Exercise Prescription And Treatment/Pharmacology OF COPD

An acute and progressive disease, Chronic obstructive pulmonary disease (COPD) is characterised by breathlessness caused by obstruction to airflow into the lungs.

In a previous blog, we looked at the classification and prevalence of COPD; now we’re looking at how this condition can be treated and alleviated by medicine and exercise prescription.

The benefits of treating COPD

While there is no cure for COPD, there are interventions that can improve the day-to-day life of those with the condition.

Treatment will depend on how far the disease has progressed and the symptoms that each individual displays.

Exercise and treatment can slow the progress of COPD, relieve symptoms, and prevent and treat exacerbations.

It can also allow the person being treated to increase their level of exercise and improve their quality of life.

What are the pharmacological treatment options for COPD?

Pharmacological treatments for COPD are prescribed to relieve or decrease symptoms and reduce complications from the disease.

They include:

• Bronchodilators – which relax the bronchial smooth muscle and dry up mucus
• Steroids – anti-inflammatories, which also reduce microvascular leakage
• Methylxanthines – like bronchodilators, these relax the bronchial smooth muscle and influence the contractility of the diaphragm
• Phosphodiesterase-4 inhibitors – these reduce inflammation

There are many potential side effects to these drugs and anyone prescribed them should consult with their GP and monitor any adverse reactions.

Personal trainers and fitness instructors should be aware that clients with COPD may have been prescribed one or more of the pharmacological treatments described above – and that they may be experiencing side effects that can affect their ability to train.

How can exercise help those with COPD?

While exercise won’t necessarily improve lung function in clients with COPD, it can help them to carry out daily activities, improve quality of life and reduce the likelihood of hospital stays. Exercise at any level can allow better use of oxygen, recondition the cardiovascular system and reduce sensitivity to dyspnoea (laboured breathing).

Exercise also offers many other benefits, such as strengthening the body, improving flexibility and enhancing mood.

What exercise is prescribed for COPD?

Exercise that most suit those with COPD are as follows:

• Aerobic – walking, cycling, swimming or other rhythmic or dynamic exercise at low or moderate intensity for up to 30 minutes, 3-5 days a week
• Resistance – using free weights or body weight or fixed resistance machines, high reps at low resistance, 2-3 days a week
• Flexibility – stretching as part of a warm up or cool down process, or in a group class such as yoga or T’ai Chi, up to 3 times a week
• Neuromuscular – walking, breathing techniques, balancing exercises, can be carried out daily

When should clients with COPD train – and for how long?

As symptoms can be worse on waking, training should take place mid- to late morning. Shorter sessions of up to 10 minutes are advised if the client is new to exercise; this can potentially be built up over time.

Extreme heat or cold can make symptoms worse and should be avoided, as should floor exercises, which can exacerbate shortness of breath.

What about pulmonary rehabilitation and respiratory physiotherapy?

Pulmonary rehabilitation involves exercise and education on managing COPD to help individuals live more comfortably with their condition.

Respiratory physiotherapy can help sufferers to breathe easier, restore maximal function and improve muscle weakness in the lungs and surrounding area.

Lifestyle interventions – such as improving diet and stopping smoking – are also likely to have a positive impact on those living with COPD.