ExercisePrescription for COPD .ppt

Exercise Prescription for COPD Asthma Dr. Roland Leung MBBS MD FRACP FCCP FHKCP FHKAM(Medicine) Specialist in Respiratory Medicine 何謂慢性阻塞性肺病 為什麼慢性支氣管炎及肺氣腫會阻塞呼吸道? 慢阻肺病有什麼徵狀? 呼吸困難 (如上樓梯、行樓梯及梳洗更衣時) 慢阻肺病影響個人、家庭及社會 全球每年有近三百萬人死於慢阻肺病 根據世界衛生組織資料，慢阻肺病是全球第四大殺手病，排名僅次於心臟病發、中風及急性肺炎 死於慢阻肺病的人數較癌症為多，並與死於愛滋病的人數相同 本港第五大殺手病 據二零零一年的衞生署年報指出，慢阻肺病是本港第五大殺手 急症入院主因之一，每十張醫管局病床之中，大概有一張是慢阻肺病病人佔有 10萬人病情屬中度嚴重,還沒有接受任何醫療診治 Airflow Limitation in COPD :Hyperinflation and Exercise Tidal Volume at rest Dynamic Hyperinflation Clinical Course of COPD Effect of Exercise on Dyspnea Relieves patients’ breathlessness during physically demanding exercise SPIRIVA increases exercise endurance time Pulmonary Rehabilitation This is the process of maximising the patients physical , mental and social wellbeing by an individualised program of exercises and education Why PR? All COPD patients benefit from exercise training programs Improvement in both exercise tolerance and symptoms of dyspnoea and fatigue Evidence to show reduce exacerbations and hospital admissions Pulmonary Rehabilitation Ideally Comprises of: Exercise Empowerment Diet Psychological well-being PR Exercise Supervised training 2 - 5 times per week Minimum 20 - 30 minutes each time (may take a time to reach this level) Course duration of 4 - 12 weeks It should involve both upper lower limb exercises both for endurance and strength Components of Exercise Prescription Mode (Type of exercise) Intensity Duration Frequency Progression of Exercise Programme PR Exercise STRETCHING of the major muscle groups of both upper and lower extremities. AEROBIC EXERCISES e.g. walking, cycling, rowing, swimming, etc. FREQUENCY - is 2 to 5 times per week with aim of daily routine. INTENSITY- “maximum limit tolerated by symptoms” or to 60 to 75% of maximal heart rate DURATION - 20 to 30 min of continuous exercise OR if this is not possible, interval training = two to three min of high-intensity training alternating with equal per