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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