David R. Bassett, Jr.
chapter21
Exercise, Asthma,and PulmonaryDisease
Pulmonary Disease
•May be due to genetic causes (e.g., cysticfibrosis) or environment (smoking, coaldust, asbestos)
•Poor gas exchange between ambient air andpulmonary capillary blood
•Reduction in VO2max
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Two Major Categories
•Chronic obstructive pulmonary diseases(COPDs)
•Restrictive lung diseases
COPD
•Reduction in expiratory airflow
•Shortness of breath on exertion
•Examples: bronchitis, emphysema,bronchial asthma
•Treatment involves bronchodilators andother drugs
Emphysema
•A type of COPD
•Often results from tobacco smoking
•Loss of elastic recoil of alveoli andbronchioles
•Enlargement of those structures
•Airways can collapse during exhalation
Asthma
•A type of COPD
•Affects 14.6 million Americans
•Reversible condition
•Varies from wheezing to severebreathlessness
•Causes include allergic reaction to dust,pollen, smoke, and pollution
•Stress, exercise, and viral infections canalso be causes
Cystic Fibrosis
•A type of COPD
•Recessively inherited genetic disorder
•Affects 1 in 2,500 White children
•Rare in Asians and African Americans
•Thick mucus blocks air exchange
Restrictive Lung Diseases
•Can be caused by kyphoscoliosis, pectusexcavatum, coal dust, asbestos,chemotherapy, or radiation therapy
•Difficulty expanding the lungs
•Reduced RV, IRV, ERV, FVC, and TV
•Increased work in breathing
Lung Volumes in PersonWith Restrictive Lung Diseaseand in Person Without Lung Disease
Reprinted from Essentials of cardiopulmonary physical therapy, 2nd ed., edited by E.A.Hillegass and H.S. Sadowsky, from P. Clough, “Restrictive lung dysfunction,” pg. 186,copyright 2001, with permission from Elsevier.
•Rehabilitation programs address COPD.
•Exercise has little effect on VO2max, lungfunction tests, and mortality rates.
•Benefits include improved functionalcapacity, better quality of life, and dyspnearelief.
Exercise and Pulmonary Disease
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Pulmonary Function Testing
Portable Pulse Oximeter
Exercise Prescriptionin Pulmonary Patients
•Rhythmic, dynamic exercise
•3 to 5 times per week
•At least 30 min a session
•Resistance training recommended
Special Considerationsin Pulmonary Disease
•Supplemental O2 to maintain SaO2 above90%
•Pursed-lip breathing in emphysema