PT Treatment For Copd

MANAGEMENT OF
COPD
GOALS
• Treatment of underlying problem
• Clearance of tracheobronchial secretions
• Relieve symptoms
• Antibiotics for infection
• Reversal of airflow obstruction
• Improve quality of life
• Prevent disease progression
PHARMACOTHERAPY
• Smoking Cessation has shown a significant improvement in the rate of
decline in pulmonary function
• Bronchodilators: the primary treatment for almost all patients with COPD
used for symptomatic benefit and to reduce exacerbations
Used in the form of inhaler
• Anticholinergic Muscarinic Antagonists:
Short-acting ipratropium bromide improves symptoms with acute
improvement in FEV1 .
Long-acting muscarinic antagonists (LAMA, including aclidinium,
glycopyrrolate, tiotropium, and umeclidinium) improve symptoms and reduce
exacerbations
• Beta Agonists:
Short-acting beta agonists ease symptoms with acute improvements in
lung function.
Long-acting agents (LABA) arformoterol, formoterol, indacaterol,
olodaterol, salmeterol, and vilanterol provide symptomatic benefit and
reduce exacerbations
• Oxygen Supplemental: O2 is the only pharmacologic therapy to
decrease mortality rates in patients with COPD.
For patients with resting hypoxemia (resting O2 saturation ≤88% in any
patient or ≤89% with signs of pulmonary hypertension or right heart
failure), the use of O2 has impact on mortality.
• Long-term maintenance therapy includes the use of nebulized
medication
SURGICAL MANAGEMENT
• The procedure involved is resection of areas of bronchiectatic lung.
Indications of surgery in bronchiectasis are the following:
Children or young adults with localised lesions, who do not respond to
medical treatment.
Recurrent haemoptysis.
Recurrent localised pneumonias.
• Lung transplantation in patients with extensive disease and

respiratory failure.
Physiotherapy management
• Airway clearance techniques
• Reduce breathlessness
• Improve exercise capacity

Airway clearance techniques
• ACTIVE CYCLE OF BREATHING TECHNIQUES (ACBT)
Breathing Control. BC is tidal volume breathing at a

patient’s own respiratory rate and volume.
Thoracic Expansion Exercises. TEEs are deep breathing

exercises (DBEs) with an emphasis on slow, controlled
inspiration through the nose. Inspiration is active, with
larger than normal volume breaths which are often
combined with a 3-second end inspiratory breath hold,
with the glottis open, prior to passive expiration.
• AUTOGENIC DRAINAGE
• Postural drainage
Postural drainage (PD) is thought to use gravity to assist drainage of secretions
• airway clearance maneuvers or mechanical techniques
• Percussion or vibrations are performed in a postural drainage position.
• They aim to jar loose secretions from the airway walls
• Percussion consists of rhythmic clapping on the chest with loose wrist and
cupped hand, creating an energy wave that is transmitted to the airways.
• vibration is utilized in postural drainage positions to clear secretions from
the affected lung segments
• Vibration involves a gentle, high frequency force, whereas shaking is more
vigorous in nature.
• Shaking is similar to vibration except that the oscillation component has a
larger amplitude and slower frequency.
• Shaking is a stronger bouncing maneuver, which also supplies a
concurrent, compressive force to the chest wall.
Mechanical aids
• Flutter
• Cornet
• Percussors, vibrators and oscillators
• Intermittent positive pressure breathing
• Positioning for Dyspnea Relief
• Improve exercise capacity
• FITT RECOMMENDATIONS FOR INDIVIDUALS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Aerobic Exercise
Frequency: At least 3–5 d wk1.
Intensity: For patients with COPD, vigorous (60%–80% of peak work rates) and light (30%–40% of peak
work rates) intensities have been recommended.
Light intensity training results in improvements in symptoms, health- related quality of life, and
performance of ADL, whereas vigorous intensity training has been shown to result in greater
physiologic improvements (e.g., reduced minute ventilation and HR at a given workload).
Intensity may be based on a dyspnea rating of between 4 and 6 on the Borg CR10 Scale
Time: Individuals with moderate or severe COPD may be able to exercise only at a specified intensity
for a few minutes at the start of the training program. Intermittent exercise may also be used for the
initial training sessions until the individual tolerates exercise at sustained higher intensities and
durations of activity. Shorter periods of vigorous intensity exercise separated by periods of rest (i.e.,
interval training) have been used with those with COPD and shown to result in lower symptom scores
despite high training work rates (261). Type: Walking and/or cycling. Resistance and Flexibility Exercise
Resistance and flexibility training should be encouraged for individuals with COPD. The Ex Rx for
resistance and flexibility training with pulmonary patients should follow the same FITT principle of Ex
Rx for healthy adults and/or older adults

PT Treatment For Copd

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MANAGEMENT OF

• Lung transplantation in patients with extensive disease and

• Improve exercise capacity

Breathing Control. BC is tidal volume breathing at a

Thoracic Expansion Exercises. TEEs are deep breathing

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