# Exercise as it relates to Disease/The effect of aerobic exercise on Emphysema
### Prevalence

Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death worldwide. Research shows that chronic respiratory diseases such as emphysema resulted in 6,570 deaths in Australia in 2011

### What is Emphysema

Emphysema is a chronic disease of the lungs characterised by progressive airflow limitation and chronic inflammation of the airways and lungs, resulting in degradation of the lung surface There is no cure.

### Signs and symptoms

* Difficulty in breathing
* Cough
* Tight chest
* Wheezing
* Sputum production
* Shortness in breath

### Causes

The most common causes of emphysema are smoking, passive smoking and air pollution including exposure to harmful gasses or chemicals for a prolonged period of time however emphysema can also be caused by other factors such as genetics. These pollutants and harmful toxins travel through the respiratory system to the lungs ultimately breaking down and destroying lung tissue (alveolar). Potentially leading to lung cancer or even death.

### Diagnosis

There are multiple ways in which the severity and presence of emphysema can be diagnosed these include numerous self report questionnaires, computed tomography (CT) and spirometry. These diagnostic tools are the most common procedures used in determining a patient with emphysema.

## Effect of Aerobic Exercise on Emphysema

Exercise is a key contributor in the rehabilitation of respiratory diseases such as emphysema. Depending on the severity of the condition and the individuals requirements an exercise program can help accommodate the limitations. As this disease is impacting the respiratory system most patients with the disease remain reasonably sedentary this is due to the breathlessness associated with physical movement involved in such things as daily tasks. Promoting an active lifestyle including daily walks is the first step in prescribing exercise as a treatment for emphysema. Aerobic exercise has shown to improve oxygen uptake, increase aerobic enzymes and improve capillary density.

### Exercise recommendations

For maximal endurance gains a supervised exercise program is recommended including lower limb exercises such as walking, cycling, climbing steps, treadmill or a combination of these. Exercise intensity and duration depend on the severity of the disease and should be tailored to the individual however existing guidelines suggest that patients with emphysema should exercise 2 to 5 times per week for 20 to 30 minutes per session over an 8 to 12 week period

### Causes of exercise intolerance in emphysema

* Ventilation limitation
* Cardiovascular limitation
* Fear
* Obesity

### Additional Information

Breathing Exercises are beneficial if patient has an intolerance with exercise
If smoking is the main cause cease smoking immediately if support is needed contact your local doctor or call quit line on 137848

## Notes

* ↑ WHO, 2013
* ↑ ABS, 2013
* 1 2 NHLBI, 2012
* 1 2 3 4 5 6 GOLD, 2013
* 1 2 3 4 5 6 U.S National Library of Medicine, 2013
* ↑ PubMed, 1986
* ↑ Wakayama, 1993
* ↑ Wilson, 2004
* ↑ Leung, et al. 2010
* ↑ OFFICIAL, 2004
* 1 2 3 4 5 6 Rochester, 2003

## References

World Health Organisation, 2013, The 10 leading causes of death in the world, 2000 and 2011, Fact sheet, Accessed: 13 October 2013, http://who.int/mediacentre/factsheets/fs310/en/
Australian Bureau of Statistics, last revised 14 March 2013, ABS House, 45 Benjamin Way Belconnen, ACT, 2617, Accessed: 13 October 2013, http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/D52CC9949E64E0EFCA257B2E000D74DA
National Heart, Lung and Blood Institute, 2012, COPD (Chronic Obstructive Pulmonary Disease), Fact Sheet, United States Department of Health & Human, Accessed 18 October 2013, www.nhlbi.nih.gov/health/public/lung/copd/what-is-copd/index.html
U.S National Library of Medicine, 2013, COPD (Chronic Obstructive Pulmonary Disease), 8600 Rockville Pike, Bethesda, MD, 20894, Accessed: 11 October 2013, www.nlm.nih.gov/medlineplus/
Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013. Accessed: 11 October 2013, Available from: http://www.goldcopd.org/.
The diagnosis of emphysema. A computed Tomographic-pathologic correlation, Europe PubMed Central, 1986, Accessed: 20 October 2013, http://europepmc.org/abstract/MED/3963623
OFFICIAL SCIENTIFIC JOURNAL OF THE ERS, 2004, New strategies to improve exercisetolerance in chronic obstructive pulmonary disease, EUROPEAN RESPIRATORY journal, 2004, Accessed: 20 October 2013, erj.ersjournals.com/content/24/2/313.full.pdf+html
Wakayama, K, Kurihara, N, et al., 1993, Relationship between exercise capacity and the severity of emphysema as determined by high resolution CT, European Respiratory Journal, October 21, pp1362–1367, http://erj.ersjournals.com/content/6/9/1362.full.pdf+html?sid=734b639f-aa42-42d7-a6e8-ff30074636c7
Wilson, M, Swank, AM & Felker, J, Exercise strategies for the individual with chronic obstructive pulmonary disease, Strength and Conditioning Journal, 50-70, 2004.
Rochester, C, 2003, Exercise training in chronic obstructive pulmonary disease, Journal of Rehabilitation Research and Development, Vol. 40, No. 5, September/October 2003, http://www.rehab.research.va.gov/jour/03/40/5sup2/pdf/Rochester.pdf
Leung, RWM, Alison, JA, McKeough, ZJ, Peters MJ, 2010, Ground walk training improves functional exercise capacity more than cycle training in people with chronic obstructive pulmonary disease(COPD): a randomised trial. Journal of Physiotherapy (Australian Physiotherapy Association).