Respiratory Therapy

Respiratory Therapy

After the enrolment there is a plan designed for the individual. This person-tailored nature of pulmonary rehabilitation, means that the desirable components of pulmonary rehabilitation should vary across individuals according to their needs suiting to their needs and in a manner most convenient to them. 

The rehabilitation sessions include breathing exercises, airway clearance techniques, thoracic mobility exercises, posture correction and incentive spirometry. It also includes teaching them energy conservation techniques such as planning, prioritising the activities, pacing, and use of proper body mechanics.

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Breathing and Exercise training

Breathing and Exercise training

Based on the number enrolled, it could be given in a group of 5 people. If there are 30 members enrolled, they may be divided into 6 groups of 5 each. 

  • Each group may be advised a pulmonary rehabilitation program for duration of 6-12 weeks.
  • There should be 3 supervised sessions per week
  • A warm up session of 5-10 minutes prior to the session and a cool down-stretching session 5 minutes’ post exercise session is recommended. 

a. Airway clearance techniques:

Choose the technique suitable for the subject among those available, based on respiratory capacity, mucus rheology, and patient preferences. 

  • 15–30 min one or more times/day.
  • Choose the duration of treatment based on chronicity
  • Suggest maintenance programme when needed

b. Breathing Exercises:

Teach the patients the mentioned techniques which will aid them in breathing in an efficient manner with all the reserves they are left with.

  • Pursed lip Breathing
  • Deep diaphragmatic Breathing
  • Incentive Spirometer
  • Postural Drainage Positions

  • Huffing/ Coughing Techniques 

     

c. Inspiratory muscle training:     

  • Load threshold devices are used with patient seated and using a nose clip. 
  • It is an interval training where 10 exercises sets are followed with 10 seconds break between each training 

 

 

d. Aerobic exercise:

Endurance training

Each person performs the following exercises in rotation 

  • Treadmill 
  • Arm ergometry
  • Walking
  • Stepping
  • Stationary cycling

Time duration for each exercise should be in bouts of 10 minutes each and the frequency should be minimum of 3 and up to 5 times a week for 4–8 weeks. The intensity to be set according to the perceived dyspnoea.

 

e. Strength training:

The following sets of exercises should be carried out in sets of 2-3 with 6-12  repetitions. The frequency of the regimen be 3 days in a week with the duration of session being 20-30 minutes. Intensity set according to perceived muscles fatigue. Free weights (dumbbells and ankle-brace) can be used.

Upper limb:

  • Shoulder forward flexion
  • Shoulder abduction
  • Overhead shoulder press
  • Biceps curl
  • Overhead triceps extension
  • Scapular retraction

                         Lower limb:

  • Wall squats
  • Lunges
  • Hip abduction
  • Hip extension
  • Dynamic quads
  • Calf raises
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Yoga training

Yoga training

The pulmonary rehabilitation program should incorporate the yoga session as per the individualized plan wherever there is availability of trained yoga teachers/ instructors under their expert guidance.

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