Exercise for Chronic Respiratory Conditions

Transcription

1 SCHOOL OF HEALTH SCIENCES Exercise for Chronic Respiratory Conditions Lung Foundation Seminar 8 th October 2016

2 Pathophysiology - Effect on Airways 2

3 3

4 More than just a lung disorder COPD is a multi-component disease characterised by systemic inflammation Respiratory System Side Effects Systemic Inflammation 4

5 Benefits of Exercise 5

6 It s not about 6

7 It s about Less More 7

8 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.

9 Therapeutic benefits of aerobic exercise training for COPD patients. Benefits Improved endurance Reduced breathlessness Improved CV health Assist with weight control Improve mood 9

10 Recommendations for Aerobic Training Exercise Component Recommendation Intensity 40-80% of maximal effort (Modified Borg 2-4/10) Duration Frequency Aim for 30 minutes; broken into smaller durations if necessary due to symptoms 1-2 sessions 3-5 days/week.

11 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 Exercise Component Recommendation Intensity % of maximal effort (Modified Borg 4-6/10) Duration Frequency Aim for minutes; broken into smaller durations eg. 30s of exercise, 30s of rest 3-5 days/week. Gloeckl et al Eur Respir Rev

12 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

13 Strength Gains 13 Liao et al, 2015

14 Recommendations for Strength Training 6-8 exercises using large muscle groups Exercise Component Recommendation Intensity 60-80% of maximal effort (Modified Borg 3-4/10) Sets and Repetitions Frequency 1 set of 8-12 repetitions initially; additional sets added as strength improves. 2-3 days/week.

15 Recommendations for Flexibility Training Exercise Component Intensity Recommendation Low to moderate Sets and Repetitions Frequency 30 seconds minimum for each static stretch; all major muscle groups 3+ days/week

16 Balance Training? COPD is associated with Increased falls risk Reduced bone density increases risk of fracture Balance training can reduce falls and fracture risk 16

17 What are Balance Exercises? 17

18 Sample Home Exercise Program 1. Warm up A few minutes 2. Exercise Duration? 3. Stretch / cool down A few minutes 18

19 Sample Exercise Program with progression Weeks 1 and 2 Walk every second day for 5-10 minutes Set an easy pace the first week, go a little faster the 2 nd week, stop and rest when needed. Introduce some light resistance exercises 2 x per week Weeks 3 and 4 Walk FOUR times a week for minutes at a comfortable pace; Increase your sets or repetitions for resistance exercises Weeks 5 and 6 and beyond 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 19

20 Contraindications 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 20

21 Resources Fact Sheets Practical Information for Patients and Carers Lung Foundation Australia 21 FACULTY of health

22 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 22

23 Need guidance & support? 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 23

24 How to find an Exercise Physiologist

25 UTAS Exercise Physiology Clinic Tamar Lane Mowbray entry to campus from Foch Street For more information contact: Andrew Williams Phone: Sibella King Phone:

26 Questions? REMEMBER.. EXERCISE IS MEDICINE!

27 Balance Exercises 27