Recreation Therapists should provide a safe, healthy and enjoyable recreational experience for everyone. Due to physiological limitations of asthma, recreation programs must be modified to include participants with asthma. Asthma is the "most common occupational lung disorder" in North America, which can be controlled with close monitoring. People with this medical condition can “live full, active lives” (American Thoracic Society, 2004; Asthma Society of Canada, 2015).
As RECREATION THERAPISTS,
we hope to help you distinguish the difference between an appropriate recreation program and a potentially harmful one.
Below is an example of a recreation program that should be avoided:
A vigorous 60-minute long outdoor mountain biking program is offered for young adults at Blue Mountain. Many people come to this tourist attraction. A variety of plants and trees are grown within the national park. Birds, animals and insects inhabit this area. The mountain participants will cycle through during the program is at a high altitude. This program is to be run despite cold weather conditions.
Why is this a potentially harmful recreation program?
Below is an example of a recreation program that should be avoided:
A vigorous 60-minute long outdoor mountain biking program is offered for young adults at Blue Mountain. Many people come to this tourist attraction. A variety of plants and trees are grown within the national park. Birds, animals and insects inhabit this area. The mountain participants will cycle through during the program is at a high altitude. This program is to be run despite cold weather conditions.
Why is this a potentially harmful recreation program?
- High environmental allergens i.e. pollen, birds, animals, insects
- High air pollution
- Cold weather: Dry, cool air
- Physical activity (also known as "exercise-induced asthma")
Limitations due to asthma
Since asthma has no set pattern, limitations will:
Typically, physical activity is the only trigger for asthma in children and young adults (BHF National Centre for Physical Activity and Health, 2011). However, exercising is still important for those diagnosed with asthma (Asthma Society of Canada, 2015; BHF National Centre for Physical Activity and Health, 2011). The example of the 60-minute long mountain biking program is considered high-intensity exercise. This program is likely to trigger exercise-induced bronchospasm (EIB) as it "increases minute ventilation and respiratory heat/water losses, which is a greater drop than 10-15% in forced expiratory volume in 1 second" (Canadian Paediatric Society, 2010).
- Vary due to the severity of asthma
- Varying triggers
- Differ for each person
Typically, physical activity is the only trigger for asthma in children and young adults (BHF National Centre for Physical Activity and Health, 2011). However, exercising is still important for those diagnosed with asthma (Asthma Society of Canada, 2015; BHF National Centre for Physical Activity and Health, 2011). The example of the 60-minute long mountain biking program is considered high-intensity exercise. This program is likely to trigger exercise-induced bronchospasm (EIB) as it "increases minute ventilation and respiratory heat/water losses, which is a greater drop than 10-15% in forced expiratory volume in 1 second" (Canadian Paediatric Society, 2010).
Modifications to the Mountain Biking program to accommodate those with asthma:
- Having an extended warm-up that lasts at least 10 minutes before the program
- Cooling down gradually after the program: By slowing the change of air temperature in airways – the chances of developing asthma symptoms reduced, which keeps symptoms under control
- Planned rest breaks: Long-distance cycling can be a strong asthma trigger, but taking breaks after 6-10 minutes of vigorous exercise can help prevent asthma attacks
- Encouraging participants to rest and to not over-exert themselves
- Allowing participants to go at their own pace
- Changing the location of the program to a national park where there is less environmental pollutants
- Choosing a mountain path at a lower altitude
- Only holding the program in warm weather
- If program is run in cold weather, have participants with asthma cover their noses and mouths with scarves or masks to avoid triggers
- Modifying activities - holding a relay bike race instead of a 60 minute long program doing vigorous mountain biking: Interval-type activities helps to build stamina and bursts of activity followed by activity at a slower pace are more appropriate for those with asthma
- Prior to starting program, review the Asthma Action Plan for each participant with asthma for information about their triggers, symptoms, inhaler, et cetera
- Controlling the asthma before exercising
- Stopping exercise if symptoms appear
- Ensuring asthma medication is taken 15 minutes prior to program i.e. preventer inhaler
- Having reliever inhaler on hand
- Observing closely during and after the activity
(American Thoracic Society, 2004; Asthma Society of Canada, 2015; BHF National Centre for Physical Activity and Health and Loughborough University, 2011; WebMd, 2015).