Exercise and Pulmonary Rehabilitation

Mary Lester, RRT, RCPPulmonary Rehabilitation Program

Medical University of South Carolina

Inactivity(avoiding activity)

Decreased work capacity and increased

shortness of breath

Muscle weakness

Increased effort to do work

People with lung conditions are often caught in a vicious circle of deconditioning.

Physical Activity

“Lifestyle Exercise”

• The Surgeon General’s report recommends that we accumulate a minimum of 30 minutes of moderate intensity activity on most if not all days of the week.

What is Pulmonary Rehabilitation?

• Pulmonary Rehabilitation is a program for people with Chronic Lung Diseases such as Emphysema, Chronic Bronchitis, Asthma, Bronchitis and Interstitial Lung Disease.

• Motivates people to regain a normal and active lifestyle.

Pulmonary Rehabilitation Objectives

• Improve Quality of Life.

• Improve ability to cope with their illness and health status.

• Restore the patient to their highest possible Functional Capacity.

• To Lead and Full and Satisfying Life.

Pulmonary Rehabilitation Components

• Medical Management

• Education

• Breathing Retraining

• Anxiety Control

• Emotional Support

• Exercise

Medical Management

• Team approach with the Physician

• Medications– Oxygen Requirements and Benefits

• Exercise Prescription

Education

• Disease Process

• Medications– What, Why, How

• Stress Management– Relaxation Techniques

• Energy Conservation

• Benefits of Exercise

Breathing Retraining

• Pursed Lip Breathing – Respiratory Rate Control– Improve Oxygen Saturation

• Diaphragmatic Breathing

• Identification of Stress (symptoms)

• Relaxation Techniques

Emotional Support

• Grieving the Loss– Recognizing & Accepting your limitations– Adapting life style changes

• Relationships

• Group Support

Benefits of Exercise

• Improve Independence

• Reduce Isolation

• Consistent exercise reduces sensitivity to breathlessness

• Improves efficiency of breathing

• Improves confidence

How do I start?

• What are your goals?– Talk to your doctor before starting any new

exercise program.

• Types of Exercise– Aerobic Exercise– Strength Training– Flexibility / Stretching

Aerobic Exercise Facts

• Two to three weeks to begin improving your fitness level.

• 6 weeks to 3 months to achieve significant improvement.

• 2 days of inactivity to begin losing endurance.

• Most of the exercise benefits will be lost within 2 weeks of inactivity.

What is Aerobic Exercise?

• It is Exercise for the Heart and Lungs. – Work up to at least 30 minutes five or more

days a week.

• Moderate Intensity– Target Heart Rate– Exertion Scale– Talk Test

Aerobic Exercise Activities

• Walking

• Biking

• Swimming

• Water Aerobics

• Low Impact Aerobics

• Dancing

• Hiking

Borg Scale of Breathlessness

• To exercise comfortably you should:– Keep your shortness of breath

rating between 3 and 4.– Keep oxygen level above 90%.

• Talk Test – Able to speak in short phrases

during exercise.

Scale and Severity0 - No Breathlessness

1 - Very Slight

2 - Slight Breathlessness

3 - Moderate

4 - Somewhat Severe

5 - Severe Breathlessness

6

7 - Very Severe Breathlessness

8

9 - Very Very Severe

10 - Maximum Scale

Stretching

• Stretching Tips– Stretch to the point of mild tension– Hold 20 to 30 seconds– No bouncing– Breathe

• If you feel pain STOP!

Exercise Tips

• If you use a fast acting inhaler be sure to take it before exercise.

• You may need to use oxygen during exercise. Oxygen will help your muscles work more efficiently.Biking

Other Important Tips

• To help with anxiety and breathlessness use pursed lip breathing and diaphragmatic breathing.

• Your are encouraged to use a walker, shopping cart or wheel chair if it allows you to be more active.

Staying on Track

• Look for ways to increase your activity.

• Set short and long term goals.

• Think of possible barriers and make a plan.

Change your lifestyle and make exercising a top priority!