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Introduction

Introduction. Me Philip Langridge Aspergillosis Specialist Physiotherapist You A diverse group of people with a variety of abilities. Aims of this afternoon’s talk (My interpretation of what you want as a group). Introduce exercise and give you some ideas about what you can do

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Introduction

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Presentation Transcript

  1. Introduction • Me • Philip Langridge • Aspergillosis Specialist Physiotherapist • You • A diverse group of people with a variety of abilities

  2. Aims of this afternoon’s talk(My interpretation of what you want as a group) • Introduce exercise and give you some ideas about what you can do • Introduce the Active Cycle of Breathing Technique

  3. Optimising general well being through exercise

  4. Physical Fitness Performance/ skill-related fitness • Agility • Balance • Coordination • Power • Reaction Time • Speed Health fitness • Body composition • Cardiorespiratory endurance • Flexibility • Muscular endurance • Muscular strength

  5. True or False? • The worse my lung function test results are the less I am able to do • All exercise is good for you • If you have arthritis it is bad for you to exercise • There is a recommendation about how much exercise to do • If you exercise more you live longer • Those who exercise are healthier • Exercise is necessary for weight loss • The gym is the best place to exercise • You need special equipment to exercise • You must warm up and cool down every time you exercise • The older you are the less fit you become • If you have heart disease it is bad for you to exercise • (All physios are super fit)

  6. What does research say about the likelihood of cardiac events with exercise? The relative risk of both exercise-related myocardial infarction and sudden death due to cardiac arrest, is greatest in individuals who are the least physically active and perform unaccustomed vigorous physical activity

  7. I believe • Exercise can help people cope better with everyday life (physically, mentally and socially) • Exercise can reduce risk of several problems • Eg stroke, deep vein thrombosis, heart disease, osteoporosis, depression, social isolation • There are lots of potential difficulties that limit/prevent exercise • Everyone can do exercise that will benefit them

  8. Potential mechanisms of exercise limitation in lung disease • Anxiety/tension and depression • Abnormal perception of breathlessness and ventilatory control • Alteration in pulmonary mechanics • Impaired pulmonary gas exchange • Cardiovascular dysfunction • Poor nutritional status • Respiratory muscle fatigue • Deconditioning due to inactivity • Decrease in endurance and power of peripheral muscle

  9. Effect of exercise on lung tissue? Negligible if any!

  10. Why Not Bother Exercising • Unpleasant • Tiring • Painful • Embarrassing • Dangerous • Fear • Unnecessary • Inconvenient • etc

  11. So what’s the point then? • Physicalbenefits • You can improve how you use what you’ve got and improve existing muscles including your breathing muscles • You can transport oxygen better around your body and get rid of waste products more effectively • You can become more flexible and reduce pain • etc • Non-physicalbenefits • Improved mood, confidence, perceived breathlessness, social health, sleep, etc

  12. Activity “Dose Response” Adapted from: U.S. Surgeon Generals Report 1996 Pate et al., JAMA; 273: 402-407, 1995 High Freq High Intensity Mod Freq Mod-High Intensity High Freq Low-Mod Intensity Fitness Benefit Level of Benefit Mod Freq Low Intensity Health Benefit Volume & Intensity of Activity

  13. Principles of exercise progression • FITT • Frequency (times per day/week) • Intensity (e.g speed of walking, weight used) • Time (how long spent each session) • Type ( e.g. cycling-walking-running)

  14. Example of intensity progression • Time how long it takes to dust a room • Try and beat this next time you dust

  15. Example of type progression (dancing)

  16. Mechanism of improvement in exercise tolerance Pulmonary disease: unable to work at sufficient workload to produce normal training effect • Increased leg and respiratory muscle efficiency • Increased motivation to exercise • Increase stride length • Desensitisation to breathlessness

  17. How do I know I’m doing enough / too much • Breathlessness • Pain • (Heart Rate) • Goals

  18. The Borg Scale for breathlessness

  19. Controlling breathlessness • Pursed lip breathing • Pacing • Prioritising

  20. Goal setting • Think SMART • Specific • Measurable • Achievable • Realistic • Timed

  21. Goals – some examples Unrealistic? • Able to run a marathon • Lose 4 stone in 2 months • Never be breathless • Do what I could 15 years ago

  22. SMART goal examples To walk to my friends’ house for drinks on Christmas Eve this year To go to my son’s wedding next year and be able to dance at the reception for more than a couple of minutes • to be able to climb my stairs without stopping half-way within 2 months (currently taking 2 rests) • Within 4 weeks to feel less breathless having got myself dressed in the morning

  23. Age as a barrier to exercise

  24. Oldest Marathon Runner • Dimitrion Yordandis, who ran the Athens race aged 98, holds the current record.Dimitrion expressed some concerns that if he continued running for the next 5 years it might not be that good for his knees

  25. One hundred years • His daily regimen would be the envy of most men 30 years his junior. Rising around 7 a.m., Gentilhomme typically plays his two hours of tennis in the morning, then takes a brief post-lunch nap before heading to the fitness club for aerobic work and weightlifting. Weekly square-dancing and bowling sessions, piano and card playing, gardening, bike riding, and reading - all help keep his mind and body engaged. After watching the 11 p.m. news, he'll catch up on e-mail before turning in

  26. Training regime Successful outcome is dependent on: • Realistic and achievable programme • Individually tailored • Easy to incorporate into Activities of Daily Living

  27. Have goals Monitor your progress Make it routine not exceptional Make it enjoyable Don’t go it alone Expect effort Be creative Give it a fair go/ Be patient! Recognise your achievements! Warm up and warm down Blow as you go! (pursed lip breathing) Use it or lose it! Be realistic! Phil’s Top Tips for exercise

  28. The active cycle of breathing technique • ACBT • LTEE – lower thoracic expansion exercises • BC – breathing control • Diaphragmatic breathing • Low volume forced expiratory technique • High volume forced expiratory technique

  29. Exercises to help clear mucus

  30. Many thanks for your attention!Now what do you think you’ll do next………….?

  31. Some examples of simple exercises you can try at home:

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  38. Neck exercises • Stand up tall and look ahead (Sit if your feeling unsteady) • Place one hand on your chin • Guide your head straight back (as if you’re trying to get a double chin!) • Repeat 5 times

  39. Stand up tall and look ahead (Sit if your feeling unsteady) • Slowly turn your head as far as you can to the right • Slowly turn your head as far as you can to the left • Repeat 5 times to each side

  40. Trunk movements • Stand up tall and place your hands on your hips • Do not move your hips • Turn as far as you can to the right, comfortably • Turn as far as you can to the left, comfortably • Repeat 5 times to each side

  41. Ankle Movements • Sit Down • Point the foot down • Pull the foot back towards you • Repeat 10 times for each foot

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