pulmonary rehabilitation Physical activity and
WHAT IS PULMONARY REHABILITATION? Pulmonary rehabilitation is a group of activities that are delivered by a team of different professionals including doctors, nurses, respiratory physiotherapists and exercise professionals with the aim of helping people with various pulmonary conditions to control or reduce their symptoms so they can lead a normal life. In the UK, pulmonary rehabilitation is normally delivered by a specialist respiratory physiotherapy in a hospital or community setting. The programme normally lasts between four and 12 weeks, depending on local provision. When this has been completed you might be referred to a long-term maintenance programme. This is held in the community by an exercise professional who has had special training in delivering exercise to patients with chronic respiratory diseases. This programme normally consists of an exercise class, which aims to promote long-term good health behaviours.
WHAT IS RESISTANCE TRAINING? Traditionally, aerobic physical activity, such as walking and cycling has been recommended as part of pulmonary rehabilitation but it has now been recognised that you can gain additional benefits from also doing resistance training. Resistance training is a group of exercises that involve a specific effort that is performed against an opposing force generated by a resistance eg. pushing, pulling, bending or twisting. This results in various muscle groups becoming stronger, which can be achieved by using weight machines, dumbbells and resistance bands. Resistance training should not be confused with weightlifting or bodybuilding, which are competitive sports that involve lifting very heavy weights.
HOW CAN IT HELP? Taking steps to help improve muscular strength will help you return to everyday and occupational tasks with greater ease. Research has shown that individuals who participate in regular resistance training can greatly improve their ability to do everyday tasks such as climbing stairs, getting out of a chair and walking further and faster. Resistance training also increases lean muscle tissue, which counteracts the muscle wasting effects of chronic respiratory disease.
WHAT ARE THE BENEFITS? These include improvements in: n Strength and stamina to perform everyday activities such as housework and gardening
n Bone density n Walking speed and efficiency n Balance n Fitness n Lean muscle tissue that helps reduce muscle wasting.
WHAT ARE THE SUITABLE TYPES OF RESISTANCE TRAINING? Resistance training programmes can involve using weight machines, dumbbells, elastic bands and even baked bean tins
and can been done at home. Listed below are some exercises that can be performed at home using simple equipment. These should only be done following the advice of an exercise professional who is qualified in delivering exercise to patients with chronic respiratory disease. n Wall press-ups n Seated row with resistance band n Lateral raises with dumbbells n Sit-to-stand n Seated single leg extensions with an ankle weight n Standing single leg curls with an ankle weight n Arm curls with dumbbells n Triceps kick backs with dumbbells. You can ask your exercise professional for exercises to do at home. You should start slowly and gradually increase these.
REMEMBER n Use slow controlled movements when performing each exercise, remembering to maintain a regular breathing pattern throughout the exercise (do not hold your breath) n Perform one set of six-to-ten repetitions on each exercise n Start slowly and gradually increase the number of sets to two-three on each exercise after six sessions. n Resistance can be increased by using heavier dumbbells and stronger resistance bands. However, the effort should feel ‘moderate’ and you should never lift a weight that causes you to strain or lose the technique of the exercise. n Perform resistance training two to three times per week after your aerobic exercise eg. walking or cycling. n Always perform a warm up and cool down and some developmental stretching for 10 minutes before and after each session of resistance exercises.
WHEN NOT TO PERFORM RESISTANCE TRAINING? Resistance training should form part of a well-rounded exercise programme that includes aerobic and stretching exercises. Resistance training should never be the main or only part of your exercise training and should always follow the aerobic part of your exercise programme. Resistance training can be performed two-three times per week. However, resistance training should not be performed if you are suffering from the following: n Angina pain at rest or on exertion n Generally feelings of unwell n Acute exacerbation n Unstable blood pressure n Unstable diabetes n If your health or exercise professional tells you not to exercise.
FOR MORE INFORMATION
n British Heart Foundation Helpline: 0300 330 3311
www.bhf.org.uk
The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case. To the extent permissible by law, the publisher, editors and contributors accept no liability for any loss, injury or damage howsoever incurred (including negligence) as a consequence, whether directly or indirectly, of the use by any person of the contents of this article.
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