Exercising With Copd

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Exercising With Copd

Cycle-based versus walking-based endurance training Walking is one of the most important activities of daily living in patients with COPD. However, most endurance training programmes are based only on cycle endurance training. In addition to the higher costs and space requirement involving a treadmill in comparison to a cycle ergometer, another possible explanation for this fact could be that patients with COPD exhibit a greater ventilatory response during walking compared to cycling . Thus, minimising dyspnoea sensations and the potential of oxygen desaturation during high intensity exercise are arguments in favour of providing cycling-based endurance training. However, walking-based endurance training programmes are also very effective in improving exercise capacity and quality of life in people with COPD . Compared to equipment-dependent training, such as cycle training, non-treadmill walking is an easily available training modality, particularly for those living in places with limited resources. Furthermore, exercising the patients’ walking skills might be more effective to the patient than exercising cycling skills that are unlikely to be essential to everyday life. A recent study has even shown that supervised, progressive walking training resulted in a significantly larger increase in endurance walking capacity compared to supervised, progressive stationary cycle training . Similar effects were found on peak walking and cycling capacity, endurance cycling capacity and health-related quality of life. Since walking endurance capacity in patients with COPD is especially impaired, this could be the rationale for the implementation of walking-based endurance training to improve the patients walking capabilities. Up-to-date detailed recommendations for prescribing walking training can rarely be found in the literature. A common reference point that was used in several studies was to set the walking speed at ∼80% of peak V′O2, which was achieved in a shuttle walking test. To avoid the complex and time consuming procedure of a ergospirometry during the shuttle walk test, peak V′O2 can be approximately derived by the following equation: peak V′O2 mL·min−1·kg−1=4.19+0.025×ISWT distance . It has been shown that this intensity is feasible in most patients and is effective in improving exercise capacity . If patients are not able to walk continuously for at least 10 min at the given speed, the intensity could be decreased stepwise by ∼10% until the patient is able to walk without taking a rest. It is easy to set and control the proper walking speed when patients are exercising on a treadmill. If patients walk on the ground it is much more difficult to accurately stick to the individualised pace. Other methods such as using a metronome or listening to music, the rhythm of which is adjusted to the individual walking speed, might be useful . Also a given track with distance marks could be helpful. If no supportive devices are available to determine walking speed, a perceived exertion on the Borg scale from 4 from 6 could be targeted. Furthermore, an interval approach could also be applied. To date, walking interval training has not been investigated. Due to practical reasons, longer interval walking periods of 1–2 min duration might be more appropriate.
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Exercising With Copd

Exercise Always check with your Health Care Professional before starting any exercise program or new activity. “I can’t exercise. No way! I’m too short of breath!” It’s normal to feel this way if you’re short of breath with COPD. However, exercise , done correctly and safely, is one of the best things you can do to be less short of breath. Shortness of breath is called dyspnea (disp-nee-yuh). Almost all individuals with COPD have dyspnea, and because of it, they tend to do less and less. The less they do, the less they are able to do, and eventually they become too weak to do much at all. This is called progressive de-conditioning. De-conditioning is losing fitness from lack of exercise. Exercise itself cannot reverse COPD, but it can change the way you feel, breathe, and function. At first, your exercise routine should be slow and easy. Even if you think you can do more, take it slow. Your muscles are not used to working like that! Your exercise time and effort should gradually increase over time – each day, do a little more. When you’ve reached the point that you’re feeling better and breathing better, don’t stop. Keep it up at least three days a week. Exercise cannot reverse lung disease but it can reverse de-conditioning and improve your quality of life. If your health care professional has told you to use oxygen with activity, you should also use oxygen with exercise. Your usual oxygen flow rate (the number you set on your oxygen machine) may not be enough for you during exercise. Ask your health care provider how to set your oxygen for exercise. While you’re here, look over these topics to learn tips on how to live better with your COPD. Newly Diagnosed Understand Your Lungs Oxygen Therapy Medications Breathing Techniques Pulmonary Rehabilitation Staying Healthy and Avoiding Exacerbations Staying Healthy and Avoiding Pneumonia Air Quality in Your Home Coping with COPD Quitting Smoking

Exercising With Copd

Walking is one of the most important activities of daily living in patients with COPD. However, most endurance training programmes are based only on cycle endurance training. In addition to the higher costs and space requirement involving a treadmill in comparison to a cycle ergometer, another possible explanation for this fact could be that patients with COPD exhibit a greater ventilatory response during walking compared to cycling . Thus, minimising dyspnoea sensations and the potential of oxygen desaturation during high intensity exercise are arguments in favour of providing cycling-based endurance training. However, walking-based endurance training programmes are also very effective in improving exercise capacity and quality of life in people with COPD . Compared to equipment-dependent training, such as cycle training, non-treadmill walking is an easily available training modality, particularly for those living in places with limited resources. Furthermore, exercising the patients’ walking skills might be more effective to the patient than exercising cycling skills that are unlikely to be essential to everyday life. A recent study has even shown that supervised, progressive walking training resulted in a significantly larger increase in endurance walking capacity compared to supervised, progressive stationary cycle training . Similar effects were found on peak walking and cycling capacity, endurance cycling capacity and health-related quality of life.
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Exercising With Copd

Endurance training is probably the most common exercise modality in patients with COPD. The main objective of endurance training is to improve aerobic exercise capacity as aerobic activities are part of many everyday tasks in these patients. It has been shown that endurance training also improves peripheral muscle function in patients with COPD . In addition, there is some evidence that high-intensity endurance training induces greater physiological benefits than lower-intensity exercise . However, most patients with severe COPD are not able to sustain high-intensity exercise due to serious symptoms, such as dyspnoea and fatigue . Therefore, alternative exercise protocols, such as interval training, have gained increasing interest especially in patients with advanced COPD.

Exercising With Copd

The benefits of long-term oxygen therapy (LTOT) in patients with COPD associated with hypoxaemia are well known. In these patients, LTOT prolongs survival and reduces hospitalisations, as well as the risk of comorbidities . More recently, the usefulness of oxygen therapy in improving outcomes from pulmonary rehabilitation in patients with COPD has been evaluated in several studies. In general, a distinction must be made between immediate effects of oxygen on exercise performance and its usefulness in the exercise-training component of pulmonary rehabilitation. As an adjunct to exercise training, supplemental oxygen therapy has been studied in patients who are severely hypoxaemic at rest or with exercise. The rationale for these studies is that supplemental oxygen therapy improves peripheral muscle oxygenation , dyspnoea and exercise capacity in patients with COPD and hypoxaemia, possibly allowing them to train at higher intensities. While the use of oxygen improves maximal exercise performance acutely in the laboratory, studies testing its effect in enhancing the exercise-training effects have produced inconsistent results. This may reflect differences in methodology among the studies, especially with regard to training workload . However, the use of continuous supplemental oxygen for patients with COPD and severe resting hypoxaemia is clearly indicated and recommended as a part of routine clinical practice. Oxygen saturation measured by pulse oximetry >90% and/or an arterial oxygen pressure >55 mmHg should be targeted .
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Exercising With Copd

Endurance training Endurance training is probably the most common exercise modality in patients with COPD. The main objective of endurance training is to improve aerobic exercise capacity as aerobic activities are part of many everyday tasks in these patients. It has been shown that endurance training also improves peripheral muscle function in patients with COPD . In addition, there is some evidence that high-intensity endurance training induces greater physiological benefits than lower-intensity exercise . However, most patients with severe COPD are not able to sustain high-intensity exercise due to serious symptoms, such as dyspnoea and fatigue . Therefore, alternative exercise protocols, such as interval training, have gained increasing interest especially in patients with advanced COPD.

Exercising With Copd

Oxygen supplementation during exercise The benefits of long-term oxygen therapy (LTOT) in patients with COPD associated with hypoxaemia are well known. In these patients, LTOT prolongs survival and reduces hospitalisations, as well as the risk of comorbidities . More recently, the usefulness of oxygen therapy in improving outcomes from pulmonary rehabilitation in patients with COPD has been evaluated in several studies. In general, a distinction must be made between immediate effects of oxygen on exercise performance and its usefulness in the exercise-training component of pulmonary rehabilitation. As an adjunct to exercise training, supplemental oxygen therapy has been studied in patients who are severely hypoxaemic at rest or with exercise. The rationale for these studies is that supplemental oxygen therapy improves peripheral muscle oxygenation , dyspnoea and exercise capacity in patients with COPD and hypoxaemia, possibly allowing them to train at higher intensities. While the use of oxygen improves maximal exercise performance acutely in the laboratory, studies testing its effect in enhancing the exercise-training effects have produced inconsistent results. This may reflect differences in methodology among the studies, especially with regard to training workload . However, the use of continuous supplemental oxygen for patients with COPD and severe resting hypoxaemia is clearly indicated and recommended as a part of routine clinical practice. Oxygen saturation measured by pulse oximetry >90% and/or an arterial oxygen pressure >55 mmHg should be targeted . The use of supplemental oxygen as an adjunct to exercise training could also be useful in patients who do not meet inclusion criteria for LTOT and do not experience exercise-induced hypoxaemia. In a double-blinded randomised trial, patients without significant exercise-induced oxygen desaturation were randomised to receive either room air or oxygen during high-intensity exercise training . Exercise performance improved significantly more in the group receiving oxygen. This improvement was accompanied by a reduction in respiratory rate. The long-term effects when supplemental oxygen is discontinued and the effect on other outcomes such as health-related quality of life remain to be determined.

Exercising With Copd