Exercise Training in Respiratory Diseases

Introduction

Respiratory disorders are debilitating conditions that cause serious tuck back to the day-to-day lifestyle of individuals. People fail to participate in activities requiring increased physical activity, including not being able to participate in their child’s playtime. Including physical and breathing exercises in daily routine can increase exercise tolerance and capacity. It also improves aerobic strength, neuromuscular coordination, and self-confidence.

What Is the Significance of Exercise?

Regular exercise, especially aerobic ones, has several benefits:

• Improves circulation and oxygen utilization.

• Improves COPD (chronic obstructive pulmonary disease) symptoms.

• Builds up the body’s energy levels without getting tired or having breathing difficulties.

• Strengthens the cardiovascular system.

• Lowers blood pressure.

• Improves muscle tone.

• Improves muscle strength.

• Improves joint flexibility.

• Decreases body fat.

• Helps with mental health conditions (like stress, anxiety, and depression).

• Boosts self-esteem and confidence.

• Improves sleep quality.

• Relaxes the body.

What Are the Various Exercises for Respiratory Diseases?

There are various ways to manage respiratory diseases non-pharmacologically. One of the ways is to implement breathing techniques and exercises. Some of the tracks are:

1. Breathing Control

Control over breathing is one of the ancient ways to get a command over respiratory diseases and even deal with several other systemic health conditions. Breathing control methods aim to make the best use of the breathing muscle - the diaphragm. This muscle contracts and relaxes as one breathes. The focus remains on reducing the tension and using the shoulder and neck muscles to ease breathing. After gaining appropriate control, breathing out should take longer than breathing in.

Breathing control, also known as tummy control, involves three Rs-rise, relax, and rest. Raise the tummy while inbreathing, relax when breathing out, and rest between breaths.

2. Breathe a Rectangle

This technique asks to focus on a rectangle in front while breathing. Tracking the short ends while breathing in and the longer edges while breathing out, covering the perimeter of the shape. Gradually slow the speed of tracking and slow the breathing.

3. Breathing Techniques

There are several techniques that can be implemented to improve breathing:

• Pursed Lip Breathing: It aims to drain out the lungs completely and is helpful in patients with COPD (chronic obstructive pulmonary disorder) as the narrowed airways can entrap air in the lungs. Breathe in through the nose and then purse the lips and breathe out as though blowing out a candle.

• Blow-As-You-Go: This can be implemented while doing tasks that make one breathless. Breathe in before effort and breathe out during effort. This can be combined with pursed-lip breathing.

• Paced Breathing: This is useful when one is actively pacing while breathing and can be done as pursed lip or blow-as-you-go method. Breathe in one step and breathe out in the next, dynamically increasing the number of steps per breath and also trying out various combination of breaths and steps that suits the best.

4. Interval Training

For advanced COPD patients, interval exercise with repeated bouts of high (30 to 60 seconds) to maximal intensity works (80 to 100 percent peak intensity) separated by 20 to 60 seconds of low-intensity work. This has been shown to be associated with a small increase in arterial lactate concentration, lower ventilation, dynamic hyperinflation, and low incidences of dyspnea and leg discomfort. Interval training improves muscle fiber oxidative capacity, thus increasing oxygen utilization by the muscles.

5. Aerobic Exercises

Moderate aerobic exercises accelerate heart rates and require three to six metabolic equivalents, whereas vigorous exercise requires more than six metabolic equivalents, causing a significant increase in heart rate and rapid breathing. Aerobic exercises cause a decrease in dynamic hyperinflation, exertional dyspnea (sensation of running out of air), improved exercise tolerance, and enhanced quality of life with fewer bouts of disease exacerbations.

6. Strength Training

Strength-training exercises are performed at intensities at 60 percent of the muscle’s force-generating capacity. 1-RM (1-repetition maximum) approach is recommended to determine the maximum amount of weight stimulus. The volume of strength training is an account of the number of repetitions and the number of sets of an exercise. Resistance should be increased after the completion of pre-established numbers is met. The frequency is the third and final component of strength training (after intensity and volume). The frequency is calculated on a weekly basis; recommended stipulations stands are two to three times a week and 48 hours of recovery time in between.

What Are the Precautions for Exercise in Respiratory Diseases?

Every exercise session should be divided into three sessions- warm-up, conditioning, and a cool-down phase. The warm-up phase reduces the stress on the heart and muscles by gradually increasing breathing, circulation, and body temperature, and it also improves flexibility and reduces muscle soreness. Warm-up includes stretching, motion activities, and low-intensity activities. The next phase, the conditioning phase, helps by burning calories. There should be constant monitoring of the workout intensity, heart rate, and blood pressure. Over time the length of this phase can be increased. The final phase, or the cooldown phase, gradually allows the body to recover while the heart rate and blood pressure return to the resting numerics. The best way to cool down is to gradually decrease the workout intensity and inculcate stretching activities.

Exercises should be discouraged during periods of active infections in patients with cystic fibrosis with less than 90 percent SpO2 (oxygen concentration) values at rest or even during exertion, uncontrolled asthma, or hypertension. They should be medically managed before exercise. Individuals with an intention to be more physically active or indulge in more intense exercises should be evaluated using a graded test using ECG (electrocardiogram) and pulse oximetry. Discovery of any cardiovascular problems should be referred to a specialist before commencing physical training.

Supervisors should have specialized training in monitoring potential pulmonary complications and common sequelae and COPD-associated comorbidities. Asthmatic patients should ensure proper control before initiating physical activities. Poor or partially controlled asthmatic patients should consult physicians well in advance. Patients under rapid-acting beta 2-agonist medications should consume the same before training. The individuals should incorporate progressive warm-up and should avoid cold environments and known triggers of asthma.

Other guidelines should be kept in mind:

• Gradually increase activity levels.

• Have fun.

• Wait for 90 minutes between exercises and meals.

• Follow fluid restriction guidelines.

• Dress appropriately for weather conditions.

• Inculcate the three phases of exercise- warm-up, conditioning, and cooling down.

• A consistent schedule of exercise.

• A consistent pace of work-out.

• Make exercises a part of the daily routine.

Conclusion

Exercise training can be beneficial for patients dealing with respiratory diseases. The patients can better deal with the symptoms, exaggerations, and acute bouts. They must also keep in mind to avoid environmental triggers and keep up with follow-ups and medications.