CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
Exercise improves respiratory fitness by promoting oxygen delivery to muscles. This results in less oxygen being required for the same daily living or physical activity – which is great news for anyone with Asthma or other respiratory conditions.
Exercising with your Exerice Physiologist can have favourable improvements in oxygen utilisation, work capacity, breathlessness, strength, anxiety
and quality of life in people with COPD.
Your Accredited Exercise Physiologist has a thorough understanding of the respiratory system and how it reacts to exercise. They know how to work within your limitations, when to rest and when to keep moving, giving you the confidence to exercise safely.
The benefits of exercise
Regular exercise creates benefits in physical conditioning and functional capacity, giving individuals with
COPD better ability to participate in recreational or lifestyle activities, thus enhancing quality of life.
An ongoing exercise maintenance program is shown through strong
medical evidence to have a significant effect on improving quality of life and managing symptoms
Physiotherapy is an important part of the management of lung disease and involves a variety of different treatments depending on your main symptoms. Overall, the most important aspect is exercise. Avoiding sedentary time and keeping up an active lifestyle is extremely important for people with lung disease to keep fit, healthy, strong and out of hospital.
Modifications to duration,
frequency and type of exercise will be necessary along the way.
It is recommended that people with lung disease do 30 minutes of aerobic exercise on at least five days of the week, such as brisk walking, jogging, riding on a stationary bike or swimming. It is also recommended to do strengthening exercises on two to three days of the week to keep your muscles strong. If you have had falls or poor balance, it is also recommended that you do balance exercises. If you’re not sure what kind of exercise is right for you, a physiotherapist can help.
The most effective exercise is normally done at a ‘moderate’ intensity. This means that during exercise your heart rate is increased slightly and you get a bit puffed, but not so puffed that you cannot talk to the person next to you. On a scale of 0 (nothing) to 10 (very very strong) your breathing should be between 3 (moderate) to 4 (somewhat strong), while completing the aerobic exercise such as walking or cycling.
No, exercise will not make your disease worse. Exercise is safe for you. When we exercise, our lungs need to work harder to deliver more oxygen to our working muscles. Therefore, when we exercise it is normal to feel breathless. You may experience increased breathlessness when exercising, however that is a good sign that you are exercising and the breathlessness should go back to normal as soon as you stop the exercise. However, for safety it is recommended that you consult a physiotherapist or GP before you start exercising for the first time.
The easiest way to learn about these exercises is to see your physiotherapist and join a pulmonary rehabilitation program. These programs are widely available throughout Australia, located at hospitals or community centres, and are open to most people with lung disease. At the pulmonary rehabilitation program a physiotherapist will measure your exercise capacity, your symptoms and your safety for exercise. They will teach you how to do the exercises and then supervise you exercising in the group environment once or twice a week for six to eight weeks. As well, you will receive education on a number of topics such as medication, lung disease and managing breathlessness. Speak to your GP or physiotherapist for more information and to get a referral.
Depending on your specific lung disease and your main problems, physiotherapy may also involve a number of other treatments. A thorough assessment by a physiotherapist following diagnosis is a good place to start.
Physiotherapy may involve breathing exercises, airway clearance techniques and inhalation therapy to help clear phlegm from the airways. This is particularly important for people with bronchiectasis or cystic fibrosis as they commonly experience high volumes of phlegm on a daily basis and should perform airway clearance techniques across the lifespan. A physiotherapist can help you work out which is the best technique for you and how to integrate these techniques in your daily life to maintain clear and healthy lungs.
If you have trouble sleeping or breathing at night, a physiotherapist in conjunction with your respiratory doctor may prescribe a breathing machine such as continuous positive airway pressure (CPAP), non-invasive positive pressure (NIV), or bi-level positive airway pressure (BiPAP) to use to help your breathing.
Physiotherapy may also involve assessment and management of other conditions that can result from, or occur along-side, lung disease. These include musculoskeletal problems such as spinal or joint pain, restricted chest wall, ribs, arm movement, or poor posture; osteoporosis; and urinary incontinence (which is common due to chronic coughing).
Physiotherapy is effective at improving many aspects of life for people with lung disease. There is a large body of research to confirm the effectiveness of physiotherapy for people with lung disease. The Lung Foundation Australia and the Thoracic Society of Australia and New Zealand have developed the COPD X guidelines to improve the management of people with COPD and recommend referral to pulmonary rehabilitation programs.
For people with COPD there is level I evidence (highest quality of evidence) that pulmonary rehabilitation reduces breathlessness, fatigue, anxiety and depression, improves fitness, emotional function and quality of life, and enhances patients’ sense of control of their disease. There is level II evidence that pulmonary rehabilitation reduces patients needing to go to hospital and that it is a cost-effective treatment. The research for pulmonary rehabilitation for patients with other types of lung disease has found similar results.