COPD & Emphysema Support Group
COPD is a progressive disease characterized by airflow obstruction or limitation. Emphysema is characterized by loss of elasticity of the lung tissue, destruction of structures supporting the alveoli and of capillaries feeding the alveoli. Both have symptoms that include shortness of breath, among other respiratory troubles. If you are a COPD or Emphysema sufferer, join...
Exercise and breathlessness
Progressive breathlessness on exertion is a key feature of COPD. Even every day activities such as washing and dressing can cause disabling breathlessness. Often the response to such experiences is activity avoidance and this can lead to a downward de-conditioning spiral whereby cardiovascular fitness decreases, skeletal muscle mass is lost and patients consequently become more breathless.
The downward spiral of breathlessness in COPD
For people with COPD breathlessness is not harmful although it is unpleasant and can provoke anxiety and panic. Regular exercise improves cardiovascular fitness, maintains function and can reduce the sensation of breathlessness. It is important to encourage COPD patients (except when they have co-morbid cardiovascular disease when specialist advice should be sought) to maintain, and preferably increase their activity levels.
The Medical Research Council Dyspnoea Score allows patients to assess how much their breathlessness interferes with their ability to undertake normal daily activities. The NICE guideline recommends its use during routine reviews.
The MRC Dyspnoea Scale
Grade Degree of breathlessness related to activities
1. Not troubled by breathlessness except on strenuous exercise
2. Short of breath when hurrying on walking up a slight hill
3. Walks slower than contemporaries on the level because of breathlessness, or has to stop for breath when walking at own pace
4. Stops for breath after walking about 100m, or after a few minutes on the level
5. Too breathless to leave the house, or breathless when dressing or undressing
A Borg scale, allows patients to grade the intensity of their breathlessness during activity. It was developed as a tool for athletes and coaches to guide the intensity of sports training, but is equally applicable as a guide to increase exercise tolerance in COPD. The eventual aim should be to experience moderate breathlessness (Borg scale 3-5) for at least 20 minutes, three or four times a week. Exercise needs to be regular and simple exercise regimes that equate with normal daily activity, such as walking, cycling or stair climbing, are most likely to be adhered to.
COPD patients usually use accessory muscles of respiration. These are less efficient and tire easily. Breathing techniques such as abdominal breathing and pursed lip breathing can improve respiratory efficiency and help patients gain a sense of control. Active cycle breathing may help expectoration.
Pulmonary rehabilitation
Pulmonary Rehabilitation is the most cost effective intervention in the management of COPD, other than smoking cessation.
Rehabilitation can
reduce breathlessness
improve both functional and maximal exercise capacity, and
improve quality of life.
The NICE guideline recommends that it is offered to all suitable patients scoring 3 or more on the MRC Dyspnoea Scale.
http://www.library.nhs.uk/respiratory/V ... sID=187257
I picked this up on another site, but it was so worth reading and important I decided to post it here.
I hope you each have a wonderful Breath Easy day,
Hugs to all,
Holly
Progressive breathlessness on exertion is a key feature of COPD. Even every day activities such as washing and dressing can cause disabling breathlessness. Often the response to such experiences is activity avoidance and this can lead to a downward de-conditioning spiral whereby cardiovascular fitness decreases, skeletal muscle mass is lost and patients consequently become more breathless.
The downward spiral of breathlessness in COPD
For people with COPD breathlessness is not harmful although it is unpleasant and can provoke anxiety and panic. Regular exercise improves cardiovascular fitness, maintains function and can reduce the sensation of breathlessness. It is important to encourage COPD patients (except when they have co-morbid cardiovascular disease when specialist advice should be sought) to maintain, and preferably increase their activity levels.
The Medical Research Council Dyspnoea Score allows patients to assess how much their breathlessness interferes with their ability to undertake normal daily activities. The NICE guideline recommends its use during routine reviews.
The MRC Dyspnoea Scale
Grade Degree of breathlessness related to activities
1. Not troubled by breathlessness except on strenuous exercise
2. Short of breath when hurrying on walking up a slight hill
3. Walks slower than contemporaries on the level because of breathlessness, or has to stop for breath when walking at own pace
4. Stops for breath after walking about 100m, or after a few minutes on the level
5. Too breathless to leave the house, or breathless when dressing or undressing
A Borg scale, allows patients to grade the intensity of their breathlessness during activity. It was developed as a tool for athletes and coaches to guide the intensity of sports training, but is equally applicable as a guide to increase exercise tolerance in COPD. The eventual aim should be to experience moderate breathlessness (Borg scale 3-5) for at least 20 minutes, three or four times a week. Exercise needs to be regular and simple exercise regimes that equate with normal daily activity, such as walking, cycling or stair climbing, are most likely to be adhered to.
COPD patients usually use accessory muscles of respiration. These are less efficient and tire easily. Breathing techniques such as abdominal breathing and pursed lip breathing can improve respiratory efficiency and help patients gain a sense of control. Active cycle breathing may help expectoration.
Pulmonary rehabilitation
Pulmonary Rehabilitation is the most cost effective intervention in the management of COPD, other than smoking cessation.
Rehabilitation can
reduce breathlessness
improve both functional and maximal exercise capacity, and
improve quality of life.
The NICE guideline recommends that it is offered to all suitable patients scoring 3 or more on the MRC Dyspnoea Scale.
http://www.library.nhs.uk/respiratory/V ... sID=187257
I picked this up on another site, but it was so worth reading and important I decided to post it here.
I hope you each have a wonderful Breath Easy day,
Hugs to all,
Holly
Lets get moving, and feeling better...
Hugs to all of you,
Holly
The payoff is huge in our quality of life.
Thanks for your responces, it helps to tell about your own experiences...
You can do it,
Hugs to all of you,
Holly
Sitting around; afraid to do anything; feeling sorry for myself.
Everything winded me. No pulmonary rehab here.
Well, I started out slow. Then, I gained a little momentum.
Now, I am walking a mile. No clue I could walk a mile.
I am at a 2, now on that breathlessness scale. Workings
towards becoming a 1. Thank you Holly, once again, for
a great post.
Well, I decided to ask a different new pulmonary Dr. and his nurse has been so kind in trying to find the right program for my needs.
Next step is to find out if I can get a scholarship (HA!) for it since I have graduated to the SSDI-Medicaid population !!
And, thank goodness for Medicaid, I would be dead without it.
THANKS FOR THE POSTING,
JOHN
There are lots of things that you can do to keep moving. There is an exercise video that was mentioned here last winter, and I went ahead and ordered it. It's called "Gentle Fitness," and they teach you to do pursed lip breathing with the exercises. There are sections for sitting in chairs, standing, or lying down. You choose what you want to do. Go to www.gentlefitness.com to order. Well worth it!
Also, hubby and I are budgeting our money so that we can give ourselves a Wii for Christmas this year. The games on there will really get you moving, and I hope this will be good during the winter when it's too cold to go out.
Just wanted to put the ideas out there. Have fun and keep moving!
Hugs, Sue