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 for Persons with Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease (COPD), such as emphysema, chronic bronchitis and asthma, is defined by the American Thoracic Society as a condition characterized by airflow obstruction that reduces the ability to sufficiently empty the lungs. The incidence of COPD is presently increasing in the U.S., with an estimated 16.5 million people now suffering from shortness of breath and the disabling effects of this disease. Lack of exercise contributes to disability in COPD. Exercise training is a major component of pulmonary rehabilitation programs today and is an established safe and effective intervention for improving physical capacity and quality of life. Aerobic exercise (riding a stationary bike or walking) and resistance exercise (lifting a light weight with the arms or legs) can help restore and maintain functional independence in COPD.
Inactivity and COPD
The shortness of breath experienced by COPD patients at rest and/or during activities of daily living can lead to an increasingly sedentary lifestyle, a progressive deterioration in functional capacity, and possible isolation at home. With progressive inactivity, cardiovascular function and skeletal muscle mass decline. The deterioration in aerobic fitness and strength creates a vicious cycle that leads to greater breathlessness with exertion, muscular fatigue, an eventual loss of functional independence, and depression. A major goal of pulmonary rehabilitation exercise programs is, therefore, to reverse the physical disability resulting from inactivity.
Benefits of Exercise in COPD
Many physiological and psychological benefits have been reported in COPD patients after participation in randomized controlled trials of prescribed exercise involving upper and lower body aerobic and resistance training. Major benefits include increased physical capacity, decreased anxiety about breathlessness, greater independence in daily activities, reduced fatigue and improved quality of life. These positive outcomes occur even though impaired lung function continues to persist after exercise training. Regular exercise thus enables COPD patients to do more recreational and vocational activities despite their lung disease.
Importantly, the gain in fitness and confidence with exercise reverses the spiral of deconditioning associated with COPD. One reason for the decrease in exercise anxiety is that patients become desensitized to the shortness of breath that they live with on a daily basis. Furthermore, researchers have shown that COPD patients who exercise may also show better performance on tests of verbal fluency, suggesting that regular exercise increases blood flow to the brain to enhance cognitive function.
Exercise Guidelines in COPD
Persons with COPD may have co-existing cardiovascular abnormalities such as high blood pressure or coronary artery disease. A medically monitored exercise evaluation is highly recommended to assess the patients cardiac risk as well as physiological and subjective responses. Patients then can be stratified according to their need for medical support and surveillance during exercise. A symptom limited exercise tolerance test is very helpful for determining the appropriate range of exertion and the optimal training heart rate. Medical supervision is recommended at least twice a week (especially at the beginning of the program) in order to develop the patients understanding and self-confidence in how hard to exercise, as well as to individualize the training intensity, duration and frequency.
Since breathlessness is often the primary determinant of exertional tolerance, ratings of shortness of breath can be used to monitor the patients exercise intensity. Ideally, the exercise intensity will not be limited by shortness of breath before the patient experiences moderate exertion. Intermittent exercise (i.e., short intervals of exercise alternating with regular rest periods) usually permits higher intensities.
After the initial weeks of training, patients may be able to sustain a high percentage of their peak work capacity for 30 to 40 minutes per training session. The benefits of exercise typically increase as the training load is gradually progressed. Moderate exercise on a daily basis has been shown to decrease the sensation of breathlessness and produce the greatest improvements in functional capacity and health status. For most patients, 15 minutes of moderate physical activity, 3 days per week is probably the minimum amount for ensuring the exercise benefits.
Aerobic training should involve the major muscle groups of the lower extremities, as these are used in everyday tasks such as walking and climbing stairs, for a total of 20 to 30 minutes. Improved walking endurance, activity tolerance and quality of life have been reported after programs using either stationary cycling, ground-based and treadmill walking, or a combination of all three. Since numerous daily activities require use of the upper extremities, endurance and strength training of the upper body can also provide practical benefits. It is advisable to combine resistance training with an aerobic training program to help increase endurance. Exercises for strengthening should include all major muscle groups. The resistance should be prescribed for each person and allow for completion of at least one set of 8 to 12 repetitions of the exercise. As muscular strength and endurance improve, more sets can be added to each exercise.
Patient Education
In addition to exercise training, education on diaphragmatic and pursed-lip breathing strategies can help patients cope with periods of breathlessness and reduce their exercise anxiety. Patient education should also include counseling on the use and timing of prescribed medications, such as supplemental oxygen, bronchodilators, mucolytics, and/or corticosteroids, before and during exercise.
As with any population, COPD patients should stop exercising if they experience pressure or pain in the chest, neck, arm or jaw that might signal inadequate blood flow to heart tissue. The onset of nausea, lightheadedness, dizziness and headache during exercise are other indications to terminate the activity and seek medical advice. Since breathlessness is usually a transient symptom during exercise, patients should slow down rather than stop suddenly. However, if the labored breathing persists, then stop and rest.
Summary
Exercise training is a vital component of comprehensive pulmonary rehabilitation. The American
College of Sports Medicine (ACSM) supports the viewpoint that light to moderate physical activity (30 minutes a day, on most, if not all days of the week) is beneficial for improving the quality of life in persons with COPD. Exercise cannot reverse the physiologic and structural deficits in COPD, but it can reduce disability associated with this condition by improving physical endurance and strength, as well as breathing efficiency and tolerance, especially in severely impaired patients. Persons with COPD who follow an individualized progressive exercise program can often increase their functional capacity 70% to 80% after six weeks of training.
Written for the American College of Sports Medicine by Rudolph H. Dressendorfer, Ph.D., P.T., FACSM (Chair) Mark J. Haykowsky, Ph.D., Neil Eves, M.Sc.
http://www.acsm.org/docs/current-comments/exerciseforpersonswithcopd.pdf
When I opened my email this morning I found this link which came to me from MedlinePlus Daily Digest Bulletin and I thought it might help some one here.
Wishing each of you an easy breathing day,
Love,
Holly
Chronic Obstructive Pulmonary Disease (COPD), such as emphysema, chronic bronchitis and asthma, is defined by the American Thoracic Society as a condition characterized by airflow obstruction that reduces the ability to sufficiently empty the lungs. The incidence of COPD is presently increasing in the U.S., with an estimated 16.5 million people now suffering from shortness of breath and the disabling effects of this disease. Lack of exercise contributes to disability in COPD. Exercise training is a major component of pulmonary rehabilitation programs today and is an established safe and effective intervention for improving physical capacity and quality of life. Aerobic exercise (riding a stationary bike or walking) and resistance exercise (lifting a light weight with the arms or legs) can help restore and maintain functional independence in COPD.
Inactivity and COPD
The shortness of breath experienced by COPD patients at rest and/or during activities of daily living can lead to an increasingly sedentary lifestyle, a progressive deterioration in functional capacity, and possible isolation at home. With progressive inactivity, cardiovascular function and skeletal muscle mass decline. The deterioration in aerobic fitness and strength creates a vicious cycle that leads to greater breathlessness with exertion, muscular fatigue, an eventual loss of functional independence, and depression. A major goal of pulmonary rehabilitation exercise programs is, therefore, to reverse the physical disability resulting from inactivity.
Benefits of Exercise in COPD
Many physiological and psychological benefits have been reported in COPD patients after participation in randomized controlled trials of prescribed exercise involving upper and lower body aerobic and resistance training. Major benefits include increased physical capacity, decreased anxiety about breathlessness, greater independence in daily activities, reduced fatigue and improved quality of life. These positive outcomes occur even though impaired lung function continues to persist after exercise training. Regular exercise thus enables COPD patients to do more recreational and vocational activities despite their lung disease.
Importantly, the gain in fitness and confidence with exercise reverses the spiral of deconditioning associated with COPD. One reason for the decrease in exercise anxiety is that patients become desensitized to the shortness of breath that they live with on a daily basis. Furthermore, researchers have shown that COPD patients who exercise may also show better performance on tests of verbal fluency, suggesting that regular exercise increases blood flow to the brain to enhance cognitive function.
Exercise Guidelines in COPD
Persons with COPD may have co-existing cardiovascular abnormalities such as high blood pressure or coronary artery disease. A medically monitored exercise evaluation is highly recommended to assess the patients cardiac risk as well as physiological and subjective responses. Patients then can be stratified according to their need for medical support and surveillance during exercise. A symptom limited exercise tolerance test is very helpful for determining the appropriate range of exertion and the optimal training heart rate. Medical supervision is recommended at least twice a week (especially at the beginning of the program) in order to develop the patients understanding and self-confidence in how hard to exercise, as well as to individualize the training intensity, duration and frequency.
Since breathlessness is often the primary determinant of exertional tolerance, ratings of shortness of breath can be used to monitor the patients exercise intensity. Ideally, the exercise intensity will not be limited by shortness of breath before the patient experiences moderate exertion. Intermittent exercise (i.e., short intervals of exercise alternating with regular rest periods) usually permits higher intensities.
After the initial weeks of training, patients may be able to sustain a high percentage of their peak work capacity for 30 to 40 minutes per training session. The benefits of exercise typically increase as the training load is gradually progressed. Moderate exercise on a daily basis has been shown to decrease the sensation of breathlessness and produce the greatest improvements in functional capacity and health status. For most patients, 15 minutes of moderate physical activity, 3 days per week is probably the minimum amount for ensuring the exercise benefits.
Aerobic training should involve the major muscle groups of the lower extremities, as these are used in everyday tasks such as walking and climbing stairs, for a total of 20 to 30 minutes. Improved walking endurance, activity tolerance and quality of life have been reported after programs using either stationary cycling, ground-based and treadmill walking, or a combination of all three. Since numerous daily activities require use of the upper extremities, endurance and strength training of the upper body can also provide practical benefits. It is advisable to combine resistance training with an aerobic training program to help increase endurance. Exercises for strengthening should include all major muscle groups. The resistance should be prescribed for each person and allow for completion of at least one set of 8 to 12 repetitions of the exercise. As muscular strength and endurance improve, more sets can be added to each exercise.
Patient Education
In addition to exercise training, education on diaphragmatic and pursed-lip breathing strategies can help patients cope with periods of breathlessness and reduce their exercise anxiety. Patient education should also include counseling on the use and timing of prescribed medications, such as supplemental oxygen, bronchodilators, mucolytics, and/or corticosteroids, before and during exercise.
As with any population, COPD patients should stop exercising if they experience pressure or pain in the chest, neck, arm or jaw that might signal inadequate blood flow to heart tissue. The onset of nausea, lightheadedness, dizziness and headache during exercise are other indications to terminate the activity and seek medical advice. Since breathlessness is usually a transient symptom during exercise, patients should slow down rather than stop suddenly. However, if the labored breathing persists, then stop and rest.
Summary
Exercise training is a vital component of comprehensive pulmonary rehabilitation. The American
College of Sports Medicine (ACSM) supports the viewpoint that light to moderate physical activity (30 minutes a day, on most, if not all days of the week) is beneficial for improving the quality of life in persons with COPD. Exercise cannot reverse the physiologic and structural deficits in COPD, but it can reduce disability associated with this condition by improving physical endurance and strength, as well as breathing efficiency and tolerance, especially in severely impaired patients. Persons with COPD who follow an individualized progressive exercise program can often increase their functional capacity 70% to 80% after six weeks of training.
Written for the American College of Sports Medicine by Rudolph H. Dressendorfer, Ph.D., P.T., FACSM (Chair) Mark J. Haykowsky, Ph.D., Neil Eves, M.Sc.
http://www.acsm.org/docs/current-comments/exerciseforpersonswithcopd.pdf
When I opened my email this morning I found this link which came to me from MedlinePlus Daily Digest Bulletin and I thought it might help some one here.
Wishing each of you an easy breathing day,
Love,
Holly
Keep up the good work!
Its very true we have a far better quality of life with exercise and if we are strong and healthy as we can be when the stem cells are offered, we will be ready.
Easy breathing to you, and Have a nice day.
Love
Holly
I now have a small gym in my house and am back to exercising,
It is a slow uphill battle bit I am feeling better every day.
I have severe COPD and if I can do it anyone can.
Stop the down hill spiral, get out n play an hour a day
walk briskly through your house, blow up a balloon.
I have a bowflex, a stepper and a inversion table.
I use them all now. I started out real slow just 2 minutes a day at first,
I am now up to 15 minutes a day and increasing by the week.
Really you can slow down or stop this disease.
But you have o put forth the effort.
Keep up the good work everyone and thanks for posting Holly, I agree you have to start at a slower pace, something manageable initially then as you progress you find you can do more than you ever thought possible.
I thought the LVRS would help you breath easier?
Perhaps to much lung gone and not a lot you can do about it.
I was wondering if LVRS would help me.
does it really make much difference?
Its important to be guided by what your own doc advises concerning exercise, this applies to us all, regular ongoing exercise will help most anyone but the intensity and therapeutic medical needs may vary from patient to patient, that's why its a good thing to be properly assessed by your medical team and why PR is such a good option as each person is assessed individually.
It would be interesting to hear what you were / are advised concerning excise after the LVRS, I expect to begin with you must got slowly but surely. How are you finding your breathing now?
Good wishes to you.
I do get short of breath at times, and have to stop a bit, but at least I can do it! And to be honest, I still can't climb hills.
I hope everyone finds an exercise they truly enjoy for it does help - immensely!
I did "give up" for quite some time; became sedentary and noticed my muscles were wasting and my Emphysema only worsened. Now, with the permission of my Pulmonary Specialist; I walk when I can.
His orders state that I walk with my oximeter (watching my heart rate and oxygen saturation at all times); always use a walker (with seat); so that I can rest when needed. When air quality is deemed safe for lung patients; I walk every morning. Each day, I attempt to walk a little farther. It is enjoyable, as I have Katie with me (she loves being outdoors); and I usually feel an uplift in my mood. So far, walking is the only thing that I am able to do. My recent knee injury, forces me to walk very slowly and carefully, but the new knee brace is of a great help. At times; I get soup cans and lift them---through repetitions---so that my arms are getting exercise. Any upper body "work" seems to cause SOB; so I do this as I can.
Wish everyone the best in their own ability to exercise.
God Bless you all