David R. Bassett, Jr. chapter 21 Exercise, Asthma, and Pulmonary Disease

Pulmonary Disease May be due to genetic causes (e.g., cystic fibrosis) or environment (smoking, coal dust, asbestos) Poor gas exchange between ambient air and pulmonary capillary blood Reduction in VO 2 max.

Two Major Categories Chronic obstructive pulmonary diseases (COPDs) Restrictive lung diseases

COPD Reduction in expiratory airflow Shortness of breath on exertion Examples: bronchitis, emphysema, bronchial asthma Treatment involves bronchodilators and other drugs

Emphysema A type of COPD Often results from tobacco smoking Loss of elastic recoil of alveoli and bronchioles Enlargement of those structures Airways can collapse during exhalation

Asthma A type of COPD Affects 14.6 million Americans Reversible condition Varies from wheezing to severe breathlessness Causes include allergic reaction to dust, pollen, smoke, and pollution Stress, exercise, and viral infections can also be causes

Cystic Fibrosis A type of COPD Recessively inherited genetic disorder Affects 1 in 2,500 White children Rare in Asians and African Americans Thick mucus blocks air exchange

Restrictive Lung Diseases Can be caused by kyphoscoliosis, pectus excavatum, coal dust, asbestos, chemotherapy, or radiation therapy Difficulty expanding the lungs Reduced RV, IRV, ERV, FVC, and TV Increased work in breathing

Lung Volumes in Person With Restrictive Lung Disease and in Person Without Lung Disease Reprinted from Essentials of cardiopulmonary physical therapy, 2nd ed., edited by E.A. Hillegass and H.S. Sadowsky, from P. Clough, “Restrictive lung dysfunction,” pg. 186, copyright 2001, with permission from Elsevier.

Rehabilitation programs address COPD. Exercise has little effect on VO 2 max, lung function tests, and mortality rates. Benefits include improved functional capacity, better quality of life, and dyspnea relief. Exercise and Pulmonary Disease.

Pulmonary Function Testing

Portable Pulse Oximeter

Exercise Prescription in Pulmonary Patients Rhythmic, dynamic exercise 3 to 5 times per week At least 30 min a session Resistance training recommended

Special Considerations in Pulmonary Disease Supplemental O 2 to maintain S a O 2 above 90% Pursed-lip breathing in emphysema