUL BRONCIO STUDIU DE CAZ

Ochianä Gabriela1,

Ochiana Nicolae2,

1,2 Universi tatea "Vasile Alecsandri", Marasesti 157, Bacau, 600115, Romania

Cuvinte cheie: Metoda Buteyco, respirale, apne, disfuncfie respiratorie obstructiva

Rezumat

Lucrarea prezintä un studiu de caz cu privire la encienda Metodei Buteyco ìn ameliorarea parametrilor functionali din astmul broncie. Principiul de bazä al folosirii acestei metode este mentinerea constante a nivelului de dioxid de carbon din sange, prin limitarea hiperventilatiei specifica bolnavilor astmatici si realizarea unei respiratii nazale superficiale asociata cu apnee. Intrucât studiile de specialitate prezintä acestä metoda ca fiind utilä bolnavilor cu astm broncie, ìn acest studiu de caz dorim sä demonsträm eficienta practica a acestei metode ìn limitarea si chiar prevenirea aparitiei crizelor de astm.

Rezultatele ob^inute confirma ipoteza formulata iar folosirea acestei metode s-a ob^inut: seäderea numärului atacurilor de astm ci a severitätii acestora, s-a ìmbunatatit dinamica respiratici ci runctia bronhiilor prin cresterea valorilor VEMS (FEV1) si a indicelui Tiffheau (FEV1/FVC) ci controlul starii de panica.

Metoda Buteyko oferä practicantilor o abordare eficientä si globalä a bolii. Ea poate fi folositä oriunde, in orice moment, oferind controlul naturai asupra simptomatologiei astmului broncie, farà medicamente, suplimente sau utilizarea inhalatoarelor.

1. Introducere

Preful astmului, piatii de catre tóate tarile occidentale, este imens, exprimât atât în bani cât si în suferinte.

Disfìinctia ventilatorie obstructiva (DVO) domina afectiunile bronhopulmonare acute si cronice, care, prin potenziami lor evolutiv, degradeazä continuu functia respiratorie, conducând inevitabil spre insuficiem> respiratorie si cordul pulmonar cronic. Bronsita cronica, bronsiolita (boala obstructiva a cäilor aeriene mici), emfizemul pulmonar, astmul broncie, mucoviscidoza sunt entitäti nosologice ale DVO, fiind încadrate în acest grup pe baza reactiilor aparatului respirator la factorii agresori si nu dupä o anumitä etiologie (Cf. Hanson 2006). Astmul bronsic este définit distinct datoritä particularitätilor sale, fiind vorba de o obstructie acuta a fluxului aerian. Cu timpul, prin cronicizare, apare obstruera cronica, practic prin asocierea de elemente ale bronsitei cronice sau/si emfizemului pulmonar. în acest sens, recuperarea prin kinetoterapie se adreseazä de fapt nu bolii, ci functiilor perturbate (disfunctii).

Astmul bronsic afecteazä oameni de diferite categorii de varstä, fiind o adeväratä povarä atât pentru copii cât si pentru pärintii lor, fapt demonstrat statistic, deoarece în majoritatea tärilor occidentale procentul de bolnavi de astm este de 25% în rândul copiilor si 10% în rândul adulfilor (Cf. Albu, C, Rascarachi, I., 2001). în activitatea medicala am întâlnit frecvent paring speriati sä vada cum copilul se înneaca, tuseste, are "sete de aer" si atacuri de anxietate, iar cäile aeriene ìi sunt obstructionate cu fiecare gurä de aer inspirata. Nu de putine ori am väzut persoane vârstnice cärora atacul de astm le-a fost fatai (www.medscape.com).

Desi, actual, exista o adeväratä industrie de inhalatoare, pastile si preparate ce promit alinarea suferintei, astmul este singura afectiune cronica a cärei rata de îmbolnavire se aflä în crestere. Medicamentele nu reusesc nimic altceva decât, în cel mai bun caz, sä reduca severitatea simptomelor, deoarece chiar si atunci când medicatia este administratä zilnic, simptomele continua sä reaparä, neînregistrânduse decât o ameliorare temporarä a afectiunii (Cf. Sbenghe, T., 1996).

în studiul realizat s -a plecat de la realitatea cä pacientii care au expérimentât si utilizai metoda Buteyko au sustinut encienta acesteia, demonstrând cum pot fi ajutati cei afectati de astm si cä în majoritatea cazurilor simptomele pot fi diminuate sau chiar eliminate, iar nevoia de medicamente redusä (www.buteykco.com) .

Literatura medicala de specialitate citeazä un numär impresionant de cazuri de astm bronsic, de ordinul miilor, vindecate de cätre dr. Konstantin Pavlovich Buteyko prin metoda care-i poartä numele. Metoda are unele avantaje, respectiv costui redus si adaptarea la spatiul de locuit a fiecärei persoane.

Scopul studiului a fost de a demonstra relatia dintre simptomele majore ale bolii astmatice (bronhospasm, tuse, blocaje ale nasului, etc) si hiperventilatie. Folosirea tehnicii de respiratie Buteyko, cunoscutä în literatura de specialitate ca o terapie pentru astmul bronsic, farà utilizarea medicatici spécifiée, a avut drept scop ìmbunatatirea calitätii vietii pacientilor cu astm bronsic prin atenuarea simptomelor si reducerea folosirii medicatici inhalatorie bronhodilatatoare.

2. Materiale si metode

Premisa de la care s -a plecat în acest studiu are la baza faptul cä astmul bronsic este cauzat de hiperventilatie, hiperventilatia cronica determinând un dezechilibru ìntre nivelurile de dioxid de carbon si oxigen, cauzând simptome de astm. Respiratia astmaticilor este de obicei mai adânca si mai accelerata decât în mod normal, pacientul se hiperventileazä si astfel se produce hipocapnee. Conform efectului Bohr prin care unul din rolurile vitale ale dioxidului de carbon consta în eliberarea oxigenului in celulele tesuturilor, atunci când nivelul de dioxid de carbon este scäzut, hemoglobina retine mai mult oxigen, prin urmare cantitatea de oxigen eliberata ìn tesuturi este considerabil mai mica. Nivelul scäzut de dioxid de carbon provoacä numeroase alte reactii cum ar fi: contraeva musculaturii netede a organismului (bronhoconstrictia), producere de histamina în excès, tahicardie,excitabilitatea SNC, alcaloza respiratorie.

Buteyko sustine cä hiperventilatia nu este doar o consecinta a ìngustarii cäilor aeriene, ci chiar cauza care o provoacä. Aceastä teorie este confirmata si de studii care au demonstrat cä astmaticii, chiar si când nu prezentä simptomele corespunzatoare, respira un volum de aer de 10-15 litri pe minut si nu 4-6 litri, cum ar fi normal. Teoria lui Buteyko sustine cä îngustarea cäilor aeriene (bronhoconstrictia) este de fapt o metodä simplä, prin care corpul ìncearca sä evite pierderea unei cantitäti prea mari de dioxid de carbon. Principalul factor care stimuleazä respiratia este mentinerea nivelului de dioxid de carbon din sänge, respiratia fiind ajustatä astfel încât nivelul sä rämanä constant (www.buteykco.com).

Utilizarea metodei Buteyko la bolnavii astmatici a avut la baza urmatoarea ipotezä: daca în recuperarea astmului bronsic se va foiosi metoda Buteyko prin mentinerea unui nivel constant de dioxid de carbon în sänge, atunci crizele de astm bronsic vor fi diminuate sau chiar stopate.

Metode de cercetare folosite - sunt cele cunoscute ìn literatura de specialitate, iar pentru evaluare am selectat cele mai eficiente teste pentru determinarea gradului de obstructie bronsicä, astfel: indicele cirtometric, VEMS-ul (FEV1), indicele Tiffneau (FEV1/FVC), scorni Seva, precum si TA, FC, FR.

Continutul experimentului

Cercetarea s-a desfasurat, la ìnceput, ìntr-un cabinet medical si ulterior, la domiciliul subiectului pe un subiect B.S., 37 de ani, sex M, diagnosticai clinic cu: Astm bronsic necontrolat terapeutic. Disfunctie ventilatorie obstructiva moderata. Durata tratamentului kinetoterapeutic, prin folosirea metodei Buteyko, a fost de 3 luni, cu o freeventä de 5 sedinte pe säptämanä, durata sedintei fiind de aproximativ 30-45 minute, 3 sedinte pe zi.

în cadmi programului de recuperare s-a pus accent pe:

* Evitarea ambientului poluant, evitarea factorilor alergeni si infectiosi de orice tip, administrarea medicatici corespunzatoare infectiilor respiratorii;

* Relaxarea pacientului în vederea abordärii tehnicilor coréete de respiratie. Pozitiile de relaxare cele mai adeevate sunt: în decubit dorsal, membrele superioare reláxate pe langa corp, genunchii flectati, plántele pe pat sau pozitia birjarului pe capra;

* Executarea exercitiilor de respiratie abdominalä - initial se învata în pozitia de decubit dorsal si ulterior se va exécuta din pozitia sezânda, din ortostatism si chiar din mers. Pacientul este învatat sä-si bombeze abdomenul în timpul inspirului, iar expirul se exécuta concomitent eu apropierea peretelui abdominal spre coloanä, miseärile putând fi ajutate de presiunea mâinilor.

* Aplicarea metodei Buteyko.

Tehnica Buteyko este, practic, o metodä experiméntala, utilizata cu precautii, bazatä pe tehnicile kinetoterapeutice respiratorii clasice, si anume:

* Constientizarea pacientului privind folosirea tehnicii de dirijare a coloanei de aer la nivelul cäilor respiratorii superioare (inspiratia pe ñas);

* Explicarea si íntelegerea mecanismului de respirare.

* Reeducarea respiratici (ritm, frecventä), prin scaderea progresiva a frecventei respiratorii cu 4-5 respiragli pentru flecare treaptä.

Pornind de la principiul conform cäruia astmul broncie este cauzat de hiperventilaîie, elementul defmitoriu care individualizeazä tehnica Buteyko în cadmi recuperarli este neacceptarea inspirului profund.

Tehnica Metodei Buteyko - cuprinde mai multi pasi si anume:

* Practica respiratici lente ("Practica Shallow Breathing"). Respiraba se realizeazä numai pe ñas, cu gura închisa, de tip abdominal si superficialä.

* Executarea respiratici - pacientul sta în pozitie vellicala si respira superficial timp de 3 minute. Se monitorizeazä starea de apnee - Control Pause (CP). Dupä un ciclu respirator normal (inspir/expir) pacientul este rugat sä-si penseze nasul si sä-si opreascä respiratia. Se cronometreazä timpul cât subiectul îsi poate mentine respiratia înainte de a resiniti cea mai mica nevoie de aer. Apoi, pacientul respira superficial timp de 3 minute, urmeazä o respiratie nórmala, acesta este rugat sä-si penseze nasul din nou si sä-si opreascä respiratia timp de 20 secunde, apoi 30 si 40 secunde cu intercalarea celor 3 minute de respiratie superficialä.

* Tehnica Buteyko folositä în viata de zi cu zi consta în - educarea pacientului privind ìnchiderea guru în timpul somnului, respiratia realizându-se nazal si limitarea utilizarli medicatici bronhodilatatoare si a inhalatorului.

3. Rezultate si discucii

Subiectul aflat în studiu, a urmat programul kinetoterapeutic timp de 3 luni, baza fiind folosirea tehnicii de respiratie Buteyko. Programul de kinetoterapie a constat în învatarea de catre pacient a modului de executare a tehnicii respiratorii si executarea zilnicä a acesteia, macar o data pe zi, cu respectarea parametrilor descrisi: numär de executii, durata, intensitate, pauze, ceea ce în final a condus la ameliorarea deficitului functional, obiectivizat prin ameliorarea indicelui cirtometric în sensul cresterii mobilitätii cutiei toracice, diferenta dintre inspir si expir crescând de la 3 cm la 6 cm (figura 1).

în urma aplicärii tehnicii de respirare Buteyko, disfunctia respiratorie obstructiva s-a normalizat, votomele respiratorii atingând valori apropíate de normal, în special volumul expirator maxim pe secunda VEMS (FEV 1)= 100,2% si indicele Tifmeau VEMS/CV (FEV1/FVC)=93,56%, diminuât în astm din cauza rezistenjei cäilor respiratorii la fluxul expirator, asa cum reiese din figura 2.

în figuea 3 este prezentat scorni de evaluare a obstructiei cäilor aeriene, care corespunde valorii 0, comparativ cu 1 initial, tradusä prin absenta zgomotelor bronsice, a tusei, expectorare! bronsice, rinoreii, dispneii.

Ca urmare a folosirii metodei Buteyco s-a constatât:

* îmbunatatirea dinamicii respiratorii si functiei bronhiilor prin cresterea valorilor VEMS (FEV1) si a indicelui Tiffiieau (FEV1/FVC) precum si ameliorarea simptomelor clinice (diminuarea tusei, cantitätii de sputa, congestiei nazale, reactiilor alergice etc);

* aprecierea stärii de sänätate a pacientului s-a realizat imediat, dupä aproximativ o säptämanä de practicare a respiratici, tusea dispärand, iar pacientul a putut respira liber pe ñas;

* limitarea utilizärii medicatici bronhodilatatoare si a inhalatorului.

4. Concluzii

In urma studiului realizat se poate afirma cä ipoteza s-a confirmât si se pot formula o serie de demente concluzive astfel:

* prin aplicarea metodei Buteyko s-a stabilii legatura dintre hiperventilatie si simptomele defmitorii ale astmului broncie care s-au diminuât (bronhospasm, tuse, expectorare, congestie nazalä);

* practicarea tehnicii se bazeazä pe constientizarea pacientului asupra scadérli profunzimii actului respirator si realizarea unei respiratii superficiale;

* respiratici Buteyko (metoda de « Balance Volum Breathe » - BVB) determina seäderea numärului atacurilor de asmi si a severitätii acestora precum si reducerea dozei de medicamente utilizate;

* metoda este eficientä ìn perioadele acute de astm, contribuind la ìmbunatatirea stärii generale a pacientului si controlul stärii de panica;

* metoda Buteyko oferä practicantilor o abordare eficientä si globalä a bolii. Ea poate fi folositä oriunde, ìn orice moment, oferind controlul naturai asupra simptomatologiei astmului broncie, farà medicamente, suplimente sau utilizarea inhalatoarelor.

* metoda Buteyko sau Respiraba Tehnicä Buteyko reprezintä o alternativa care propune recalificarea respiratici, ca tratament pentru astm, precum si alte conditii : stari de panica, cefalee, anxietate, apnee in somn, insomnie si dispnee, tulburäri pulmonare obstructive cronice - BPOC, emfizem pulmonar.

Bibliografìe

1. ALBU, C, RASCARACHI, L, ALBU, ?., RASCARACHI, G., ( 2001), §tifi sä respirati corect?, Edit. Polirom, Iasi

2. HARRISON, (2006), Principii de medicina interna - edi/ia a XIII-a, Edit. Teora, Bucuresti

3. OCHIANÄ, G., (2008), Kinetoterapia ìn afec/iuni respiratorii, Edit. Pim Iasi

4. PLAS, F., HAGRON, E., (2001), Kinetoterapie activa, Edit. Polirom, Iasi

5. SBENGHE T., (1996), Recuperarea \a la domiciliul boina vului, Edit. Medicala- Bucuresti

6. www.buteyko.com

7. www.medscape.com