CHRISTOPHER O. OLOPADE, M. D. , KENNETH C. BECK, Ph. D. , ROBERT W

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Presentation transcript:

Exercise Limitation and Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease CHRISTOPHER O. OLOPADE, M.D., KENNETH C. BECK, Ph.D., ROBERT W. VIGGIANO, M.D., BRUCE A. STAATS, M.D. Mayo Clinic Proceedings Volume 67, Issue 2, Pages 144-157 (February 1992) DOI: 10.1016/S0025-6196(12)61316-0 Copyright © 1992 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 1 Diagram of flow-volume loop dynamics in a normal person and a patient with chronic obstructive pulmonary disease (COPD). In patient with COPD, during tidal breathing expiratory flow abuts the expiratory limb of maximal expiratory flow-volume curve. During exercise (Ex), patient with COPD breathes at a slightly higher lung volume (leftward shift of flow-volume loop). This result contrasts with that in normal subject, who has a large ventilatory reserve both at rest and during exercise. TLC = total lung capacity. Mayo Clinic Proceedings 1992 67, 144-157DOI: (10.1016/S0025-6196(12)61316-0) Copyright © 1992 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 2 Diagram depicting flattening of diaphragm and loss of region of apposition in patient with emphysema. Contraction of flattened diaphragm leads to inward movement of costal region, which is noticeable on physical examination (Hoover's sign). Mayo Clinic Proceedings 1992 67, 144-157DOI: (10.1016/S0025-6196(12)61316-0) Copyright © 1992 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 3 Perceived exertion rating of subjective exercise intensity. Scale ranges from perception of “very, very light” exercise to “very, very hard” exercise. Mayo Clinic Proceedings 1992 67, 144-157DOI: (10.1016/S0025-6196(12)61316-0) Copyright © 1992 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 4 Diagram showing application of nasal mask for continuous positive airway pressure. Mask, which is secured by straps around head and fastened with Velcro patches, is connected to a blower unit. Mayo Clinic Proceedings 1992 67, 144-157DOI: (10.1016/S0025-6196(12)61316-0) Copyright © 1992 Mayo Foundation for Medical Education and Research Terms and Conditions