COPD
Chronic Obstructive Pulmonary Disease (COPD) refers to a group of lung diseases that block airflow to the lungs and make it increasingly difficult to breathe.
  • Emphysema (air sacs of the lungs are damaged) and chronic bronchitis (inflammation of the mucous membrane) are the two main conditions that make up COPD. Generally, people are diagnosed with both of these conditions at the same time.
  • In all cases of COPD, damage to airways eventually interferes with the exchange of oxygen and carbon dioxide in the lungs.
  • COPD is a leading cause of death worldwide.

external image 220px-Copd_versus_healthy_lung.jpg
http://en.wikipedia.org/wiki/Chronic_obstructive_pulmonary_disease


Understanding Chronic Obstructive Pulmonary Disease:


http://www.youtube.com/watch?v=aktIMBQSXMo


Causes of COPD
  • Long-term exposure to lung irritants
  • Smoking, especially long-term, is a major cause of COPD.
  • Cigarette, pipe, cigar, and other types of tobacco smoke can all cause damage to the lungs.

Additional Information on Causes:
  • COPD can be prevented by not smoking or by quitting soon after you start.
  • Breathing in second-hand smoke, air pollution, chemical fumes, and dust can also contribute to COPD.
  • The damage that is done to your lungs cannot be reversed.


Who is at Risk for COPD?
  • Smokers
  • Individuals who have a family history of COPD or lung disease.
  • Individuals aged 40 or above
  • Individuals who have issues with their lungs as children.

Signs and Symptoms

  • Cough without mucus
  • Fatigue
  • Recurrent respiratory infections
  • Shortness of breath that gets worse with mild activity
  • Wheezing
  • Trouble catching one's breath

Tests used for Diagnosis

  • One common test is a spirometry, which helps indicate lung function.
  • X-rays or CT scans can be helpful
  • Blood tests which measure arterial blood gases such as oxygen and carbon dioxide
  • A stethoscope can be used by a physician to listen to the patient's lungs

Spirometry Testing Example:


http://www.youtube.com/watch?v=6kbgZWS5wH0

Common Treatment for COPD


Treatment is dependent on the specific patient and the severity of the condition. A few common treatments are listed below.
  • Many times inhalers will be used to help open airways. O
  • Inhaled steroids may help with inflammation
  • Anti-inflammatory medications are typically prescribed

If the patient presents with a more severe case other treatments may need to be implemented. Some of these include:
  • Intravenous steroid use
  • Oxygen therapy
  • Breathing machine assistance
  • Use of a bronchodilator

Dietary Treatments


  • There are several antioxidant, vitamin, and mineral considerations that have shown a positive relation in the treatment of COPD. A recommended increase in dietary intake of vitamin C has been known to improve pulmonary function. Antioxidant therapy can also slow COPD's progression so consumption of adequate fruits and vegetables is important.

  • Osteoporosis is a common risk factor of COPD with 36%-60% of patients eventually developing the condition and, for this reason, calcium and vitamin D supplements are strongly encouraged.

  • A healthy diet and proper nutrition can help reduce carbon dioxide levels and improve breathing. A study found that a high-fat diet (55% fat) is more beneficial to COPD patients than a high carbohydrate diet (55% carbohydrate) because it decreased carbon dioxide production and improved ventilation though general consensus has not been met due to potential side effects.

  • Protein should be based on an individual's conditions but is generally about 1.2 to 1.7 grams per kilogram of protein each day. Fluid intake should be about 2 to 3 liters per day to keep mucous thin and help clear the airways.

Dietary Tips for Better Breathing


Some nutritional tips for better breathing in patients with COPD include:
  • Consume several small, nutritious meals each day to avoid becoming breathless while eating.
  • Eat slowly and chew foods thoroughly to avoid aspiration.
  • Limit salt intake due to the retention of water which can make breathing more difficult
  • Modify food consistency if increased fatigue happens while eating
  • Limit caffeinated beverages due to medication interference along with restlessness.
  • Rest before meals.
  • Eat while sitting up straight to ease lung pressure.
  • Consume liquids after eating to avoid feeling full.

Recommendations for Exercise Programming


Exercise should be encouraged for all individuals with COPD. Benefits of exercise training include:
  • Cardiovascular reconditioning
  • Improved ventilatory efficiency
  • Reduced hyperinflation
  • Decreased dyspnea
  • Increased muscle strength
  • Improved body composition
  • Enhanced body image
  • Slowed progression of disease
  • Improved ADLs

Sample COPD Exercise Program:
Modes
Goals
Intensity/Frequency/Duration
Time to goal
Aerobic
Large muscle group activities: walking, cycling, swimming
Increase VO2max
Increase lactate threshold and ventilatory threshold
Become less sensitive to dyspnea
Develop more efficient breathing patterns
Facilitate improvement in ADLs
1-2 sessions 3-5 days/week
30 minute sessions (may be intermittent at first)
Emphasize progression of duration
2 to 3 months
Strength
Free weights
Increase maximal number of reps
Increase lean body mass
Low resistance, high reps
2-3 days/week
2 to 3 months
Flexibility
Stretching, Tai chi
Increase range of motion
3 days/week
Ongoing
Neuromuscular
Walking, balance exercises, breathing exercises
Improve balance
Improve breathing efficiency


ACSM's Exercise Management for persons with Chronic Diseases and Disabilities. (Table 17.2, Pg. 134)

Helpful Links for Exercise Recommendations


COPD Exercise and Activity Guidelines
COPD Management: Staying Healthy (Video)
Exercise and COPD (Video)


References

http://www.mayoclinic.com/health/copd/DS00916

http://www.nhlbi.nih.gov/health/health-topics/topics/copd/causes.html

http://www.youtube.com/watch?v=aktIMBQSXMo

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001153/

http://www.youtube.com/watch?v=6kbgZWS5wH0

http://en.wikipedia.org/wiki/Chronic_obstructive_pulmonary_disease

http://www.todaysdietitian.com/newarchives/td_020909p54.shtml

http://www.youtube.com/watch?v=DFemC5giG1Y

http://www.youtube.com/watch?v=4U77OwWuc-Q&feature=related

ACSM's Exercise Management for Persons with Chronic Diseases and Disabilities (3rd Edition)

http://my.clevelandclinic.org/disorders/chronic_obstructive_pulmonary_disease_copd/hic_copd_exercise_and_activity_guidelines.aspx