Exercise and Pulmonary Rehabilitation Mary Lester, RRT, RCP Pulmonary Rehabilitation Program Medical University of South Carolina

capacity and increased shortness of breath 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 Stress Management What, Why, How Stress Management Relaxation Techniques Energy Conservation Benefits of Exercise

Breathing Retraining Pursed Lip Breathing Diaphragmatic Breathing Respiratory Rate Control Improve Oxygen Saturation Diaphragmatic Breathing Identification of Stress (symptoms) Relaxation Techniques

Emotional Support Grieving the Loss Relationships Group Support 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? Types of Exercise 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 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 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.

Stretching Stretching Tips If you feel pain STOP! 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!