COPD: Exercise Therapy Dramatically Improves Breathing Outcomes

By 2018, the National Health Survey estimated the prevalence at one in twenty Australians age 45+.² Either way, this is a significant burden. The resulting difficulty breathing, reduced exercise tolerance, and reduced ability to speak hamper quality of life. Worse yet, each year, roughly one in five people with moderate to severe COPD experience flare ups requiring urgent care, often followed by hospitalisation. On the other hand, the Lung Foundation Australia finds that many people with more mild breathing problems don’t realise they have COPD, making it harder for them to access important solutions.

What Is COPD?

COPD stands for chronic obstructive pulmonary disease. It encompasses a group of progressive lung diseases that hinder breathing. This includes emphysema and chronic bronchitis. Normal airways and air sacs are elastic. During inhalation, the air sacs fill like small balloons. When you exhale, the air sacs deflate. With COPD, less air flows because of one or more problems:

• Loss of elasticity in airways and air sacs.
• Destruction of walls between air sacs.
• Thickening and inflammation of airway walls.
• Increased mucus production and airway clogging.

Exercise Therapy for COPD

Through pulmonary rehabilitation and programs such as Advanced Physiotherapy’s exercise physiology, people can receive professionally designed exercise programs to perform at the office and independently. These programs are designed to improve the experience of COPD and lessen its progression. How effective are such programs? Recently, Nina Bausek, PHD published a simple but useful measurement of what people might expect when they receive exercise therapy for COPD.⁴

Researchers took before and after measures from a COPD rehab program. Patients received at least eight visits for patient education, upper limb exercises, lower limb exercises, cardiovascular fitness, and respiratory muscle training. It was a relatively short course of treatment. The ability to rise from a seated position and then sound the letter “A” increased from an average of 5.8 seconds to 12.1 seconds. That measure is called maximum phonation time. The maximum speed at which patients could exhale increased from an average of 191 litters per minute to 325 litters per minute. That measure is called the peak expiratory flow. Not only did the averages improve; 100% of patients in this study saw some sort of improvement.

Past research has found similarly positive outcomes from patient education and rehabilitation for COPD.^5-10

• Reduce overall healthcare use and expense.
• Decrease hospitalisations 27%.
• Improve survival.
• Decrease emergency department visits 21%.
• Improve exercise tolerance.
• Reduce pain and discomfort from breathing.

If you or someone you care for suffers from difficulty breathing, please call to schedule an evaluation: (02) 4954 5330.

 References

1. Toelle B, Xuan W, Bird T, Abramson M, Atkinson D, Burton D, James A, Jenkins C, Johns D, Maguire G, Musk A, Walters E, Wood-Baker R, Hunter M, Graham B, Southwell P, Vollmer W, Buist A, Marks G. Respiratory symptoms and illness in older Australians: The Burden of Obstructive Lung Disease (BOLD) study. Med J Aust 2013;198:144-148
2. Australian Bureau of Statistics. National Health Survey First Results (2017 - 2018). Last accessed August 2021. Available at: https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey-first-results/latest-release.
3. Rubí M, Renom F, Ramis F, Medinas M, Centeno MJ, Górriz M, et al. Effectiveness of pulmonary rehabilitation in reducing health resources use in chronic obstructive pulmonary disease. Arch I 2010;91: 364–368.
4. Bausek N, Havenga L, Aldarondo S. Respiratory muscle training improves speech and pulmonary function in COPD patients in a home health setting-a pilot study. BioRxiv. 2019 Jan 1:523746.
5. Coultas DB, Jackson BE, Russo R, Peoples J, Singh KP, Sloan J, et al. Home-based physical activity coaching, physical activity, and health care utilization in chronic obstructive pulmonary disease. Chronic Obstructive Pulmonary Disease Self-Management Activation Research Trial Secondary Outcomes. Ann Am Thorac Soc. 2018;15: 470–478.
6. Kessler R, Casan-Clara P, Koehler D, Tognella S, Viejo JL, Dal Negro RW, Díaz-Lobato S, Reissig K, González-Moro JM, Devouassoux G, Chavaillon JM. COMET: a multicomponent home-based disease-management programme versus routine care in severe COPD. European Respiratory Journal. 2018 Jan 1;51(1):1701612.
7. Bourbeau J; Julien M, Maltais F, et al. Reduction of hospital utilization in patients with chronic obstructive pulmonary disease: a disease-specific self-management intervention. Arch Intern Med. 2003; 163 (5): 585-91.
8. Gadoury M, Schwartzman K, Rouleau M. et al. Self-management reduces both short- and long-term hospitalisation in COPD. Eur Respir J. 2005; 26 (5): 853-7.
9. Salman G, Mosier M, Beasley B, et al. Rehabilitation for patients with chronic obstructive pulmonary disease: meta-analysis of randomized controlled trials. J Gen Intern Med. 2003: 18a (3): 213-21.
10. Murphy N, Bell C, Costello R. Extending a home from hospital care programme for COPD exacerbations to include pulmonary rehabilitation. Respir Med. 2005; 99(10): 1297-302.