Exercise and Pulmonary Rehabilitation
Mary Lester, RRT, RCP
Pulmonary Rehabilitation Program
Medical University of South Carolina
People with lung conditions are often caught
in a vicious circle of deconditioning.
(avoiding activity)
Decreased work
capacity and increased
shortness of breath
Muscle weakness
Increased effort to
do work
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
Breathing Retraining
Anxiety Control
Emotional Support
Medical Management
• Team approach with the Physician
• Medications
– Oxygen Requirements and Benefits
• Exercise Prescription
• 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
• 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
Water Aerobics
Low Impact Aerobics
Borg Scale of Breathlessness
• To exercise comfortably you
– 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 Severity
0 - No Breathlessness
1 - Very Slight
2 - Slight Breathlessness
3 - Moderate
4 - Somewhat Severe
5 - Severe Breathlessness
7 - Very Severe Breathlessness
9 - Very Very Severe
10 - Maximum Scale
• 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
Change your lifestyle and make
exercising a top priority!
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