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. Inactivity (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 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 Severity 0 - 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!