COPD Flashcards
What are the benefits of pulmonary rehabilitation?
Reduce dyspnea
Increase exercise capacity
Improve quality of life
What is pulmonary rehabilitation and what is its aim?
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.
Exercise capacity in patients with COPD is impaired, and is often limited by:
Dyspnea
Exertional dyspnea in COPD is a reflection of:
Peripheral muscle dysfunction, the consequences of dynamic hyperinflation, increased respiratory load, or defective gas exchange
Improved oxidative capacity and efficiency of the skeletal muscles leads to:
a reduced ventilatory requirement for a given
submaximal work rate
Exercise intolerance in individuals with cCOPD
may result from:
Ventilatory constraints, pulmonary gas exchange abnormalities, peripheral muscle dysfunction, cardiac dysfunction, or any combination of the above
In COPD, ventilatory requirements
during exercise are often higher than expected because of:
Increased work of breathing, increased dead space ventilation, impaired gas exchange, and increased ventilatory demand as a
consequence of deconditioning and peripheral muscle dysfunction.
Lactic acidemia resulting from anaerobic metabolism by the muscles during higher intensity exercise contributes to:
Muscle task failure and increases pulmonary ventilation
Lactic acid buffering results in:
An increase in carbon dioxide production and acidosis stimulates the carotid bodies
What is the most important effect of COPD on the heart?
It increases right ventricular afterload.
Right ventricular hypertrophy may also compromise left ventricular filling by:
Producing septal shifts; these further reduce the ability of the heart to meet exercise demands
What type of training would you reccommend patients with severe SOB?
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
Successful Pulmonary Rehabilitation requires:
Behavioral change
How can we facilitate behavioural change for successful pulmonary rehabilitation in COPD patients?
Exercise training; psychosocial support; nutritional intervention; self-management; and education, pacing and energy conservation strategies,
What tests other than CPx tests are recommended before starting an exercise program in COPD patients
Spirometry
O2 Saturation
Dyspnea monitoring using the Borg CR 10 scale
How long should a graded exercise testing be in severe to very severe COPD disease .
5 to 9 minutes
Intermittent exercise may be used until sustained periods of longer duration. How many minutes would that be?
ACSM’s describes a duration that is generally greater than 30 minutes on the basis of severity of COPD
What are the RT recommendations in COPD?
Same as healthy people
What are ACSM recommendations on SpO2 during exercise? And when should supplemental oxygen be used?
SpO2 should be >88% during exercise.
If SpO2 is ≤88% while breathing room air, supplemental oxygen should be used to maintain SpO2 at >88%
What is the aim of endurance training?
Condition the muscles of ambulation and improve cardiorespiratory fitness
True or False:
The outcomes of interval and continuous training are not different when the same total work is performed
True
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?
Overload - involves increasing the exercise dosage over time
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.
True
The core components of exercise training programs for COPD are:
Endurance and resistance training
What type of training is considered the cornerstone of effective pulmonary rehabilitation
supervised exercise training
