Exercise Rehabilitation for Pulmonary Disease

Pulmonary Disease affects 1 in 6 Kiwis - that's more than 700,000 people! Pulmonary Disease is currently the fourth leading cause of death in New Zealand. 1

What is Pulmonary Rehabilitation?

  • It is a comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies that include, but are not limited to, exercise training, education, and behaviour change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviours. 2
  • There is now substantial evidence that pulmonary rehabilitation is beneficial for patients with COPD, asthma and other chronic lung diseases. 

Chronic Obstructive Pulmonary Disease (COPD)

  • COPD is globally a major cause of poor health and morbidity, with an estimated 15% of Kiwis over 45 living with the condition. 3,4,5

  • As people with COPD tend to use more energy just to breathe it can mean that previously simple tasks can become extremely difficult due to breathlessness and fatigue.

  • This often leads to avoidance of exercise because the feeling of breathlessness is unpleasant or frightening. In turn this leads to a reduction in fitness, and then further breathlessness on exertion.

Benefits of Exercise for COPD

Pulmonary rehabilitation that includes an exercise component is one of the key recommended approaches.

Whilst it cannot reverse lung disease, it can:

  • improve exercise tolerance by relieving symptoms of shortness of breath and fatigue

    • several studies have shown exercise tolerance to increase by 20% in a short time frame of 12 weeks 6

  • improve maximal exercise capacity

    • studies have shown that adherence to a pulmonary rehabilitation programme increases your capacity for work - you can do more! 3

  • improve emotional function by reducing anxiety over frightening episodes of breathlessness

    • studies conclude that a brief period of pulmonary rehab can reduce the prevalence of anxiety by 16% and depression by 11% 7

  • improve breathlessness, fatigue, emotional function and mastery which have all been found to enhance a persons control over their condition 3

Asthma

Affecting 1 in 9 adults and 1 in 7 children, the prevalence of asthma is on the rise.

People with asthma may show less tolerance to exercise due to worsening asthma symptoms during exercise or other reasons such as deconditioning as a consequence of inactivity.

Benefits of Exercise for Asthma

Appropriate exercise programmes can provide valuable benefits to people with asthma including:

  • Improved exercise tolerance (a study reported an increase of 5 ml/kg/min in VO2peak after exercise rehabilitation)9
  • Subjectively, many people with asthma report that they are symptomatically better when fit.
  • Exercise can help to reduce the severity of attacks or prevent them entirely. 

Evidence

1. Milne, 2015. Hospital admissions for chronic obstructive pulmonary disease in New Zealand. 2. Spruit, 2013. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. 3. McCarthy, 2015. Pulmonary rehabilitation for chronic obstructive pulmonary disease. 4. Ries, 2007. Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based clinical practice guidelines. 5. https://www.asthmafoundation.org.nz/research/the-burden-of-copd-in-new-zealand 6. Vogiatzis, 2002. Interval training as an alternative modality to continuous exercise in patients with COPD. 7. Bhandari, 2013. Comprehensive pulmonary rehabilitation results in clinically meaningful improvements in anxiety and depression in patients with chronic obstructive pulmonary disease. 8. http://health.govt.nz/publication/annual-update-key-results-2014-15-new-zealand-health-survey. 9. Carson, 2013. Physical training for asthma.