COPD

Question 1

What are the benefits of pulmonary rehabilitation?

Answer 1

Reduce dyspnea
Increase exercise capacity
Improve quality of life

Question 2

What is pulmonary rehabilitation and what is its aim?

Answer 2

An intervention based on 
- patient assessment
- exercise training
- education
- behaviour change
To improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors.

Question 3

Exercise capacity in patients with COPD is impaired, and is often limited by:

Answer 3

Dyspnea

Question 4

Exertional dyspnea in COPD is a reflection of:

Answer 4

Peripheral muscle dysfunction, the consequences of dynamic hyperinflation, increased respiratory load, or defective gas exchange

Question 5

Improved oxidative capacity and efficiency of the skeletal muscles leads to:

Answer 5

a reduced ventilatory requirement for a given

submaximal work rate

Question 6

Exercise intolerance in individuals with cCOPD

may result from:

Answer 6

Ventilatory constraints, pulmonary gas exchange abnormalities, peripheral muscle dysfunction, cardiac dysfunction, or any combination of the above

Question 7

In COPD, ventilatory requirements

during exercise are often higher than expected because of:

Answer 7

Increased work of breathing, increased dead space ventilation, impaired gas exchange, and increased ventilatory demand as a
consequence of deconditioning and peripheral muscle dysfunction.

Question 8

Lactic acidemia resulting from anaerobic metabolism by the muscles during higher intensity exercise contributes to:

Answer 8

Muscle task failure and increases pulmonary ventilation

Question 9

Lactic acid buffering results in:

Answer 9

An increase in carbon dioxide production and acidosis stimulates the carotid bodies

Question 10

What is the most important effect of COPD on the heart?

Answer 10

It increases right ventricular afterload.

Question 11

Right ventricular hypertrophy may also compromise left ventricular filling by:

Answer 11

Producing septal shifts; these further reduce the ability of the heart to meet exercise demands

Question 12

What type of training would you reccommend patients with severe SOB?

Answer 12

Shorter high-intensity exercise periods alternated with low-to moderate-intensity exercise recovery periods. This form of training may be more comfortable and adherence may be better

Question 13

Successful Pulmonary Rehabilitation requires:

Answer 13

Behavioral change

Question 14

How can we facilitate behavioural change for successful pulmonary rehabilitation in COPD patients?

Answer 14

Exercise training; psychosocial support; nutritional intervention; self-management; and education, pacing and energy conservation strategies,

Question 15

What tests other than CPx tests are recommended before starting an exercise program in COPD patients

Answer 15

Spirometry
O2 Saturation
Dyspnea monitoring using the Borg CR 10 scale

Question 16

How long should a graded exercise testing be in severe to very severe COPD disease .

Answer 16

5 to 9 minutes

Question 17

Intermittent exercise may be used until sustained periods of longer duration. How many minutes would that be?

Answer 17

ACSM’s describes a duration that is generally greater than 30 minutes on the basis of severity of COPD

Question 18

What are the RT recommendations in COPD?

Answer 18

Same as healthy people

Question 19

What are ACSM recommendations on SpO2 during exercise? And when should supplemental oxygen be used?

Answer 19

SpO2 should be >88% during exercise.

If SpO2 is ≤88% while breathing room air, supplemental oxygen should be used to maintain SpO2 at >88%

Question 20

What is the aim of endurance training?

Answer 20

Condition the muscles of ambulation and improve cardiorespiratory fitness

Question 21

True or False:

The outcomes of interval and continuous training are not different when the same total work is performed

Answer 21

True

Question 22

Since there are no specific recommendations for RT in COPD patients what exercise principle could you utilise to maximize gains in muscle strength and endurance?

Answer 22

Overload - involves increasing the exercise dosage over time

Question 23

True of False:
A minimum of 8 weeks of training is required for clinically important changes in exercise capacity and quality of life. Improvements in functional exercise capacity seem to plateau after 12 weeks of exercise training.

Answer 23

True

Question 24

The core components of exercise training programs for COPD are:

Answer 24

Endurance and resistance training

Question 25

What type of training is considered the cornerstone of effective pulmonary rehabilitation

Answer 25

supervised exercise training