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Physical therapy is an important tool for managing COPD.
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Chronic obstructive pulmonary disease is a progressive lung disorder characterized by inflammed airways, lung overinflation and labored breathing. COPD affects an estimated 12 million Americans, according to the Centers for Disease Control and Prevention. It is the 3rd leading cause of death in the United States. Although COPD is generally irreversible, it typically responds to treatment. Inhaled and oral medications and supplemental oxygen are the mainstays of medical therapy. Pulmonary rehabilitation -- a type of physical therapy designed to strengthen your lungs and body -- may also help.
Breaking the Cycle
COPD's progressive course is driven by a constellation of factors. Inflammatory airway damage overinflates your lungs and interferes with the absorption of oxygen and elimination of carbon dioxide. Poor oxygenation and rising carbon dioxide levels impair your organs' functions.
COPD increases the workload on your respiratory muscles, which may weaken under the strain. As your respiratory muscles fail, reduced air movement further worsens gas exchange. Eventually, this cycle becomes self-perpetuating. COPD treatment is aimed at correcting one or more of these issues and interrupting the cycle. The American Thoracic Society reports that pulmonary rehabilitation improves respiratory muscle function and reduces the symptoms of COPD.
Pulmonary rehabilitation is a comprehensive program that involves physical therapy, nutritional counseling, patient education and psychosocial support. Physical therapy, respiratory conditioning and exercise training are a primary focus of most pulmonary rehabilitation programs. One example is a highly effective regimen devised at Tokyo's Juntendo University School of Medicine. With this program, COPD patients participate in hour-long training sessions twice daily 2 days per week for 6 weeks. Rehabilitation sessions include physical therapy, large muscle exercise and respiratory muscle training.
In the initial phases of pulmonary rehabilitation, you typically participate in physical therapy to improve use of your rib cage, spine and the muscles of your neck, back, trunk and legs. Your physical therapist will perform manual stretching and strengthening techniques, such as compressing your rib cage during breathing or alternately stretching and relaxing your muscles. You will be taught to stretch your own muscles and your therapist will help you adjust your posture to facilitate more effective breathing. You may be encouraged to use machines, such as an inspiratory muscle trainer, to optimize your respiratory muscle function.
Large Muscle Training
Loss of muscle mass is common among people with COPD. Part of your reconditioning will involve strengthening the muscles of your arms, back, abdomen and legs. This training, which is supervised by a physical therapist, aims to increase your exercise tolerance and improve your body's metabolic use of oxygen. This helps reduce shortness of breath and fatigue. Your strengthening program might include low-intensity stationary cycling, walking, free-weight exercises or wearing hand and ankle weights. As your strength and endurance improve, the intensity of your exercise may be increased.
Studies indicate that COPD patients who participate in pulmonary rehabilitation programs commonly experience improved airflow, exercise endurance, capacity for self-care and quality of life. Physical therapy for COPD should not be delayed until your lung disease is far advanced because early intervention appears to provide significant long-term benefits.
The duration and makeup of your physical therapy program will be based on your overall health status and the severity of your COPD. To maintain the benefits you achieve during your program, your doctor will likely urge you to continue an at-home exercise regimen.