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.
References
ACSM’s Exercise Management for Person’s with Chronic
Diseases and Disabilities
