COPD Flashcards
What is COPD?
Refers to emphysema and chronic bronchitis. Chronic obstructive pulmonary disease.
What is emphysema?
Destruction of alveoli
This reduces surface area for gase exchange and impaired lung function
What is chronic bronchitis?
Inflammation and irritation of bronchial tubes.
Airways become swollen and excess mucus is produced obstructing airways.
What are symptoms of COPD?
Dyspnoea
Cough
Wheezing
Chest tightness
What are the contraindications for exercise in COPD?
Sever hypoxia
Recent MI 3-6 months
Unstable angina
Recent exacerbation of COPD requiring hospitalisation
Infection
Severe hypotension
What are possible assessments for COPD?
2-minute walk test
Modified BORG
BODE index
- BMI
- Obstruction of airflow
- Dyspnoea
- Exercise e.g. 6-minute walk test / 2 minute walk test
Auscultation
Respiratory Rate
How is the 2 minute walk test performed
- Walk as far as possible in 2 minutes
- Can use walking aids
- Should be independently mobile
~ 15m course
What are predicted distances for populations in the 2-minute walk test?
Women 257.177 - (0.723 x age) - (1.688 x BMI)
Men 279.096 - (0.998 x age) - (1.426 x BMI)
What are the areas of the modified BORG dypnoea scale?
0 - nothing at all
0.5 extremely slight (just noticeable)
1 very slight
2 slight
3 moderate
4 somewhat severe
5 severe
6
7 very severe
8
9 extremely severe (almost maximal)
10 Maximal
What cardiorespiratory exercises can be done for COPD?
ACBT
- breathing control
- Thoracic expansion
- Huff
Pursed lip breathing
Rectangular breathing
Blow as you go breathing
What is ACBT?
Breathing control
Thoracic Expansion exercises
Huff (forced expiratory technique)
What is breathing control in ACBT?
- Breathing control
- Hand on stomach gentle rise and fall diaphragm
- Ideally in through nose and out mouth
- Can use pursed lip breathing
- Gradually slow breaths
- 3-5 cycles
How is thoracic expansion exercise completed in ACBT?
Thoracic expansion exercises (TEE)
- Relax chest and shoulders
- Hands on ribs
- Take long slow and deep breath in through nose
- Hold breath 2-3s
- Gentle and relax breath out
- Repeat 3-5 times if let headed back to breathing control
How is Huff completed in ACBT?
Huff
- Medium or high volume
- Medium normal in long out
- High deep in quick out
What is pursed lip breathing?
Good for asthma, COPD and pulmonary fibrosis
Relax your neck and shoulder muscles
Breathe in slowly through nose with hand on stomach
Purse lips as though going to whistle or blow on hot drink
Breathe out slowly and gently through lips for 4 or more seconds
How is blow as you go breathing carried out?
For doing activities that make someone breathless
Breathe in before making effort
Breathe out whilst making effort
e.g.breathe in before lifting heavy bag, out while lifting heavy bag
What is rectangular breathing?
Imagine rectangle or follow something like a book
Breathe in on short edge and out on long edge
Gradually slow speed that eyes move round rectangle
What are aerobic exercises for COPD?
Seated marches
Arm raises
Leg extensions
Sit to stand
Walking/ cycling/ swimming
Step ups
what level of the borg scale should be exercises completed in?
3-4 so moderate or fairly breathless
What warm up exercises can be suggested for COPD
Neck rotations
Neck side flexs
Shoulder rolls
Chest stretch
Trunk rotations
Trunk bends
Sitting marching
Knee extensions
Heel raises
Standing marches
What strength exercises can be suggested for COPD
Half squat
Standing press up
Knee lifts
Shoulder press
Hip abduction
Upright row
Knee extension
Bicep curls
What endurance exercises can be recommended for COPD?
Walking
Steps
WHat are possible cool down exercises?
Thigh stretch
Calf stretch
Trunk tilts
Hamstring stretch
Chest stretch
Tricep stretch
What advice can be provided for COPD self-management?
Evidence shows attending pulmonary rehab classes can help manage COPD, prevent flare-ups, hospital admissions and improves QoL
What education can be provided to COPD patients?
Education focused on knowledge of condition. Medications- do they known which meds to take/when to take them.
Healthy diet, energy conservation: life style changes- find easiest way to do ADLs to save energy to do the things you like.
What goal setting can be provided to COPD patients?
Benefits of moving, smoking cessation.
Support for themselves and carers.
What to do if they exacerbate- recognising deterioration, flare up education.
What strategies to manage breathlessness can be provided to COPD patients?
ACBT techniques, pursed lip breathing, positioning, huffing. Sitting leaning forwards- elbows on table.
