exercise for chronic respiratory conditions - lung … · exercise for chronic respiratory...
TRANSCRIPT
SCHOOL OF HEALTH
SCIENCES
Exercise for Chronic
Respiratory Conditions
Lung Foundation Seminar
8th October 2016
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More than just a lung disorder
Systemic Inflammation
COPD is a multi-component disease characterised by systemic inflammation
Respiratory System Side Effects
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It’s not about…
Components of Exercise
Endurance (Aerobic) • Any prolonged rhythmic exercise that raises your breathing rate,
such as walking, swimming, dancing, and cycling. These are especially good for your heart, lungs and circulatory system.
Strength (Resistance) • Include lifting weights, climbing stairs, doing body weight
exercises. These will strengthen your muscles and improve balance, which will help to prevent falls, the leading cause of death from injury in people over 65.
Flexibility (Stretching) • Activities include stretching, yoga, Tai Chi, and Pilates. These keep
joints limber. Increased flexibility will allow you to continue to reach the top shelf in your kitchen and do simple day to day activities.
Therapeutic benefits of aerobic exercise
training for COPD patients.
Benefits
• Improved endurance
• Reduced
breathlessness
• Improved CV health
• Assist with weight
control
• Improve mood
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Recommendations for Aerobic
Training
Exercise
Component
Recommendation
Intensity 40-80% of maximal effort (Modified Borg 2-4/10)
Duration Aim for 30 minutes; broken into smaller durations if
necessary due to symptoms
Frequency 1-2 sessions 3-5 days/week.
Role of Interval Training
• Greater benefits to exercising muscle without overloading
the heart and lungs
• More severe COPD patients unable to sustain continuous
load
• Interval exercise is as effective as continuous exercise
Gloeckl et al. 2013 Eur Respir Rev
Exercise
Component
Recommendation
Intensity 80-100% of maximal effort (Modified Borg 4-6/10)
Duration Aim for 45-60 minutes; broken into smaller durations
eg. 30s of exercise, 30s of rest
Frequency 3-5 days/week.
What about resistance training
• COPD patients have high levels of skeletal muscle
wasting, dysfunction and peripheral muscle weakness
– Strength scores in COPD patients average ~80% of those in a
control population
– Cross section of thigh muscle averaged 76% of that of the
control
• Leads to decreased physical function, quality of life
and increased morbidity
Recommendations for Strength Training
Exercise
Component
Recommendation
Intensity 60-80% of maximal effort (Modified Borg 3-4/10)
Sets and
Repetitions
1 set of 8-12 repetitions initially; additional sets added
as strength improves.
Frequency 2-3 days/week.
6-8 exercises using large muscle groups
Recommendations for Flexibility
Training
Exercise
Component
Recommendation
Intensity Low to moderate
Sets and
Repetitions
30 seconds minimum for each static stretch; all major
muscle groups
Frequency 3+ days/week
Balance Training?
• COPD is associated with Increased falls
risk
• Reduced bone density increases risk of
fracture
• Balance training can reduce falls and
fracture risk
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Sample Home Exercise Program
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1. Warm up – A few minutes
2. Exercise – Duration ?
3. Stretch / cool down – A few minutes
Sample Exercise Program… with progression
• Walk every second day for 5-10 minutes
• Set an easy pace the first week, go a little faster the 2nd
week, stop and rest when needed.
• Introduce some light resistance exercises 2 x per week
• Walk FOUR times a week for 10-20 minutes at a
comfortable pace;
• Increase your sets or repetitions for resistance exercises
• Walk FOUR to FIVE times a week.
• Increase your pace as capable while aiming for up to 30
minutes of continuous walking;
• Start to pump or swing your arms;
• Do some resistance exercises every second day
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Weeks 1 and 2
Weeks 3 and 4
Weeks 5 and 6
… and beyond
Contraindications
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If you experience any of the following symptoms when you are exercising stop and rest immediately: • Nausea • Chest Pain • Dizziness or feeling faint • Extreme shortness of breath • Excessive wheezing • Coughing up blood
• Fact Sheets
• Practical Information for Patients and Carers
• Lung Foundation Australia www.lungfoundation.org.au
FACULTY of health 21
Resources
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Lungs in Action
• Eligibility? – Patient with a chronic respiratory condition who has
completed pulmonary or heart failure rehabilitation with the last 12 months without any subsequent hospitalisations
• Referral Requirements? – From a GP or your pulmonary/heart failure rehabilitation
physiotherapist/accredited exercise physiologist
• Location (Tasmania) – Launceston, Hobart, Ulverstone
• Referral Forms – http://lungsinaction.com.au/health-professionals/participant-
eligibility/lfa-lia-entry-form-standard/
Need guidance & support?
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See an Accredited Exercise Physiologist AEPs specialise in individualised exercise programs for persons at high-risk of developing, or with existing chronic conditions (such as COPD, heart disease or diabetes) or injuries. Rebates are available through:
GP chronic disease management plan
Medicare (EPC items)
Department of Veterans Affairs (DVA)
WorkCover-NSW
Private Health funds
www.essa.org.au
UTAS Exercise Physiology Clinic
Tamar Lane Mowbray – entry to campus from Foch Street
For more information contact:
Andrew Williams
Phone: 6324 5487
Sibella King
Phone: 6324 4005