Chronic Obstructive Pulmonary Disease (COPD) is a complex breathing condition affecting not only the ventilatory system, but also the respiratory, cardiovascular and muscular systems. Ventilatory problems include increased resistance of the airways, increased effort to breath, weakness and fatigue of the ventilatory muscles, inefficient breathing and later, failure to breathe. Respiratory problems refer to the impaired exchange of gases (oxygen and carbon dioxide) at a cellular level in the lungs. Cardiovascular complications include reduced cardiovascular fitness due to decreased physical activity, and inadequate cardiac function with increased demand. Muscular problems include deconditioning as a result of reduced physical activity.
People with COPD also often suffer with psychological complications such as depression, as they are unable to perform normal daily activities, and anxiety linked to their symptoms, the most common of which is breathlessness.
As exercise increases breathing rate and cardiac output, people with COPD will most likely experience difficulty with exercise and thus often do not participate in any regular physical activity. It is important, however, that individuals with this condition do participate in regular exercise in order to improve cardiovascular fitness, muscle strength and endurance, balance, flexibility, and body composition leading to enhanced self image. Exercise also helps to desensitize one’s response to breathlessness, assisting in the management of symptoms and thus reducing anxiety. Breathing also becomes more efficient and effective with appropriate exercise.
It is important to consider the effects of certain medications on exercise capacity, as these individuals are often on various medications to manage their condition. Exercise programming will thus need to be individualised and must be adjusted each day, depending on how the individual is feeling. Some individuals may need to monitor their oxyhaemoglobin saturation levels, especially in the early days of starting an exercise programme. It is important to always listen to one’s symptoms and adjust the exercise intensity accordingly, and allow lots of rest intervals.
The main goal is to keep one engaged in an ongoing regular exercise regimen. It must therefore be manageable from a physical capacity perspective, and enjoyable to ensure that it is continued. Then, not only will one reap the disease-related benefits, but also the many other benefits of participating in a regular exercise regimen.
ACSM’s Exercise Management for Person’s with Chronic Diseases and Disabilities