# Exercise as it relates to Disease/The effects of aerobic training on chronic obstructive pulmonary disease
## Defining Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) refers to a number of lung diseases that limit airflow into the lungs, including emphysema and chronic bronchitis. COPD is progressive, and often causes shortness of breath and coughing fits. An estimated 310,000 Australians over the age of 55 suffer from COPD and 1 in 7 Australians over the age of 40 have some form of airflow limitations. Due to the irreversibility of the disease aerobic based training can be a form of treatment. Common consequences of COPD include a depletion of muscle tissue and an unhealthy level of weight loss.

#### Causes of COPD

- Smoking cigarettes – directly or indirectly
- Genetics – alpha-1 antitrypsin deficiency
- Hazardous chemicals, fumes or pollution - exposure to this can have an inflammatory response within the lungs, which denotes to agitation of the airways

#### Symptoms

- A long-lasting cough (also called ‘smoker’s cough’)
- Tightness in the chest region
- Shortness of breath
These symptoms lead many people with COPD to stop participating in physical activity in order to escape the daily suffering of the disease, and when no further action is taken, this can lead people into even more unhealthy lifestyles on a pathway to further health complications particularly in the more elderly population.

## Benefits of Aerobic Exercise

COPD can feel very uncomfortable during exercise, but there are many benefits that aerobic activity can provide. It will not improve the functioning of the lungs, but it will severely enhance the capabilities to use the existing function to the full potential, allowing a more active life. Increased focus on breathing while calm and breathing while the body is under a mild amount of stress is essential to ensure that the body will be able to cope with the light to moderate intensity that is best suited for sufferers of COPD. Exercise is beneficial to self-confidence levels and feelings of self-worth and can be important for life enjoyment.

##### Aerobic Exercise can Improve

- A raised involvement in daily activities
- Reduced fatigue levels
- Fitness
- Confidence levels
- Decreased breathlessness anxiety
- Respiratory endurance
- More efficient oxygen consumption
- Energy levels
- Quality of life - Bone strength - Function of the immune system
- Reduced risk of heart disease

## Recommendations

It is common for people suffering with COPD to also suffer from cardiovascular irregularities and diseases due to the fact that many people struggle to exercise with COPD, which leads to increased health risk factors. The minimum amount of exercise to maintain relative health is around 15 minutes for at least three days a week, and exercise of this amount is not likely to produce large improvements. Exercise should be done at light to moderate intensity with an aim to exercise for around 30 minutes. This exercise should target gross motor skills, which are used often during every day tasks.

#### Recommended Exercises

| Weeks 1-3 | Exercise | Target Heart Rate | Duration (minutes) |
| Session 1 | Walking | 55% of Maximum | 25 |
| Session 2 | Cycling | 55% of Maximum | 25 |
| Session 3 | Stair Climbing | 55% of Maximum | 20 |
| Weeks 4-6 | Exercise | Target Heart Rate | Duration (minutes) |
| Session 1 | Walking/jogging | 65% of Maximum | 30 |
| Session 2 | Cycling | 65% of Maximum | 30 |
| Session 3 | Stair Climbing | 65% of Maximum | 25 |
Sufferers of COPD who exercise regularly have shown an increase of 70%-80% in their functional capacity after only a few weeks. This rapid improvement is partially due to the body’s ability to adapt and cope with anxiety of breathlessness. Weeks 1-3 is aimed at supplying the COPD sufferer with relatively easy introduction to exercising with the disease, and building confidence is a main goal of the period along with brief improvements in aerobic fitness. Weeks 4-6 are designed to continue to challenge the COPD sufferer with gradually more difficult exercises. It is important to remember that this is just a guide. Breathing should be slightly difficult, but if it becomes too uncomfortable then exercise should be ceased. This type of exercise is quite easy to access and at a very convenient price. People that suffer from Chronic Obstructive Pulmonary Disease will always be inhibited. But the ways to combat this provide the sufferer of COPD to have some control over the amount of limitations that the disease produces.

### Further reading

* About COPD Australian Institute of Health and Welfare
* COPD Fact Sheet American Lung Assiciation
* Support Groups Lung Foundation Australia

### References

* ↑ Son, D (2009), ‘Is COPD Really a Cardiovascular Disease?’, American College of Chest Physicians 136(2):329-330
* ↑ Rennard, S (2002), ‘Overview of Causes of COPD’, Postgraduate Medicine: The Rapid Peer-Reviewed Journals for Physicians 111(6):28-38
* ↑ Hurst, J et al. (2003), ‘Upper Airway symptoms and quality of life in COPD’, Respiratory Medicine Vol 98 Issue 8 pp. 767-770
* ↑ Hurst, J et al. (2003), ‘Upper Airway symptoms and quality of life in COPD’, Respiratory Medicine Vol 98 Issue 8 pp. 767-770
* ↑ O'Donnell, D. E., Webb, K. A., & McGuire, M. A. (1993), 'Older patients with COPD: benefits of exercise training' Geriatrics, 48:1, 59
* ↑ Storer, T. W. (2001). Exercise in chronic pulmonary disease: aerobic exercise prescription. Medicine and science in sports and exercise, 33:7 680-686
* ↑ Serres, I. Gautier, V. Prefaut, C. Varray, A. (1998), ‘Impaired Skeletal Muscle Endurance Related to Physical Inactivity and Altered Lung Function in COPD Patients’, American College of Chest Physicians, 113:4 900-905