Possibilities of respiratory rehabilitation in correction of small airway dysfunction

Introduction. It is now recognized that small airway dysfunction is a component of the development of chronic obstructive diseases. The damage of the small airways is characteristic of certain phenotypes of bronchial asthma and chronic obstructive pulmonary disease, which determines the characteristics of the clinical manifestations of the disease and requires a personalized approach to treatment.Aim. Summarizing the data of domestic and foreign researchers on the possibility of using non-drug methods of rehabilitation of chronic obstructive diseases in terms of their impact on the small airways.Materials and methods. The review uses data from articles published in PubMed, Google Scholar, eLIBRARY.Results. The article presents modern methods for assessing small airways. The choice of criteria and the complexity of diagnosing small airway dysfunction at the stage of rehabilitation treatment are discussed. The effectiveness of the use of natural and preformed physical factors in the rehabilitation treatment of chronic obstructive pulmonary diseases has been shown. The authors analyze the influence of physiotherapeutic factors on the dynamics of spirometry parameters, indirectly indicating the state of small airways. The preferred choice of inhalation preparations with extrasmall sizes of medicinal particles penetrating into the distal respiratory tract is shown. The influence of natural and preformed physical factors on the small airway dysfunction in chronic obstructive pulmonary diseases is highlighted.Conclusion. Literature data suggest a positive effect of pulmonary rehabilitation methods on the small airway dysfunction. Further studies are required to study the mechanisms of action of physiotherapeutic factors on the peripheral parts of the respiratory tract and the development of targeted medical technologies.