Cardio Pulmonary Rehabilitation
The Cardiopulmonary Rehabilitation Program is a medically supervised, individually tailored program consisting of exercise and education to help patients feel better, increase endurance and improve their overall quality of life. It is an area of physiotherapy that specializes in the prevention, rehabilitation, and compensation of clients with conditions manifesting as shortness of breath, persistent cough, increased work of breathing or the reduced ability to exercise.
How Does Cardio Pulmonary Rehabilitation Works?
Cardiac rehabilitation increases the quality of life and decreases health care costs.
Cardiac rehabilitation has many physiologic benefits due to its exercise component. Exercise
training has been shown to increase maximal oxygen uptake (VO2max), improve endothelial function,
and improve myocardial reserve flow. Additionally, cardiac rehabilitation can reduce smoking, body
weight, serum lipids, and blood pressure.
Cardiac rehabilitation goals can be designated into
two broad categories:
| Short-term goals | Long-term goals |
|---|---|
| Enhance functional capacity | Alter natural history of coronary artery disease |
| Limit unfavorable psychological | Stabilize or reverse the progression of atherosclerosis |
| physiologic effects of cardiac illness and Boost psychosocial and vocational status | Lessen the risk of sudden death and reinfarction |
Cardio Pulmonary Rehabilitation services
1. Deep Breathing Exercise: to encourage increased lung volumes
2. Hands-on Techniques and Breathing Facilitation Exercises: to expand your lung
capacity.
3. Percussions and Vibrations: to help you loosen secretions and make coughing
easier
4. Coughing and Breathing Strategies: to help you cough and manage
your shortness of breath
5. Breathing and Circulation Exercises: to prevent further respiratory and
vascular complications such as chest infection and deep venous thrombosis (DVTs)
6. Mobility Assistance: to move safely in bed, sit up, stand and walk
7. Mobility Aids: advice, prescription and instruction on how to safely use a
walking frame, or other walking aids as required
8. Individually Tailored Exercises: to control your breathing pattern, build
muscle strength and endurance and improve your general health and wellbeing.
ACBT - Active cycle of breathing technique
Hypertension
What is hypertension?
Borderline hypertension or high blood
pressure is for the adult, a systolic blood pressure between 140 and 159 mmHg or a diastolic blood
pressure between 90 and 95 mmHg. While a systolic and diastolic pressure of 160 and 96 mmHg
respectively or greater is considered to be absolute hypertension. Hypertension and its
complications (stroke, congestive heart failure, kidney failure and heart attack) are major medical
problems all over the world. How can physiotherapy help manage high blood pressure?
Our physiotherapist can advise you about how to lower your risk of developing high blood pressure
and also about how to reduce your risk of health problems once you have been diagnosed.
A
well-being review delivered by a our physiotherapist with knowledge of pulmonary hypertension can
identify simple lifestyle changes that can help prevent you having to take medication.
Supervised exercise training has been shown to be beneficial in patients with pulmonary
hypertension. Exercise in patients with pulmonary hypertension is safe and leads to improvements in
functional ability and quality of life.
In particular, our physiotherapists can tell you which
exercise programs are suitable for you, depending on how high your blood pressure is, how fit you
are and how any other health conditions or disabilities you may have will affect your ability to
exercise.
Asthma
Asthma is a relatively common condition that is characterised by at least partially reversible inflammation of the airways and reversible airway obstruction due to airway hyperactivity. It can be acute, sub-acute or chronic and/or exercise induced.
What happens in Asthma?
Asthma is a condition of acute, fully
reversible airway inflammation, often following exposure to an environmental trigger. The
pathological process begins with the inhalation of an irritant (e.g., cold air) or an allergen
(e.g., pollen), which then, due to bronchial hypersensitivity, leads to airway inflammation and an
increase in mucus production. This leads to a significant increase in airway resistance, which is
most pronounced on expiration.
Airway obstruction occurs due to the combination of:
•
Inflammatory cell infiltration.
• Mucus hyper secretion with mucus plug formation.
•
Smooth muscle contraction.
These irreversible changes may become irreversible over time due to
• Basement membrane thickening,
• Collagen deposition, and
• Epithelial desquamation.
Airway remodeling occurs in chronic disease with smooth muscle hypertrophy and hyperplasia.
Role of physiotherapy
The majority of patients suffering from asthma
will seek physiotherapy for dyspnoea and hyperventilation. Our physiotherapists treat asthma in a
variety of ways with the aim to improve breathing technique. Physiotherapy techniques for asthma are
in addition to medication and should never be used as a replacement for prescribed medication,
however may reduce the dosage required.
1. Breathing Retraining Techniques -
to normalise breathing patterns by stabilising respiratory rate and increasing expiratory
airflow. Instructions are given from the physiotherapist on how to complete this technique, with the
following components:
• Decreasing Breaths Taken (Reducing Respiratory Rate)
• Taking
Smaller Breaths (Reducing Tidal Volume)
Diaphragmatic breathing through use of
abdominal muscles and lower thoracic chest movement)
Relaxation – Relaxed and
controlled breathing
Pursed lip breathing
These retraining techniques
help control breathing and reduce airflow turbulence, hyperinflation, variable breathing pattern and
anxiety.
2. Physical Training : Physical training should be prescribed by
physiotherapists for asthmatics to –
• Increase fitness and cardiorespiratory performance,
• Reduce symptoms such as breathlessness and improve quality of life.
3. Respiratory Muscle Training - Hyperinflation in asthma causes increased lung
volume, leading to altered inspiratory muscle mechanics. Inspiratory muscles are shortened resulting
in a sub-optimal length-tension relationship for contraction. There is a decreased capacity for
tension generation when breathing, resulting in accessory muscles of inspiration being utilized.
Breathing exercises are carried out using an external device to make breathing more difficult.
This helps to strengthen the inspiratory muscles, making it easier to breathe in everyday life.
A breathing device is used which sets up a load to breathe against. During inspiration air is only
released if enough effort is used to force open the valves of the device. Respiratory muscles are
forced to work harder, increasing their strength, leading to diaphragmatic breathing becoming
easier, reducing hyperinflation.
4. Removal of secretions
• Percussions
• Shaking
• Vibrations,
• Postural drainage and
• Effective coughing
5. Range of motion
exercises
6. Education about condition - use of a bronchodilator
and any other medication, how to prevent chest infection from occurring, Correct posture in standing
and sitting which assists in the management of asthma attacks by allowing the chest to expand
appropriately and the lungs to function optimally.
