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