Chronic Obstructive pulmonary disease - the umbrella term

increased airway resistance, decreased lung elastic recoil

Increased work, ventillatory muscles weaken(mechanical disadvantage)

Dead space, ventillatory innefficiency 

40% of energy goes into breathing - fatigue - failure

Cystic Fibrosis: Life shortening, inherent

Chronic Bronchitis: FEV₁<5%. Ventillation perfusion - wasted not getting enough O2 into the blood

Rt ventricle unable to respond adequately to increased Q during exerc

-> ability to train is compromised. Breathless->anxious-> depression

Emphysema - physiological dead space, alveoli damaged (irreversible)

Hyperinflation so air is trapped
Ventillatory limitation, muscle function decreases
Alveoli stretch out, not moving the air well bc of hyperinflation

Cardio effects cause blood viscosity to increase

-Increase Cardio Health

-Reduce O₂ expenditure

Desensitize dyspnea (make them less frightened and anxious)

Increase components of fitness: muscle strength, flexibility, balance, body composition and body image

Know where their inhaler and meds is at all times!

Optimize respiratory system and hypoxia (lack of oxygen) with training

Help them breathe (retrain them) to lower anxiety

Help conserve their energy - improve coordination, balance, and mechanical efficiency

Manage comorbitidies

Meds: Diuretics, antidepressants, steroids(side effects)

Ramp protocol with gentle and small increases

Endurance - a 6min walk

Isotonic or Isokinetic strength training

Goniometer for flexibility - balance and gait(neuromusc)

Precautions:

Monitor BP and dyspnea, regular spiromitry for FEV₁ (decrease of 15% and peak of 20%)
Intensity of 75% max HR, 8min test
Meds can cause arrhythmias 

Exercise Prescription for Pulmonary Diseases

Aerobic: large muscle activities (new step)

Strength: isokinetic, isotonic, free weights, careful!

Flex: stretch, tai chi

Neuro: Walk, balance, breathing

Asthma: Recurrent respiratory systems, variable air flow obstruction

With Exercise Induced Asthma  one can avoid an attack by doing a vigorous warm up  30-45min before