Saturday, December 10, 2016

Rehabilitation for Lung disorders

Pulmonary disorders have been shown to have some negative effects on physical activity that make it hard for an individual to accomplish everyday activities. Although these disorders are non-reversible, they can be managed for a better quality of life. The effects of lung disorders can have an effect on an individual physically and mentally. A person may have a hard time physically catching their breath, but also mentally finding the motivation and confidence to work through it.
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Pulmonary rehabilitation is geared toward helping people with COPD exercise for a better quality of life. When a COPD patient experiences dyspnea during physical activity, they end up using accessory muscles around their lungs to help compensate for the damage they already have. Due to these muscles being smaller, they are prone to get tired faster. During pulmonary rehabilitation, those accessory muscles along with larger breathing muscles, such as the diaphragm, are trained with cardiovascular and resistance exercises. Cardiorespiratory training has been shown to reduce muscle fatigue and lowers the ventilatory requirement. Resistance exercises on accessory muscles will put less strain on the cardiorespiratory system but still have beneficial effects.2 This will allow the person to work with a high load, but have less dyspnea. A combination of cardiorespiratory and resistance training has resulted in better outcomes than cardiorespiratory training alone.

Just like with cardiorespiratory and resistance training in healthy individuals, there are beneficial adaptations in the cells as well. Some of these include a higher mitochondrial density, capillary density, and muscle fiber size. This allows for a bit higher lactate threshold, which will allow the patient to be able to work longer with less dyspnea and discomfort.
With the added physical activity the patient is doing, it is important to add nutritional awareness to their rehabilitation as well. Considering the added energy expenditure and muscle breakdown and growth, and increase in protein is very important. This increase can help promote a healthy weight and fat-free mass.2
Although pulmonary disease is non-reversible, they symptoms can be managed with rehabilitation for an improved quality of life. A combination of cardiorespiratory and resistance training can provide the best results for a patient seeking an improved quality of life.
1Powers, S.K. and Howley, E. T. Exercise Physiology. Theory and Application
to Fitness and Performance. 2015; (9).
2Vogiatzis, I., Zakynthinos, S. The physiological basis of rehabilitation in chronic heart and lung disease. Journal of Applied Physiology. 2013; (1) 115; 16-21.

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