Diagnosed with COPD and afraid to exercise? Try this!

The main clinical manifestations of COPD patients are

Chronic cough, sputum production, and difficulty breathing

Many patients also have decreased respiratory muscle strength

Problems such as decreased exercise endurance seriously affect the patient's quality of life

In addition to traditional drug treatments

Comprehensive management of COPD also includes a variety of non-drug interventions

Among these methods, pulmonary rehabilitation occupies an important position.

Regular exercise training is the core of pulmonary rehabilitation

The focus of this popular science article will be on an important part of respiratory rehabilitation - exercise rehabilitation

What kind of exercises can COPD patients do?

Even normal people may face problems such as increased risk of hypertension and decreased exercise tolerance if they lack exercise for a long time. For COPD patients, lack of proper exercise may accelerate the aging process of the body, lead to further muscle atrophy, and aggravate the symptoms of dyspnea . Therefore, it is particularly important to formulate personalized exercise prescriptions for COPD patients based on their individual conditions and disease characteristics.

First, it is necessary to comprehensively assess the patient's health status , including their ability to carry out daily activities, such as whether they can walk or run normally. For patients who can carry out these activities, it is recommended to adopt whole-body ground exercise, such as running, swimming, or Tai Chi. In the early stage, you can start with 1-2 minutes each time, 1-2 times a day, and gradually increase to 20-30 minutes each time to adapt to the body's needs and gradually enhance physical fitness.

For older patients with severe lung damage and severe dyspnea, family members or medical staff are required to accompany them during exercise rehabilitation. For such patients, supine rehabilitation exercises can be chosen. The advantages are that they are suitable for elderly and severe COPD patients, and they can exercise under oxygen inhalation and non-invasive ventilation. The movements are simple and effective , which helps to improve physical functions under relatively safe conditions.

Zheng's supine rehabilitation exercise

Developed by Professor Zheng Zeguang of the First Affiliated Hospital of Guangzhou Medical University, Zheng's supine rehabilitation exercise is suitable for COPD patients at home and is not restricted by time and space. The specific exercise forms of this rehabilitation exercise are as follows:

(1) Skybike

The patient lies flat on his back, straightens his legs, bends his knees and lifts them up, leaving his legs suspended in the air while keeping his upper body still. Then, alternately do bicycle pedaling movements with your legs in the air, making sure that your legs are fully straightened each time you kick out. This movement helps to strengthen the lower limb muscles and joint flexibility.

(2) Stretch and sit-ups

The patient lies flat on his back, holds both ends of the bed rails with both hands, and uses the strength of the upper limbs to slowly pull up the upper body to a sitting position. After holding this position for 3 seconds, slowly lie down. Repeat this action to strengthen the upper limbs and core muscles. If there is no bed rail to assist at home, family members can act as support. Family members stand by the bed, cross their hands and hold the patient's fingers together, and gently use force to help the patient pull up to a position where the upper body is raised. After holding for 3 seconds, slowly help the patient lie down. Ensure that the entire process is smooth and safe, and avoid sudden force.

(3) Bridge exercise

The patient lies on his back with his knees bent, his fingers clasped together, placed around his navel, his feet flat on the bed, and uses the strength of his waist to lift his buttocks about 10-15cm off the bed, hold for 3-5 seconds, then slowly lower them, repeating this action over and over again. During each exercise, the number of repetitions can be gradually increased according to one's own physical condition. This exercise mainly exercises the muscles of the waist and back, helps to enhance core stability, and improves the body's support ability.

These three movements cover most of the activities of the trunk and limbs in daily human exercise, and comprehensively exercise the core muscles and limb strength. It is recommended to perform 2-3 times a day, 15 minutes each time. Through scientific and reasonable exercise rehabilitation training, COPD patients can improve their respiratory function, alleviate symptoms, and significantly improve their activity endurance to a certain extent . It is important that the effect of rehabilitation exercise depends on long-term persistence. In order to achieve the best results, COPD patients should integrate these rehabilitation exercises into their daily lives and cultivate good habits of regular exercise to promote long-term physical health and quality of life.

In addition to rehabilitation exercises, other forms of exercise include aerobic training, resistance training, balance and flexibility training, respiratory muscle training, etc.

Aerobic training (endurance training)

Aerobic training refers to the body's use of large muscle groups throughout the body to maintain long-term exercise ability according to a certain load. The recommended exercise time is 20 to 60 minutes of continuous or intermittent exercise per day for 4 to 12 weeks. Common aerobic exercises include brisk walking, jogging, swimming, playing ball, etc.

During aerobic exercise training, the finger pulse oxygen saturation (SpO2) should always be ≥88%. If the patient's SpO2 is <88% or drops by more than 4% during exercise, training should be stopped and supplemental oxygen therapy should be given.

Resistance training (strength training)

Impedance training refers to a form of exercise that trains local muscle groups by overcoming a certain amount of load. The recommended exercise frequency is 1 to 3 sets/day, 8 to 10 times/set. Impedance training methods usually include machine training and freehand training . Machine training mainly includes dumbbells, elastic bands, and various impedance training equipment. Freehand training uses methods that resist one's own gravity, such as squats and push-ups. Avoid holding your breath during impedance training.

Balance and flexibility training

Balance and flexibility training plays an important role in preventing sports injuries and expanding the range of joint motion. Common flexibility training includes Tai Chi, Ba Duan Jin, yoga, etc.

Respiratory muscle training

Decreased respiratory muscle function is one of the common causes of insufficient lung ventilation and shortness of breath in patients with COPD. Pursed lip breathing and abdominal breathing are currently the most commonly used respiratory muscle training contents.

(1) Pursed lip breathing means that the patient inhales through the nose with the mouth closed for about 2 seconds, and then exhales slowly for 4 to 6 seconds with pursed lips like whistling. When exhaling, it is best to be able to gently blow a piece of white paper 30 cm in front of you. Exhale as much as possible, and emphasize that the ratio of inhalation to exhalation time should be 1:2 or 1:3.

(2) Abdominal breathing exercises are usually performed in a supine position. The patient curls up his legs and places his hands on his chest and abdomen. He breathes in slowly through his nose, trying to bulge his lower abdomen as much as possible. After inhaling a full breath, he pauses for a moment. He exhales slowly, trying to retract his abdomen as much as possible. At the same time, he gently presses upward and inward with his hands to help the diaphragm rise and exhale deeply. There is no strict time requirement for respiratory muscle training. Generally, 2 to 3 times/day and 15 to 30 minutes/time are appropriate.