Topical issues in rehabilitation treatment of asthma in the elderly
https://doi.org/10.36604/1998-5029-2026-99-150-158
Abstract
Аsthma in the elderly is a significant medical and social problem due to its high prevalence, polymorbidity, polypharmacy, and age-related changes in the body's regulatory systems. This review examines current approaches and features of the restorative treatment of аsthma in the elderly. Attention is drawn to the importance of using non-drug methods in the restorative treatment of elderly patients, including physical rehabilitation, breathing exercises, educational programs, and physiotherapy. The main physiotherapeutic methods (inhalation therapy, laser therapy, ultrasound, magnetic therapy, electrotherapy, speleoclimatotherapy, interval hypoxic hyperoxytherapy), their mechanisms of action, and the evidence base for their effectiveness are presented. It is noted that age is not a contraindication for physiotherapy treatment.
Particular attention is paid to the principles of rehabilitation in elderly patients, which require an individualized, comprehensive, dosed, and safe approach, taking into account age-related characteristics and comorbidities. Insufficient study of the long-term effects and specific application of many methods in geriatrics is noted.
Further research into the specific application of physiotherapy methods in the elderly, taking into account involutional processes and comorbidities, will enable the development of individualized rehabilitation programs. The need to improve the accessibility and quality of rehabilitation care for this category of patients is emphasized.
Supporting agencies: This study was not sponsored
About the Authors
K. A. Syunikova
Vladivostok Branch of Far Eastern Scientific Centre of Physiology and Pathology of Respiration – Research Institute of Medical Climatology and Rehabilitative Treatment
Russian Federation
Russian Federation
Kseniia A. Syunikova, MD, Postgraduate Student
Laboratory of Rehabilitation Treatment
690105; 73g Russkaya Str.,; Vladivostok
M. V. Antonyuk
Vladivostok Branch of Far Eastern Scientific Centre of Physiology and Pathology of Respiration – Research Institute of Medical Climatology and Rehabilitative Treatment
Russian Federation
Russian Federation
Marina V. Antonyuk, MD, PhD (Med.), DSc (Med.), Professor, Head of Laboratory
Laboratory of Rehabilitation Treatment
690105; 73g Russkaya Str.,; Vladivostok
N. S. Yubitskaya
Vladivostok Branch of Far Eastern Scientific Centre of Physiology and Pathology of Respiration – Research Institute of Medical Climatology and Rehabilitative Treatment
Russian Federation
Russian Federation
Natalia S. Yubitskaya, MD, PhD (Med.), Staff Scientist
Laboratory of Rehabilitative Treatment
690105; 73g Russkaya Str.,; Vladivostok
References
1. Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention (Update 2024). Available at: https://ginasthma.org/wp-content/uploads/2024/05/GINA-2024-Main-Report-WMS-1.pdf
2. World Health Organization (WHO). Asthma Fact Sheet, 2022. Available at: https://www.who.int/news-room/fact-sheets/detail/asthma
3. Chuchalin A.G., Avdeev S.N., Aisanov Z.R., Belevskiy A.S., Vasil'eva O.S., Geppe N.A., Ignatova G.L., Knyazheskaya N.P., Malakhov A.B., Meshcheryakova N.N., Nenasheva N.M., Fassakhov R.S., Khaitov R.M., Il'ina N.I., Kurbacheva O.M., Astaf'eva N.G., Demko I.V., Fomina D.S., Namazova-Baranova L.S., Baranov A.A., Vishneva E.A., Novik G.A. [Federal guidelines on diagnosis and treatment of bronchial asthma]. Pulmonologiya = Pulmonology 2022; 32(3):393–447 (in Russian). doi: 10.18093/0869-0189-2022-32-3-393-447
4. Chuchalin A.G., editor. [Respiratory medicine: a guide (Vol. 1)]. Moscow: Litterra; 2017 (in Russian). ISBN: 978-5-4235-0262-1.
5. Chuchalin A.G., Khaltaev N., Antonov N.S., Galkin D.V., Manakov L.G., Antonini P., Murphy M., Solodovnikov A.G., Bousquet J., Pereira M.H.S., Demko I.V. Chronic respiratory diseases and risk factors in 12 regions of the Russian Federation. Int. J. Chron. Obstruct. Pulmon. Dis. 2014; 9:963–974. doi: 10.2147/COPD.S67283
6. Arkhipov V.V., Grigorieva E.V., Gavrishina E.V. [Control of bronchial asthma in Russia: results of NIKA multicenter observational study]. Pulmonologiya = Pulmonology. 2011; 6:87–93 (in Russian). doi: 10.18093/0869-0189-2011-0-6-87-93
7. Trofimov V.I., Mineev V.N., Mironova Zh.A., Sorokina L.N., Korostovtsev D.S. [The age specifics of severe uncontrolled asthma in children, adolescents and adults: joining forces is a must]. Meditsinskiy sovet = Medical Council 2016; 15:28–32 (in Russian). doi: 10.21518/2079-701X-2016-15-28-32
8. Avdeev S.N., Volkova O.A., Demko I.V., Ignatova G.L., Leshchenko I.V., Kanukova N.A., Kudelya L.M., Nevzorova V.A., Nedashkovskaya N.G., Ukhanova O.P., Shulzhenko L.V., Fassakhov R.S. [Severe bronchial asthma patient care organization in various regions of the Russian Federation. From endotypes and phenotypes of bronchial asthma to personalized choice of therapy]. Terapevticheskiy arkhiv = Therapeutic archive 2020; 92(2):119–123 (in Russian). doi: 10.26442/00403660.2020.02.000555
9. Nasyrova M.Sh., Zhuraeva Kh.I., Mukhamedzhanova M.Kh. [Features of the clinical characteristics of patients with a combination of bronchial asthma and arterial hypertension]. Biologiya i integrativnaya meditsina = Biology and Integrative Medicine 2019; 12(40):4–17 (in Russian). EDN: MHPLCG.
10. Avdeev S.N., Nenasheva N.M., Zhudenkov K.V., Petrakovskaya V.A., Izyumova G.V. [Prevalence, incidence, phenotypes and other characteristics of severe bronchial asthma in the Russian Federation]. Pulmonologiya = Pulmonology 2018; 28(3):341–358 (in Russian). doi: 10.18093/0869-0189-2018-28-3-341-358
11. Avdeev S.N., Aisanov Z.R., Arkhipov V.V., Belevskiy A.S., Vizel’ A.A., Demko I.V., Emel’yanov A.V., Il’ina N.I., Kurbacheva O.M., Leshchenko I.V., Nenasheva N.M., Ovcharenko S.I., Fassakhov R.S. [Principles of selecting therapy for patients with mild asthma RAACI and RRO agreed recommendations]. Rossiyskiy allergologicheskiy zhurnal = Russian journal of allergy 2017; 14(3):55–63 (in Russian). EDN: ZFUADB.
12. Emel'yanov A.V., Leshchenkova E.V., Sergeeva G.R., Tsukanova I.V. [Modern therapy of bronchial asthma]. Novyye Sankt-Peterburgskiye vrachebnyye vedomosti = New St. Petersburg Medical Records 2025; 104(3):11–18 (in Russian). doi: 10.24884/1609-2201-2025-104-3-11-18
13. Dobrynina I.S., Budnevskii A.V., Kozhevnikova S.A. [Bronchial asthma in the elderly: features of the course, psychosomatic status and quality of life of patients]. Nauchno-meditsinskii vestnik Tsentral'nogo Chernozem'ya = Medical scientific bulletin of Central Chernozemye 2012; 47:33–40 (in Russian). doi: 10.18499/1990-472X-2012-0-47-33-40
14. Avdeev S.N., Aisanov Z.R., Belevskiy A.S., Kulbaisov А.М., Kurbacheva O.M., Leshchenko I.V., Nenasheva N.M., Fassakhov R.S. [Mild bronchial asthma: the present and the future]. Pulmonologiya = Pulmonology 2018; 28(1):84–95 (in Russian). doi: 10.18093/0869-0189-2018-28-1-84-95
15. Stridsman C., Axelsson M., Warm K., Backman H. Uncontrolled asthma occurs in all GINA treatment steps and is associated with worse physical health – a report from the OLIN adult asthma cohort. J. Asthma 2020; 57(12):1345–1354. doi: 10.1080/02770903.2020.1713150
16. Panova E.A., Serov V.A., Shutov A.M., Bakumtseva N.N., Kuzovenkova M.Yu. [Polypharmacy in elderly out-patients]. Ul'yanovskiy mediko-biologicheskiy zhurnal = Ulyanovsk medico-biological journal 2019; 2:16–22 (in Russian). doi: 10.34014/2227-1848-2019-2-16-22
17. Avdeev S.N., Gainitdinova V.V., Pozdnyakova A.A., Vlasenko A.E., Gneusheva T.Yu., Baytimerova I.V. [Risk factors for adverse outcomes in elderly patients with bronchial asthma and severe COVID-19 at the hospital and early post-hospital stages]. Terapevticheskiy arkhiv = Therapeutic archive 2023; 95(1):57–65 (in Russian). doi: 10.26442/00403660.2023.01.202049
18. Miller R.L., Grayson M.H., Strothman K. Advances in asthma: new understandings of asthma's natural history, risk factors, underlying mechanisms, and clinical management. J. Allergy Clin. Immunol. 2021; 148(6):1430–1441. doi: 10.1016/j.jaci.2021.10.001
19. Bożek A., Filipowski M., Fischer A., Jarzab J. Characteristics of atopic bronchial asthma in seniors over 80 years of age. Biomed Res. Int. 2013; 2013:689782. doi: 10.1155/2013/689782
20. Battaglia S., Benfante A., Spatafora M., Scichilone N. Asthma in the elderly: a different disease? Breathe (Sheff) 2016; 12(1):18–28. doi: 10.1183/20734735.002816
21. Scichilone N., Pedone C., Battaglia S., Sorino C., Bellia V. Diagnosis and management of asthma in the elderly. Eur. J. Intern. Med. 2014; 25(4):336–342. doi: 10.1016/j.ejim.2014.01.004
22. Wardzyńska A., Kubsik B., Kowalski M.L. Comorbidities in elderly patients with asthma: association with control of the disease and concomitant treatment. Geriatr. Gerontol. Int. 2015; 15(7):902–909. doi: 10.1111/ggi.12367
23. Bożek A., Rogala B., Bednarski P. Asthma, COPD and comorbidities in elderly people. J. Asthma. 2016; 53(9):943–947. doi: 10.3109/02770903.2016.1170139
24. Schleich F., Graff S., Guissard F., Henket M., Paulus V., Louis R. Asthma in elderly is characterized by increased sputum neutrophils, lower airway caliber variability and air trapping. Respir. Res. 2021; 22(1):41. doi: 10.1186/s12931-021-01619-w
25. Ponomarenko G.N., editor. [Physical and rehabilitation medicine: national guide]. Moscow: GEOTAR-Media; 2025 (in Russian).
26. Ovchinnikova A.N., Rassudova M.A., Kuandykov M.V. [Physiotherapeutic methods for the treatment of respiratory diseases]. Astma i allergiya 2018; 1:3–7 (in Russian).
27. Asiryan E.G., Novikov P.D., Golubeva A.I. [Immunomodulatory therapy for bronchial asthma with the use of physiotherapeutic methods]. Vestnik Vitebskogo gosudarstvennogo meditsinskogo universiteta = Vitebsk Medical Journal 2017; 16(1):7–15 (in Russian). doi: 10.22263/2312-4156.2017.1.7
28. Abramovich S.G. [Fundamentals of physiotherapy in geriatrics : a textbook]. Irkutsk: Redaktsionno-izdatel′skiy otdel Irkutskogo gosudarstvennogo instituta usovershenstvovaniya vrachey; 2008 (in Russian). EDN: PUXRNB.
29. Kindras M.N., Ermakova A.E. [Physiotherapeutic methods in the treatment of elderly patients]. Klinicheskaya gerontologiya = Clinical gerontology 2017; 23(9–10):34 (in Russian). EDN: ZFRTQR.
30. Erokhina G.A. [Peculiarities of physiotherapy as a component of the combined treatment of aged patients]. Fizioterapiya, bal’neologiya i reabilitatsiya = Russian journal of physiotherapy, balneology and rehabilitation 2012; 1:39–41 (in Russian). EDN: PGPGSJ.
31. Ivashchenko A.S., Dudchenko L.Sh., Kaladze N.N., Mizin V.I. [Phenotypes of bronchial asthma during the health resort period and personalized programs of medical rehabilitation]. Voprosy kurortologii, fizioterapii i lechebnoy fizicheskoy kul'tury = Problems of balneology, physiotherapy and exercise therapy 2020; 97(1):13–24 (in Russian). doi: 10.17116/kurort20209701113
32. Yusupalieva M.M., Savchenko V.M., Dudchenko L.Sh. [Physiotherapeutic methods in rehabilitation of patients with bronchial]. Vestnik fizioterapii i kurortologii = Herald of physiotherapy and health resort therapy 2017; 23(2):18–24 (in Russian). EDN: YLJILP.
33. Antonyuk M.V., Mineeva E.E., Yurenko A.V., Fotina O.N., Khodosova K.K. [Complex rehabilitation of patients with asthma]. Bûlleten' fiziologii i patologii dyhaniâ = Bulletin Physiology and Pathology of Respiration 2017; 63:16–20 (in Russian). doi: 10.12737/article_58e32a86065e31.62595630
34. Rohrer V., Schmidt-Trucksäss A. [Impact of exercise, sport and rehabilitation therapy in asthma and COPD]. Ther. Umsch. 2014; 71(5):295–300 (in German). doi: 10.1024/0040-5930/a000516
35. Tribuntseva L.V., Budnevskii A.V., Shkatova Ya.S., Ivanchuk Yu.S., Tokmachev R.E. [Significance of physical activity for the clinical course of bronchial asthma : a literature review]. Rossiyskiy mediko-biologicheskiy vestnik imeni akademika I.P. Pavlova = I.P. Pavlov Russian medical biological herald 2021; 29(1):161–170 (in Russian) doi: 10.23888/PAVLOVJ2021291161-170
36. Garagorri-Gutiérrez D., Leiros-Rodríguez R. Effects of physiotherapeutic treatment in patients with bronchial asthma : a systematic review. Physiother. Theory. Pract. 2022; 38(4):487–498. doi: 10.1080/09593985.2020.1772420
37. Xiong T., Bai X., Wei X., Wang L., Li F., Shi H., Shi Y. Exercise rehabilitation and chronic respiratory diseases: effects, mechanisms, and therapeutic benefits. Int. J. Chron. Obstruct. Pulmon. Dis. 2023; 18:1251–1266. doi: 10.2147/COPD.S408325
38. van‘t Hul A.J., Frouws S., Van Den Akker E., Van Lummel R., Starrenburg-Razenberg A., van Bruggen A., Braunstahl G.-J., in‘t Veen J.C.C.M. Decreased physical activity in adults with bronchial asthma. Respir. Med. 2016; 114:72–77. doi: 10.1016/j.rmed.2016.03.016
39. Stubbs M.A., Clark V.L., McDonald V.M. Living well with severe asthma. Breathe 2019; 15(2):e40–e49. doi: 10.1183/20734735.0165-2019
40. Antonyuk M.V., Yubitskaya N.S., Gvozdenko T.A., Lebedev S.V. [Prospects of personalized restorative medicine]. Bûlleten' fiziologii i patologii dyhaniâ = Bulletin Physiology and Pathology of Respiration 2021; 79:117–126 (in Russian). doi: 10.36604/1998-5029-2021-79-117-126
Review
For citations:
Syunikova K.A., Antonyuk M.V., Yubitskaya N.S. Topical issues in rehabilitation treatment of asthma in the elderly. Bulletin Physiology and Pathology of Respiration. 2026;(99):150-158. (In Russ.) https://doi.org/10.36604/1998-5029-2026-99-150-158
Views:
173
JATS XML
Email this article 