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

2. 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

3. 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.

4. 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.

5. 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.

6. Pulmonary Rehabilitation Components
Medical Management
Education
Breathing Retraining
Anxiety Control
Emotional Support
Exercise

7. Medical Management Team approach with the Physician Medications
Oxygen Requirements and Benefits
Exercise Prescription

8. Education Disease Process Medications Stress Management
What, Why, How
Stress Management
Relaxation Techniques
Energy Conservation
Benefits of Exercise

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

10. Emotional Support Grieving the Loss Relationships Group Support
Recognizing & Accepting your limitations
Adapting life style changes
Relationships
Group Support

11. Benefits of Exercise Improve Independence Reduce Isolation
Consistent exercise reduces sensitivity to breathlessness
Improves efficiency of breathing
Improves confidence

12. 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

13. 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.

14. 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

15. Aerobic Exercise Activities
Walking
Biking
Swimming
Water Aerobics
Low Impact Aerobics
Dancing
Hiking

16. 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.

17. 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!

18. 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

19. 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.

20. 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!