CARDIOPULMONARY REHABILITATION

Pulmonary rehabilitation is a relatively late topic on the medical agenda. Although COPD (chronic obstructive pulmonary disease) is one of the first diseases that comes to mind when it comes to pulmonary rehabilitation, it has application areas in many respiratory tract diseases.

Exercise constitutes the most important part of pulmonary rehabilitation programs. With exercise, heart and lung functions improve, muscles become stronger and the feeling of shortness of breath decreases.

Exercise programs in pulmonary rehabilitation should be determined according to individual needs. Aerobic and strengthening exercise programs such as walking, cycling, treadmill (walking belt) to be applied individually or in groups should be among the first choices. In addition, breathing exercises, relaxation, energy use techniques during daily activities and methods of reducing shortness of breath should form other parts of the pulmonary rehabilitation program.

What is Pulmonary Rehabilitation?

Pulmonary rehabilitation can be described as a treatment method that uses individuals with clinical and / or physiological respiratory diseases to maintain their daily personal and life functions at the highest level. Those with respiratory problems restrict their physical activities due to fear of developing shortness of breath. When physical activity is restricted, strength and endurance will decrease. In addition, the degree of life satisfaction and independence of individual’s job will decrease.

To Whom is Pulmonary Rehabilitation Applied?

As an exercise, endurance (aerobic, endurance) and strengthening (resistance) exercises and respiratory muscle exercises should be planned. Exercise training should be adapted to the needs of the individual. Diseases in which pulmonary rehabilitation is applied;

• Obstructive lung diseases, (COPD, asthma, bronchiectasis, cystic fibrosis)
• Restrictive lung diseases (interstitial lung diseases, chest wall diseases, neuromuscular diseases)
• Other (lung malignancies, primary pulmonary hypertension, pre / post cardiac surgery, ventilator dependent patients, etc.).

What Should Be the Goals in Pulmonary Rehabilitation?

• Increasing exercise capacity, muscle resistance and endurance,
• Increasing awareness about lung disease by increasing compliance with recommended treatments,
• Reducing the severity and frequency of the symptoms, thus reducing the dependence on the environment,
• To maximize the functional and psychological status of the person, to increase motivation,
• Participation in daily life and increasing the quality of life,
• Prolonging the life span by controlling the disease.
• Reducing hospital admissions and hospitalizations.

What Are The Exercise Methods Applied In Pulmonary Rehabilitation?

• Aerobics (endurance exercises): With these exercises, vascularization in the muscles increases and the protein and myoglobin contents of the muscles increase. Thus, the distribution of oxygen in muscle tissue becomes easier. As a result of the increase in the aerobic capacity of skeletal muscles, an improvement in shortness of breath is observed. Improvements occur in daily life activities and functional abilities, and as a result, an increase in the quality of life is observed.

Generally, treadmill, free-time walking or bicycle ergometer should be used for the lower extremities of the patients. This group of exercises will affect large muscle masses.

• Muscle strengthening exercises: These types of exercises are also exercises that have very positive effects on general health. It affects speed, balance and coordination positively. Strengthening the upper arm and back muscles should be aimed in this group.
• Upper limb and shoulder girdle exercises: The muscles we call the shoulder girdle on the upper part of the body also contribute to respiration. Developing these muscles with weight exercises will improve respiratory functions. Exercises such as swimming will increase the development of this group of muscles in the upper extremities.
• Respiratory muscle exercises: Especially the dysfunction that may occur in this group of muscles causes shortness of breath and exercise restriction in all lung patients, especially COPD. Exercises that increase the strength and endurance in the respiratory muscles will increase the exercise capacity and quality of life. For this purpose, there are various working methods to strengthen the respiratory muscles. Exercises for the respiratory muscles should be applied if symptoms related to the respiratory tract persist despite the strengthening of the peripheral muscles and endurance exercises.

Apart from these exercise methods, there are many different forms of exercise used in respiratory diseases. The main purpose of all is to increase muscle strength and strength, especially respiratory muscles.

What Are the Benefits of Pulmonary Rehabilitation in a Patient with COPD?

Pulmonary rehabilitation program can be combined in patients with COPD. In this way, an increase in exercise capacity and significant improvements in muscle strength can be achieved. In training programs, exercises such as cycling, climbing up and down stairs, and walking should be combined to increase muscle mass and strength. The benefits of pulmonary rehabilitation in patients with COPD;

• Increasing exercise capacity,
• Improving the quality of life, increasing independence,
• Decrease in hospital admissions and hospital stay times,
• Reduction in anxiety and depression related to COPD
• Increasing muscle resistance and endurance.