Written By: Amy Shevlin, PT, MS, DPT, GCS
November is COPD Awareness month. COPD, or Chronic Obstructive Pulmonary Disease, includes conditions such as Emphysema, Chronic Bronchitis, and Asthma. COPD is the tenth most prevalent disease in the world, and they estimate that by the year 2050, it will be the fifth leading cause of death worldwide. COPD is a collective term for those diseases that block the passage of air through the lungs leading to difficulty with breathing, especially exhalation. Over time, this difficulty with exhalation can lead to hyperinflated lungs and what is known as a “barrel chest”. As the disease progresses, patients find it increasingly difficult to breathe, leading to limiting activity and increased dependence on functional mobility and ADL tasks. Because of this, patients are often referred to Physical and Occupational Therapy to help manage generalized muscle weakness, respiratory muscle weakness, decreased activity tolerance, and decreased capacity for physical activity.
However, progressing patients with COPD through a plan of care can be challenging for therapists. To get a sense of how these patients may feel, I always ask people to try a quick breathing drill. Take an inhale for a count of 2, then exhale, but hold the exhale for as long as you can. What number did you get to? How were you feeling at the end of that exhale? I’m sure it wasn’t comfortable, and you were probably ready to return to normal breathing. It makes me wonder, is this how patients with COPD feel a lot of the time? I can imagine feeling like this can be anxiety-inducing and lead to sedentary behavior. We are challenged with motivating these patients to exercise when they feel like they can’t even breathe. But that’s where the challenge and the reward lie, we can teach them strategies to help them manage their dyspnea so they can perform an activity more comfortably. During my course, Rehab Strategies for Patients with COPD, Diabetes, Heart Failure, and Hypertension, we will discuss different breathing techniques and exercises that will help these patients manage their dyspnea and potentially increase the strength of the respiratory muscles. We will also discuss evidence-based techniques to maximize the benefit of our strength and endurance training programs as well.
I imagine they chose November as COPD Awareness month because we are approaching winter. As we get into the winter months and the cold, dry air, remember this can make breathing even more difficult for our patients with COPD. As our patients are spending more time indoors, we need to continue to help get our patients moving. Work with your patients to find activities they enjoy AND get them moving. It can be very rewarding not only for our patients as they engage in meaningful activities but for us as therapy clinicians as well.
For more information on best techniques, common medications, treatment precautions, and overall comprehensive information on COPD and related chronic diseases, register for my course, Rehab Strategies for Patients with COPD, Diabetes, Heart Failure, and Hypertension. Watch on-demand or find an upcoming live workshop near you!
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Cropp AJ, Apostolis M. Chronic obstructive pulmonary disease and emphysema. In: Domino FJ, ed. The 5-minute Clinical Consult Standard 2017. 25th Philadelphia, PS: Wolters Kluwer Health/Lippincott Williams & Wilkins;2017:200-201
Global Strategy for the Diagnosis, Management, and Prevention of COPD, Updated 2016. Global Initiative for Chronic Obstructive Lung Disease (GOLD) Web site. http://goldcopd.org/global-strategy-diagnosis-management-prevention-copd-2016/. Published 2016 Accessed July 15, 2017