Physical activity reduces the risk of hospitalization on patients with COPD
The American Thoracic Society (ATS) and the European Respiratory Society (ERS) define Respiratory Rehabilitation (RR) as a program of integral intervention based on patient evaluation, followed with therapies focused on muscular training, respiratory physiotherapy, education, and changes on lifestyle.
Respiratory rehabilitation is a program that includes different disciplines, it is focused on reducing the impact, promote well-being, and the individual’s performance on his/her physical and occupational function, psychological state, social interaction, recreational hobbies, as well as to improve the physical and psychological conditions of people with Chronic Obstructive Pulmonary Disease (COPD).
This intervention is considered fundamental on the treatment of COPD, the main guidelines of the treatment state so. According to the WHO, COPD is a disease presented more often on the elderly, where a reduction of air flow on the lungs is present because of excessive phlegm and/or air entrapment causing the obstruction of the respiratory tract.
Among the most frequent symptoms are:
- Dyspnea, worsening with activity.
- Presence of phlegm (not in all cases).
- Chronic cough.
According to the Mortality and global health estimates, the COPD prevalence in 2016 was of 251 million cases. It is estimated that in 2015, 3.17 million people died because of this, representing a 5% of total deaths registered that year. The main cause of COPD is exposure to tobacco smoke, active or passive. Other risk factors are the exposure of contaminated air on interiors or the exterior, as well as dust and smoke, and especially if in contact inside the work place.
Various research have indicated that physical activity on patients with COPD have less risk of hospitalization. A study performed in Copenhagen, Denmark in 1981 – 1983, and 1991 – 1994 of cohort prospective on adults recruited from the general population, had the objective of examine the association between regular physical activity and hospitalization for COPD and mortality for other causes. Starting from a population sample of 2,386 individuals with COPD were identified and were followed-up until the year 2000. Regular physical activity at the start of the study was classified in four categories: very low, low, moderate, and high). The study found that subjects that reported low, moderate, or high physical activity had less risk of hospitalization by COPD during the follow-up period than those who reported very low physical activity.
As part of the treatment, respiratory physiotherapy is considered an important part of RR programs. Among the techniques used on the area are:
- Bronchial Drainage: the objective is to drain secretions on patients with excessive production of these or difficulty of expectoration with manual or instrumental techniques.
- Respiratory reeducation techniques: breathing through pursed lips to reduce dyspnea and save energy.
- Relaxing techniques: promote self-control of hyperventilation and dyspnea produces as consequence of anxiety caused by the pathology.
Other parts that the RR program include are:
- General muscular training and respiratory muscles: among the hospital aerobic exercise, the treadmill is used; at home, walking outdoors and dancing is recommended. A minimum of 3 times a week is advised and 20 to 30 minutes on continuum or on intervals. It is recommended an intensity of 60 to 80% of the maximum effort capacity, with a minimum of 8 weeks or 20 sessions. On strength training, weightlifting is used performed with gym apparatus with 70 to 85% of 1 repetition load capacity. 1 to 3 series of 8 to 12 repetitions and 2 to 3 sessions by weeks is advised. At home it is recommended to use dumbbells and elastic bands.
- Education: must be a primordial component on RR programs for people with COPD, and must include information on the disease and learning strategies through self-care.
If you suffer from COPD, RR is totally recommended. Here are a few recommendations:
- Avoid a sedentary lifestyle and encourage an active lifestyle with physical exercise.
- Stop smoking, especially if it is the cause of the disease.
- Consult with a dietician for support on malnourishment and increase of energy to increase exercise performance and muscular strength.
- Seek psychological help to manage stress and depression.
- If necessary, use oxygen therapy to increase oxygen levels by dyspnea.
Reviewers: Brenda Giselle Álvarez Rodriguez, Perla Karime Olais Vega (Public Health Research), and Cassandra Saldaña Pineda (Knowledge Management Unit).
- Normativa SEPAR – Rehabilitación respiratoria.R. Güell Rous et al / Arch Bronconeumol. 2014; 50(8):332–344.
- Article: “Selection criteria and programmes for pulmonary rehabilitation in COPD patients”. Eur Respir J 1997; 10: 744–757.
- Article: “Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study” Garcia-Aymerich J, Lange P, Benet M, et al. Thorax 2006;61:772-778.
- Mayo Foundation for Medical Education and Research.