CVR - COPD Flashcards
What are the key problems for pts with stable COPD
Dyspnoea
Retained secretions
Reduced exercise capacity
What physio management treatments are available for dyspnoea
- positioning
- breathing control
- pursed-lip breathing
- energy conservation and pacing
- fan therapy
What physio management treatments are available for airway clearance?
- active cycle of breathing technique (ACBT)
- positive expiratory pressure (PEP) devices
- postural drainage
- manual techniques
What physio management treatments are available for reduced exercise capacity?
- inspiratory muscle training
- tai chi
- pelvic floor muscle training
- pulmonary rehab
What are the aims of physio in the management of dyspnoea in patients with COPD?
- reduce work of breathing (WOB)
- improve the quality of life
How does positioning benefit patients with dyspnoea?
- encourages relaxation of upper chest and shoulders
- allows movement of lower chest and abdomen
- optimises length-tension relationship of the diaphragm
- overall reduces the work of breathing (WOB)
How would you perform positioning for COPD patients with dyspnoea?
Lean forwards position
Abdominal contents raise the anterior part of the diaphragm
Facilitates its contraction during inspiration
‘Loading the diaphragm’
How can pursed-lip breathing help pts with dyspnoea?
Aims to prevent airway closure on expiration and increase expiratory time
Generates a small positive pressure during expiration
May lead to decreased RR, increased TV and improved gaseous exchange
Describe the ‘blow-as-you-go’ technique and why it is used
Breathe in before the effort and breath out during the effort
- as you lift a heavy object
Helps make tasks easier and can be combined with pursed-lip breathing
Briefly describe paced breathing and how it is beneficial in day to day life
Pt paces steps with breathing
- inhalation on one step, exhalation on the next step
Useful during activities such as walking or climbing the stairs
How can fan therapy benefit those with dyspnoea?
A cool draft of air may reduce sensation of dyspnoea
Can be combined with positioning and breathing techniques
Hold fan approx 15cm away from the face
Aim draft at the center of the face
Describe the technique of pursed-lip breathing
- pt should be in a comfortable, well-supported position
- pt encouraged to relax upper chest, shoulders and arms
- inspire to normal tidal volume through the nose for approx 2 seconds
- during expiration, purse the lips and though blowing through a straw, and exhale for 4 seconds
What is tai-chi and how is it beneficial to those with dyspnoea?
Combination of exercise and meditation and consists of slow movements and deep breathing
Low-intensity exercise with benefits of lung function and exercise capacity
Beneficial in improving balance and reducing falls
Estimated to work at 50-74% max HR
Describe the active cycle of breathing technique
Comprises a cycle of:
- breathing control
- thoracic expansion exercises (deep breathing)
- forced expiration technique (one or 2 huffs combined with breathing control)
What are the aims of thoracic expansion exercises?
AKA deep breathing exercises
- get air behind retained secretions in order to aid removal using forced expiratory techniques
- re-inflate areas of lung collapse