Pulmonary Fibrosis is a disease caused by scarring in the lungs. The tissue inside and between the air sacs becomes thick, stiff and scarred. As the lung tissue becomes scarred, oxygen cannot pass through to the red blood cell, which carries oxygen. Creating hypoxia, a reduction in oxygen to all your body tissue. Once the lung tissue becomes scarred, the damage cannot be reversed. So what can we do to maintain our quality of life?
Let’s start by looking at pulmonary rehabilitation. Pulmonary rehabilitation is a comprehensive, multidisciplinary program that uses a combination of teaching, counseling, and behavior modification techniques to improve self-management, reduce symptoms, optimize functional capacity, and increase participation in patients with all kind of lung disease. Typical PR programs offer an intense component (variable time period, often 6–10 weeks) followed by a maintenance component for those patients who wish to continue to participate. Usually, rehabilitation staff performs a comprehensive assessment of patients’ physical strengths and deficiencies along with their emotional and other needs prior to enrollment. An exercise and overall intervention (e.g., psychosocial, nutritional) program is tailored to the individual, and the patient returns to the center 2–3 times per week to complete it in a setting with close monitoring by staff—usually physical or respiratory therapists.
Components of pulmonary rehab target many of these limiting factors. For example, pursed-lip breathing aims to decrease respiratory rate (prolong expiration) and dyspnea while increasing tidal volume (amount of oxygen the lungs will hold) and oxygen saturation. The exercise component of pulmonary rehab has several potential beneficial effects including improving cardiac conditioning, increasing fat-free body mass, making the quadriceps more fatigue resistant; and enhancing the efficiency of skeletal muscle function at the cellular and molecular levels.
From a clinical outcomes standpoint, pulmonary rehab has been shown to not only improve exercise capacity—as measured by distance walked during a 6-min walk test or by oxygen uptake during a maximal cardiopulmonary exercise test. Moreover, emerging data suggest that pulmonary rehab improves psychological adjustment and cognitive impairment in patients with pulmonary fibrosis.
A large study shows that pulmonary rehab will improve functional capacity (as measured by 6-min walk), dyspnea for a given level of exertion, anxiety, mood, fatigue, and better quality of life in patients with pulmonary fibrosis. The chart below shows the results of pulmonary rehab and how it can improve quality of life (QOL).
Exercise is a well-documented safe and effective intervention for prevention and rehabilitation of chronic lung diseases patients.
Often without pulmonary rehab patients start to loose their ability to exercise, which increases the level of dyspnea, depression, anxiety, and fatigue. These patients often see a decline in their quality of life and become more dependent on their caregivers. They have more trouble bouncing back from a flare.
Facts that pulmonary fibrosis patient need to keep in mind.
- Exercising may require more oxygen at first. Keep moving. Allow the respiratory therapist or nurse to increase the amount of oxygen you need during exercise. Often this is a sign of deconditioning, and can be corrected. No one is telling you that you will come off oxygen. Remember everyone is oxygen dependent since taking their first breath.
- Exercise in a temperature controlled environment. Too hot or too cold uses more oxygen, increasing oxygen needs is not healthy for a chronic lung disease individual.
- Pulmonary rehab is not just walking. It is weight training, muscle building and education on nutrition and pursed lip breathing. All of these elements help you use the oxygen in the blood stream more efficient.
- Pulmonary rehab is not completed; it is a life long program. After you have completed the course, normally about 8-12 weeks, it is advised to start a maintenance program. The more you do, the more you will be able to do!
- Weight loss or maintaining a healthy weight is critical. Pulmonary rehab can help with this goal.
- Depression. Pulmonary fibrosis is a debilitating chronic fatal disease. Patients often suffer with depression without even realizing the change in their mood. Exercising enhances the action of endorphins, chemicals that circulate throughout the body. Endorphins improve natural immunity and reduce the perception of pain. They may also serve to improve mood. Another theory is that exercise stimulates the neurotransmitter norepinephrine, which may directly improve mood.
- An exercise regiment can improve cardiopulmonary, musculoskeletal, and psychosocial.
If you are not in pulmonary rehab, call your physician, ask for a referral. Then let’s get moving…….. YOU CAN DO IT.
PulmonaryFibrosisTogether.com support group will be meeting on Friday Feb 3, 2017. Add your email address to this blog if you would like to get reminders and notices regarding this blog and support meetings.