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Inspiratory Muscle Training Products do they help asthma suffers ?

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I have come across resistance training breathing products. Has anyone had experience of them and does it help asthma suffers who exercise ? Or are they just a gimmicks ? I have a tendancy not to trust manufacturers websites.

Thanks

Nigel a runner.

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52 Replies

Hi Nigel

You mean Powerbreath, I have one, had it before I had asthma, and it worked before my asthma days, but does it help with asthma, simple answer is don't know. They are designed to help strengthen the muscles, and as this isn't usually a problem associated with asthma my bet would be no, but then they do make you use the full capacity of your lungs, so in that respect may be of benefit, but as you run like myself, just save your money, and enjoy a run.

Chris

Had i still been at uni doing sports science I hopfully woudl ahve been able to give you an answer as I was goign to study for my dissertation the effects of respitaotry muscle traingin on asthmatics but sadly due to asthma i was nto able to complte it.

i am however hoping in the furture to be able to start it up agian and do the research.

i think they are quite good but there is very little hard evidence to say yes they do work.

also ahve a look at the powerlung too.

olive

Thanks for the replies. Pity there isn't more research. As long as I take my inhaler 5-10 minutes before the run Im good.

Nigel

Powerbreathe

I was still an athlete before the accident that caused my asthma and I used Powerbreathe as part of my training regime, I was also advised to use it when I was first diagnosed - and it did help. As my asthma evolved, though, I was told to stop using Powerbreathe, so before you use it I would advise that you consult your asthma specialist.

Kindest regards,

John

Tried it for about 6 months just made me more wheezy

Tried a powerbreathe product for about 6 months but every single time it resulted in a wheeze after doing the recommended number of puffs in a session. Gave it a few goes (left it a week or two in between up to a month) as had hoped would improve my lung capacity but didnt seem to work for me.

while looking for research papers on another topic, this one actually does suggest a benefit.

tinyurl.com/yebnote

Inspiratory Muscle Training Products do they help asthma suffers ?'

On success with Powerbreathe I reckon the following from a specialist is good guidance

“When you are comfortable with that full five minute session, then increase your work load by about 5 cm H2O, and start again to build up to a comfortable five minute exercise time. Note, if initially your muscles are very weak, you may lower your inspiratory load about 10 to 20 cm H2O, as well as reducing your work time to only a minute or so. In this case, also gradually increase your work load as well as your exercise time as your strength and exercise fatigue improves.

When should you stop your IMT (aka Powerbreathe) program? Ideally, you should again have your Maximum Inspiratory Pressure measured. If you are able to achieve a MIP of 80 to 90 cm H2O pressure you have probably achieved your therapeutic goal and will no longer benefit from further IMT. Otherwise, if you can exercise for about ten minutes with an inspiratory work load of 40 cm H2O you will probably have reached your training goal.” (see sierrabiotech.com/bt_copd_i... )

To monitor suction pressure with Powerbreathe and to find your maximum inspiratory pressure (MIP), simply make a 2mm hole in the side of the PVC mouthpieceof the Powerbreathe or some other similar device to receive the top end of a suitable length of 2mm tubing as used in infusion sets to be bought very cheaply at a pharmacist/chemist. Then see how far you can draw up colored water from a bottle. Monitoring Powerbreathe in this way gave me a much better incentive. I personally think that pressure monitoring is the key to success. With a bit of tinkering about you can do IMT without a professional gadget as follows:

To make the choke or resistor to inhale through, roll up a 6cm x 2cm piece of PE blister foil as used in aroFOL padded envelopes. After popping some of the blisters to get the right degree of resistance, breathe through the roll in the 2cm length direction and you will find you can vary the amount of resistance by squeezing radially. This roll of strip is secured on the one end of the monitoring tube so that IMT training is quite possible with some practice. RF.

Richard; don't mean to sound offensive here however your three posts regarding 'Powerbreathe* are exactly the same! Are you trying to sell it or something? Just curious as yes fully get the improvment bit re: muscles but to me that is generating a false benefit somehow???

Hmm fair point Emlou, does seem to have been busy posting

best thing is to see a physio....... discuss it with your gp or consultant who can refer you on...... the physio can assess if it will help and usually issue something free of charge !!!!!!!!

Cheers TJ I just found it rather bizarre as these threads are not recent. The posts were odd with details and stuff. I just did not get the benefit etc. Think I'll stick with my flute!

Gusspypoo defo sound advise there.

EDIT - Free now thats my kind of thinking :D

For some general guidance on Powerbreathe and similar appliances, see

sierrabiotech.com/bt_copd_i... by the reputed respiratory therapist Deane Hillsman. He talks in terms of a water column for suction pressure. To measure this conveniently at home, make a roll of a piece of PR blister foil (such as “aroFOL”) measuring about 5 X 15 cms. If this is placed in the mouth one may breathe through it in its length direction. Place the one end of a length of 2mm. PVC tube of the type used in infusion sets and sold at a low price at chemists. The other end is placed in a glass of colored water at a lower level. Now you can either draw in air through the roll either more or less freely or with a substantial restrictive effect as a choke. In the latter case you can monitor the suction effect directly as the degree the colored water is drawn up the PVC tube.

Hmm, Richard you have not answered emlou's question below about do you have a commercial interest in this product?!

I'm also curious as to whether this is actually a (not so subtle) method of advertising this product. I PM'd Richard a couple of days ago asking if he had any commercial interest in this product, and haven't yet had a response. Today I referred the comment from Richard with the link in to the moderators as I believe it's bordering on spam.

I had a Google around and I couldn't find any peer-reviewed evidence on the Powerbreathe having any significant beneficial effect on people's asthma control.

I've never heard of this thing but it does sound rather like you could get the same effect (and have more fun!) learning to play a wind instrument. Though your family/neighbours might prefer you to stick with the training product lol

I can definitely speak for the fact that high PFs don't necessarily mean your asthma is better! Just seems to make life more difficult as you're forever trying to explain you're still struggling even if PFs are above predicted. Though I guess it's possible I could be a lot worse without that.

angievere profile image
angievere

There have been similar threads on PowerBreathe before. We brought one for £40 years ago and got NO benefit from it at all. They are now much cheaper. I asked our consultant about it at the timeand his response 'Wont do any good, wont do any harm'...

Richard Friedel obviously has a commercial interest in PowerBreathe.

Philomela defo agree with the PF thing there. It is so frustrating. I have found I get no proper help until I get admitted. My consultant told me to keep playing through bad spells - not that I ever get much noise out at these times! Ah ha much to the hubbies pleasure! :P

Reply to Inspiratory Muscle Training Products do they help asthma sufferers

Well, obviously IMT with the muscle training-detraining scenario has put a different perspective on chest diseases like asthma.

Indeed, according to Professor Alison McConnell and and others it is all rather dull and a question of patient exercise without any magic bullet just round the corner producing a dramatic effect.

See sierrabiotech.com/bt_copd_i... for some general points on IMT without mentioning asthma. In view of this added scientific knowledge and in view oi the ever-increasing amount of asthma accompanying modern medical treatment it cannot be sound and cautious medical advice to prefer modern drug treatment over IMT or to define the disease as something only able to be drug-influenced. More specifically using muscle-relaxing drugs obviously weakens the power to inhale, or can anybody show that this is not the case? RF

More specifically using muscle-relaxing drugs obviously weakens the power to inhale, or can anybody show that this is not the case? RF""

Richard, I'd suggest as you are the one making this assertion, the onus is on you to provide the evidence for your statement.

You've also not responded to any queries whether you have a commercial interest in this product.

Many asthmatics have no issue in breathing in - inspiration. The problem is breathing out - expiration which results in hyper inflated lungs as shown in x ray!

I remain unconvinced that this device is effective at all.

Richard are you insinuating that asthma is just an issue of breathing in/inspiration? To claim to be cured of asthma by such a device is alarming as your profile states.

Its not endorsed by Asthma UK or recommended by hospital so I wouldn't touch it with a barge pole as an asthma sufferer. Maybe if i was a non asthmatic athlete I would consider it but I'm not. If it truely worked for asthmatics AUK would have told us, they have not so I would say don't raise your hopes or waste your money fellow asthmatics.

Joint reply

To Lois:

The important point is that IMT- inspiring against a resistance/choke - increases the inspired volume. This may need some, to my mind honest, hard work, but this is better than the prospect of life-long, merely symptpmatic medication. Seen from this perspective IMT would seem a scientific step forward to be taken advantage of, unless there is some fatal flaw.

To emlou:

Asthma is likely to lead to dynamic hyperinflation but even so a bronchodilator provides relief by letting in more air.

To queerpup:

If you accept that IMT increases vital capacity, then you must have some basic mistrust – but could you be more specific?

The conclusion that asthma drugs cause asthma seems obvious, since they would thwart dynamic physiological adaption and natural training of the body.

See statistics on . ( Asthma and the Indoor Environment - Current Issues and Potential Strategies, by Dr Gillian Durham Chief Executive Public Health Commission .(moh.govt.nz/notebook/nbbook... especially page 7) RF.

Richard if I understand your post correctly you would appear to be saying that asthma meds cause asthma? Am sure I have misunderstood this as asthma meds save lives, asthma is something that is not always taken seriously and still in the UK people die of asthma on a daily basis. There would be more deaths if people did not comply with their meds. In short asthma is not an illness that should be taken lightly, fair enough if you were promoting say a dietry aid that at worst would only result in weight gain but you are not. Fact; asthma kills and as such any products such as this should, to my mind be used only if endorsed by Asthma UK, or the NHS. I would say if you are asthmatic don't touch this product with a barge pole. Until AUK or the NHS say its safe that is.

If you accept that IMT increases vital capacity, then you must have some basic mistrust – but could you be more specific?""

Richard, lung capacity isn't the be all and end all.

Asthma's a disordered inflammatory response by the airways. When healthy, the lungs could have vasy capacity, but when they inflame & fill with mucus, all the capacity in the world won't make breathing more easy.

Increased capacity is clearly going to be helpful to athletes, singers, musicians. And good strong lungs may well help someone with mild asthma (like me) fend off attacks, but when attacks happen tgst increased capacity isn't that much help.

Bronchodilators don't ""weaken muscles"", they relax the airways temporarily allowing air to pass through them. they work on the smooth muscles of the bronchioles. Lung capacity trainers work on the chest muscles & diaphragm - not the muscles like those of the bronchioles that aren't under voluntary control.

Please take your advert elsewhere.

angievere profile image
angievere

Reported this thread to moderators as it is advertising.

Increasing inspired volume: device or medication?

Increasing inspired volume: device or medication?

As I posted, the effect of inspiratory muscle training and the immediate effect of inhaling against a resistance is to increase the inspired volume. Asthma sprays also increase the inspired volume, but their use is accompanied by an ever increasing rise in asthma. Unless there is some flaw or fallacy in the muscle training hypothesis, it is really hard to understand why inspiratory muscle training should not be generally recommended by the medical profession. RF.

Moderator Message (warning - contains boring respiratory physiology, sorry)

Some interesting concepts on this thread...

Bronchodilators work by activating beta-2 adrenoreceptors in bronchial smooth muscle (which is not under voluntary control) in order to relax them. This has no effect on your inspiration capacity, as this is primarily controlled via the diaphragm and, to some extent, by the intercostal muscles - both of which can be under voluntary control.

I would argue that, actually, physiologically, bronchodilators primarily increase EXPIRED capacity, rather than inspired capacity - one of the major physiological effects of bronchoconstriction is that it becomes significantly more difficult to get air out, rather than in; consequently, in acute severe asthma, there is a degree of hyperinflation of the lungs as expired volume tends to be less than inspired volume. The respiratory muscles (by which I am referring to the whole combination of the diaphragm, intercostal muscles, and accessory muscles such as the upper trapezius muscles) are more efficient in inspiration than in expiration.

In chronic asthma, inhaled steroids will also help to increase bronchodilation by reducing inflammation in the airways, and hence decreasing airflow obstruction.

Hence, I'm not sure where the assertions ""asthma drugs cause asthma"" comes from.

Anyhoo, I'm not against devices such as Powerbreathe - I own one myself, but only in the context of trying to improve my running, and I have to say I feel it has helped somewhat in this context, perhaps. I can't see that it's detrimental to strengthen the inspiratory muscles at all - it can only help.

Someone made reference to learning to play a wind instrument to help - this may be more relevant, as this concentrates your respiratory strength training on using your diaphragm to force air out (in a controlled fashion, of course!).

I don't think Richard is advertising as such - just think he is passionate about this subject.

CathBear

(Moderator)

Thanks for the teaching session Cathbear ;) Don't know about anyone else but I kindof miss the medical knowledge that was here a few years ago

Not that I was around a few years ago but thanks CathBear as well, that was interesting.

Also great to know how good playing the oboe is for me. If I ever manage to a) get it serviced and b) get rid of this cold as I don't think coughing constantly is going to help me get the notes out.

More physiology

A physiological issue is connection with inspiratory muscle training is the muller maneuver: inhaling against a resistance reopens collapsed airways. See for example scribd.com/doc/50203970/Air.... Apologies to T.J. again for the mention of a proprietary source, but see ers-education.org/media/200... on this maneuver in the IMT context.

As for the position that asthma drugs do not cause asthma, the IMT research stresses the dependency of effective muscle action for lung inflation. Where is the argument that unloading inhalation muscles would not weaken them? The topic cannot be taboo. There is a book on the subject generally in the field, see “Drug-induced and Iatrogenic Respiratory Disease” P. Camus et al.

IMT is also being used for heart conditions, at least in research. RF.

Text book on Respiratory Disease

A Google look inside search of “Drug-induced and Iatrogenic Respiratory Disease” P. Camus et al. turns up the wording (page 71) “Collapse of upper airway structures during deep inspiratory efforts” This contrary to received IMT concepts. Too much conservatism? RF

Why state ""Apologies to T.J. again for the mention of a proprietary source""?

Further pro-IMT argument

A further strong theoretical argument in favor of IMT is provided by research of Dr. Gwen Skoot

“Our laboratory focuses on clinical asthma studies. We hypothesize that hyperresponsiveness is caused by impairment in the ability of inspiration to stretch airway smooth muscle (ASM) -- i.e. impaired bronchodilation. This hypothesis is supported by our finding that sensitivity to the constrictor agent Methacholine is the same in normals and asthmatics when challenge is conducted without deep breaths. It is also known that deep inspiration (DI) prior to a constrictor agent is bronchoprotective in normal subjects. We have shown that this effect relates to inspiratory velocity, i.e. a fast DI is more bronchoprotective than a slow DI. We speculate that in healthy subjects, DI stretches ASM and breaks cross bridges and that cross bridge breakage is enhanced with increased inspiratory velocity. In asthmatics, inflammation may impair this ability. Further protocols will focus on the mechanism of the impaired response to DI in asthma in order to ultimately develop interventions to treat this aspect of hyperresponsiveness. “mountsinaifpa.org/profiles/...

To Lois:

The important point is that IMT- inspiring against a resistance/choke - increases the inspired volume. This may need some, to my mind honest, hard work, but this is better than the prospect of life-long medication. Have you any objection to the statement that the relaxing effect of asthma drugs would weaken chest breathing muscles. Seen from this perspective IMT would seem a scientific step forward to be taken advantage of, unless there is some fatal flaw.

To emlou:

Asthma is likely to lead to dynamic hyperinflation but even so bronchodilator provides relief.

To queerpup:

If you accept that IMT increases vital capacity, then you must have some basic mistrust – but could you be more specific?

The conclusion that asthma drugs cause asthma seems obious, since they would thwart physiological adaption.

I remain unconvinced that this device is effective at all.

Richard are you insinuating that asthma is just an issue of breathing in/inspiration? To claim to be cured of asthma by such a device is alarming as your profile states.

Message this user Report this post

• queerpup 07 Jan 12 9:16am

"" More specifically using muscle-relaxing drugs obviously weakens the power to inhale, or can anybody show that this is not the case? RF""

Richard, I'd suggest as you are the one making this assertion, the onus is on you to provide the evidence for your statement.

You've also not responded to any queries whether you have a commercial interest in this product.

You wrote: ""Richard if I understand your post correctly you would appear to be saying that asthma meds cause asthma? Am sure I have misunderstood this as asthma meds save lives, asthma is something that is not always taken seriously and still in the UK people die of asthma on a daily basis. There would be more deaths if people did not comply with their meds. In short asthma is not an illness that should be taken lightly, fair enough if you were promoting say a dietry aid that at worst would only result in weight gain but you are not.""

Asthma drugs are purely symptomatic as nobody is denying The novel challenge of IMT that asthma depends on the effectiveness/in effectiveness of the breathing muscles was not taken into account in the development of asthma drug treatment in the last fifty years or so. RF

To lois

You wrote: on 12.1 ""Richard if I understand your post correctly you would appear to be saying that asthma meds cause asthma? Am sure I have misunderstood this as asthma meds save lives, asthma is something that is not always taken seriously and still in the UK people die of asthma on a daily basis. There would be more deaths if people did not comply with their meds. In short asthma is not an illness that should be taken lightly, fair enough if you were promoting say a dietry aid that at worst would only result in weight gain but you are not.""

Asthma drugs are purely symptomatic as nobody should be denying Ask a doc what the consequence of using symptomatic medication as cure is likely to be. The novel challenge of IMT that asthma depends on the effectiveness/ineffectiveness of the breathing muscles was not taken into account in the development of asthma drug treatment in the last fifty years or so. RF

The conclusion that asthma drugs cause asthma seems obious, since they would thwart physiological adaption.""

Richard.

This is to be my final reply. I believe you are peddling a product that has no proven efficacy in the treatment of asthma. I think your presence here is unhelpful at best, and possibly mischievous.

1) Asthma occurs in people that have never used asthma drugs. Or any type of bronchodilator.

Asthma diagnoses are increasing, but they are increasing along with environmental pollution and exposure to industrial contaminants. All or the vast majority of asthma diagnoses are made in people that have never used bronchodilators in their lives. It is not the use of bronchodilators that is causing increased asthma diagnosis.

2) I have no issue with the idea that IMT increases lung capacity. I want you to show me that there is a correlation between lung capacity in the asthmatic, and severity of asthma symptoms. I do not believe there is adequate evidence to show increasing lung capacity is useful as a lone method of controlling asthma symptoms.

It has been pointed out that bronchodilators act on the involuntary, smooth muscle. IMT works on the voluntary muscle. Improving the strength of the voluntary muscles may help people manage asthma symptoms, but if the involuntary muscles swell and go into spasm, there is very little the voluntary muscles can do.

I don't think you actually have any evidence, you're just pointing people at one person's book, it isn't peer reviewed, and it doesn't have the backing of any rational asthma organisation or national health organisation. It may have use in sports training, and may be helpful in improving overall lung capacity, but it's not a cure for asthma.

I'd also like to add, you have still not responded to my Private Message inquiring whether you're commercially interested in this product.

Hearhear, queerpup

angievere profile image
angievere

Well said Queerpup!

Ditto queerpup! Nice one :D

Asthma drugs are purely symptomatic as nobody should be denying Ask a doc what the consequence of using symptomatic medication as cure is likely to be.""

Again, you appear to be referring only to bronchodilators. Inhaled corticosteroids, long-acting bronchodilators, leukotrine receptor antagonists, theophyllines and oral steroids ALL address underlying pathological processes in asthma. (I am a doctor, by the way)

""The novel challenge of IMT that asthma depends on the effectiveness/ineffectiveness of the breathing muscles was not taken into account in the development of asthma drug treatment in the last fifty years or so.""

Asthma doesn't depend on the effectiveness or ineffectivenes of your respiratory muscles. It's really rather more dependent on the degree of bronchospasm and inflammation within your airways....

From an IMT enthusiast

As I said, the NHS is giving its blessing to IMT by making a device prescribable. “Inhaled corticosteroids, long-acting bronchodilators, leukotrine receptor antagonists, theophyllines and oral steroids” as mentioned by you are also merely symptomatic and not causal. Although, fairly stated, acceptance of IMT for asthma might be a bitter pill and slap in the face for doctors’ present asthma etiology you will surely be hoping with me that IMT as a pragmatic and non-theoretical approach is not utopian and is safe. It may well be argued that it is an albeit rather tough natural cure. RF

Richard, I'm not sure whether some of what I am saying is getting lost in translation, or if I am misunderstanding you. Inhaled corticosteroids, long-acting bronchodilators, leukotrine receptor antagonists, theophyllines and oral steroids are NOT treating the symptoms of asthma, they are treating the well-demonstrated and scientifically proven underlying pathological causes of asthma, such as allergy pathways, histamine release and global inflammation.

Whilst I accept IMT may a useful adjunct in the management of asthma symptoms, I'm afraid I have seen no evidence to suggest that it can address the underlying allergic, inflammatory and immune aspects of asthma pathogenesis.

A curative asthma medication from the pharma industry - just a vain quest?

The point, Cathbear, is that they (inhaled corticosteroids, long-acting bronchodilators, leukotrine receptor antagonists, theophyllines and oral steroids ) do not cure asthma. What you are really saying is that there are different types of symptom suppressing drugs, all with their different side effects. That is the bitter truth.

You seem to be putting the cart before the horse and groping in the dark if you talk about “well demonstrated underlying pathological causes of asthma, such as allergy pathways” if the current medical wisdom is that the cause of asthma is unknown. Just why should there be a curative asthma pill or spray waiting for us? Let us hope that IMT succeeds. Jenner, Louis (on blood letting) and Semmelweis as successful medical researchers had a different type of originality. RF.

Richard, I think Cathbear's point is (and Cathbear, I hope I have this right, not being a medic of any description):

-Nobody really knows what causes asthma, as in no-one knows why some people develop asthma pathology. However, although there is more that can be learned, we do know what happens in the basic underlying processes, as Cathbear said.

-The long-term preventer medications can't cure this, no, as in they can't stop it ever coming back, the inflammation and symptoms will return if you stop taking them and they sometimes have an uphill struggle with some people and when a person comes into contact with a trigger.

-However, they can in many cases control the pathology so it doesn't cause many symptoms. If you removed the medication, the underlying processes would flare up again and the symptoms would come back, so they aren't cured by the medication but they can be made manageable a lot of the time so they don't interfere with people's lives too much.

-On this forum, there are a lot of people for whom this doesn't work so well; that's why a lot of us are here, because, at varying levels of severity, we haven't managed to get control or have lost control (the current holy grail of asthma treatment as there isn't a cure right now) and want to talk about it. Even then, I suspect pretty much all of us would be considerably worse off without our medication. You may have seen posts saying that such and such a medication seems to be making someone worse. This does seem to happen sometimes but it doesn't mean that medication doesn't work very well for someone else, or that another medication won't do the job if the first one doesn't.

I know I'm not that well controlled, but I went a long time with no medication at all because I was told I wasn't asthmatic and didn't need any, and believe me, it was most definitely worse without any medication. I'm a wind player and singer and that made no difference except to my peak flow readings; I could hardly walk around (slowly) without getting exhausted. Leukotriene receptor antagonists and, more recently, the addition of another reliever, have meant I'm able to do a lot of things as normal which I couldn't before.

Sorry for the long post but I felt I had to reply to this.

yaf_user681_4328 profile image
yaf_user681_4328

My current preventer inhaler is not working but I just need to swap it to another one !

I also didn't have inhalers for ages as I was told it couldn't be asthma as I was not wheezing

but this are better with using salbutmol even if I use alot

To queerpup,

People's general mistrust was quite sound. The imt device (Powertbreathe ) I used had the effect of requiring a big suction effect during a deep breath. Since the body is not designed for creating this suction , respiration can be impaired and asthma worsened. It seems to be a sad little tale, despite hype of the manufacturers trials. Richard Friedel

I think queerpup and Dr Cath have nicely covered the points re inspiratory training products, so wont go there - but just wanted to mention PEP devices, which are recommended by respiratory physiotherapists and respiratory consultants for asthma, bronchiectasis and other lung conditions.

I have one, and it bores me to death using it, but essentially its a device which you blow IN to, and as you blow in, (I have the acapella) the magnets in the acapella vibrate, causing vibrations deep in your lungs. This opens smaller airways, and loosens mucous. It is a mainstay of treatment for people with bronchiectasis, but is also very beneficial for asthmatics. I think from memory, they are in the BTS physiotherapy guidelines.

Lynda :)

are PEP devices just for asthmatics who have issues getting the gunk up, or is the 'opening small airways' bit significant enough that all asthmatics might benefit>

Soph, I dont know what the party line is - but Im an asthmatic who doesnt have much gunk. However I have to use one daily, to keep my airways sufficiently open and prevent gunk accumulating. Does that help...? :) (Obv that was on the instruction of the specialist physio at Papworth - they use them a lot).

Lynda :)

Yeah, i obvs want to reduce drug type things so as PEP is drug free its something i might ask about, i just dont want to sound stupid by asking for something which doesnt match my problems (i dont *tend* to be gunky), but i'd guess pretty much all asthmatics could do with small airways opening, so possibly worth seeing what they think, cant remember if i have an appt with a physio anytime soon - i guess they are the best people to ask. Thanks :-)

Without wanting to get involved in what has turned into quite a heated debate, I should say that I was recommended to get one of these by the physiotherapists at the Severe and Brittle Asthma Unit at Heartlands. I had lost a lot of muscle strength generally, partly from protracted hospitalisations and surgeries, partly from high-dose steroids and partly from undiagnosed diabetes causing massive weight loss. It hadn't occurred to me that weak muscles would include weak breathing muscles, but I was finding it increasingly difficult to cough sufficiently effectively to help clear my chest. The physios said that if I could improve the strength of my respiratory muscles, this would have great benefit (for both in and out!). The hospital wrote to my GP asking him to prescribe it for me.

As it happens, I can't testify to it's effectiveness or not as my condition progressed quite rapidly and I now use a non-invasive ventilator to help support my weak muscles. I just thought some people might be interested to know that even specialist hospitals are recommending them in some cases, so they must be useful for some patients under some circumstances....

I think I'm most intrigued by the year-and-a-bit gap between this conversation running its course and Richard posting to it again!

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