COPD

Question 1

Acute response to exercise (11)

Answer 1

1. Decrease MC
2. Decrease VC (MVV)
3. Increase VE for given task (Inc fb and dec VT for given VE)
4. Exhaustion of ventilatory reserve (VE/MVV) - ventilatory limitation
5. Abnormal gas exchange (dec Sao2/Spo2 and inc PaCO2)
6. Early dyspnea and leg fatique
7. Dynamic hyperinflation (dec IC)
8. Normal VO2/WR slope
9. Possibility dec O2 pulse
10. Reduced peak HR
11. PVCs.

Question 2

BENEFITS (11)

Answer 2

1. dec dyspnea
2. desensitization of sensation of dyspnea
3. dec VE for given workload of VO2
4. dec hyperinflation for given VE
5. Increase exercise exerc tolerance
6. Improvement in skeletal muscle strength
7. Improve oxidative capacity
8. Improvement in MC and VO2 peak
9. Increase in endurance time to constant load exercise
10. Improvement in HRQoL
11. Greater ability to perform ADL

Question 3

Precautions (3)

Answer 3

1. Can lead to O2 desaturation: consider oxygen therapy if PaO2 less or equal 55 mmHg or SaO2 less or equal 88 mmHg
2. Use pursed-lip breathing which prevent collapse of distal airways–> reduced fB, PaCO2 and dyspnea and inc VT and SaO2.
3. If acute exacerbation of respiratory symptoms, limit exercise until symptoms have subsided