What kinds of exercise should be encouraged for COPD patients?
Upper extremity training is important because arm movement can increase dyspnea. Simple weight training or other resistance exercises strengthen the upper arms, shoulders, and legs. Walking or riding a stationary bicycle improves endurance. Patients who have limited endurance or balance difficulties should not walk on a treadmill. Simple activities performed frequently are preferable to more complex activities performed less frequently. Breathing exercises may improve the ability to exercise as well as to breathe. Diaphragmatic breathing exercises strengthen the ventilatory muscles and improve dyspnea. Pursed-lip breathing?intentionally exhaling through pursed lips for as long as possible?also reduces dyspnea and improves blood gases. Begin an exercise program only when the patient’s condition is relatively stable, with no evidence of CHF or acute exacerbations of bronchitis, pneumonia, or thromboembolism. Terminate exercise when dyspnea, fatigue, or signs of cardiac strain appear. • W
