Pulmonary Rehabilitation Home Exercises

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The material contained in this video presentation provides general information on the management of chronic obstructive pulmonary disease. This information is for reference purposes only and should not be considered medical advice. Before beginning or modifying any exercise program, please consult your medical provider to ensure that the activities demonstrated in this video presentation are appropriate for your specific health condition.

Hi, I'm Janice Me. I'm a doctor of physical therapy, and I'm going to discuss aerobic exercise and breathing. Today, we're going to discuss how cardiovascular exercises can change your body, know the FIT principles for aerobic exercise, and understand the different phases of exercise and monitoring your activity.

Some of the disclaimers we'd like to discuss are that you should always seek medical clearance from your doctor prior to starting an exercise program. Take all medications and oxygen as prescribed. Use an assistive device as needed. If you feel faint during exercise, please stop and rest. If it's a medical emergency, please call 911.

Some of the cardiovascular changes we expect include decreased respirations during the day, improved energy, improved mood, sleep, muscle tone and strength, and improved balance and flexibility. Some of the FIT principles for aerobic exercise are frequency, intensity, time, and type. Frequency: 3 to 5 days a week. Again, start slow, one to two days per week, having a day of the week between each. Intensity: exercise at a moderate level or 3-6 on the RPE scale. Starting slow or low at 3-5 and increasing to 6. Time: start slowly, at least 10 minutes at a time, but work your way up to 30 minutes. Type: could be anything that you really enjoy doing that will get your heart rate up, including walking, jogging, jumping rope, and swimming.

There are three phases of exercise: the warm-up, conditioning or exercise phase, and the cooldown phase. Be sure to set reasonable goals for each phase of exercise. The warm-up phase is the first five minutes of exercise. You want to do some slow stretching and some walking to get your heart rate up. Again, make sure we're practicing our diaphragmatic breathing, inhaling, and then exhaling twice as long as you inhale.

The conditioning phase or the exercise phase: you're going to want to complete your favorite exercise, such as jogging, running, or stair climbing. Be sure to monitor your oxygen levels, your heart rate, and your blood pressure during the exercise. If you feel like completing 10 minutes is too difficult, you can try some interval training, taking short breaks after bouts of activity. The cooldown phase or the last phase of exercise: what we're trying to do is to decrease the intensity of our exercise and bring down your heart rate and your blood pressure. During the conditioning phase, we're going to want to keep in mind our RPE scale and our O2 stat. Be sure you're exercising between the 3 to 6 and keep your oxygen levels between 88 to 90 percent at a minimum, with a goal of 95 to 100%.

Your heart rate during exercise is an important thing to monitor. Although I want you to keep in mind that some of the medications you're on may decrease your heart rate or keep your heart rate at a certain level, including a pacemaker. In order to find your maximum heart rate, you can take 220 minus your age. That'll be your max heart rate. What we can do then is find a percentage of that heart rate to work at, and that would be time six. So, if I was 55 years old, I could take 220 minus my age of 55 and have 165 beats per minute as my max heart rate, and then 60 percent or 0.6 would be my ideal heart rate at 99 beats per minute.

When we exercise, we expect the top number, the systolic number, to increase and the bottom number should stay about the same. Be sure to take your blood pressure prior to exercise. If your top number is above 190 and your bottom number is above 90, do not exercise. The next few slides we're going to talk about Baseline tests. This is going to give you your baseline to find out how your body's going to react to exercise. Always monitor your RPE, oxygen levels, heart rate, and your blood pressure.

Some of the standardized tests which you could find in physical therapy you can do at home. Some are the timed up-to-go, the 30-meter walk, the six-minute walk test, the five sit-to-stand or 30 seconds to just stand, and the standing balance tests. Some tips for exercising: avoid extreme weather, dress appropriately, try to exercise in the morning or late morning, and wear comfortable clothes.

Thank you.