Will yoga exercises help COPD patients manage breathlessness better?
Many people who suffer from a lung disease find it very hard to exercise. Often even the thought of physical activity makes them feel breathless. But there is a way to overcome these fears that only lead to a downward spiral of both physical and mental decline, practising yoga. This low impact form of exercise will not only help raising your energy levels, it also clears your mind from worry. Being good for everybody, it is also more and more recommended especially for people with lung diseases, like emphysema, chronic bronchitis, and other lung diseases commonly known as COPD.
Why can yoga exercises be especially beneficial for COPD patients?
In yoga practice there are two essential parts that complement each other in a synergistic way. One part is the Asanas, physical posture that improve range of motion, balance, flexibility and strength of the body. The other part is the Pranayamas, breathing techniques that teach you how to control your breathing and keep your lungs more fully. It also strengthens your respiratory muscles. The two combined will help you improve your general fitness and make breathing easier and more efficient. Additional meditation helps relieve stress and anxiety, which allows you to extend the benefits of the pranayamas and asanas.
Pranayamas, breathing techniques, that can be beneficial for COPD patients are:
This is an exercise especially suitable to learn control your breathlessness. While leaning slightly forward you slowly breath out with your lips pursed, imagine you are blowing a kiss or cooling your soup. This slows down the exhalation and stimulates the abdominal muscles to contract and forces the diaphragm upwards, so the lungs will empty themselves better. Instead of long inhalations and short exhalations, which is a common reaction to breathlessness, you learn to do it the other way around, with an ideal rhythm being to make the exhalation twice as long as the inhalation. Not only will this calm you down and relieve the breathlessness, it also help to strengthen the breathing muscles.
Abdominal or Belly Breathing
COPD patient can benefit especially from the abdominal breathing technique, as it stimulates the diaphragm moving upward and downward, so more oxygen can be taken into the lower lobes of the lungs and spread through the body. At the same time the abdominal organs are massaged by the moving diaphragm, thus improving their intake of oxygen and functioning. By doing the belly breath your body relaxes and becomes re-energized at the same time.
Ujjayi Breathing or Ocean Breath
This is a special form of breath, typically used while practicing asanas. It is used to slow down the breath and make an audible sound by creating a constriction in the base of your throat, like you do when blowing out to create a fog on a mirror. It helps you to stay calm during the practice while focusing on the sound and avoiding breathlessness. It also is said to create heat in your body, which helps to keep up your energy levels throughout the practice. The diaphragm controls the length and the speed of your breath and will become stronger in doing so.
Correct breathing is an essential part of yoga; as the blood will be provided with more oxygen, which makes it possible to control energy levels and this will help you relax and calm your mind. Once you have controlled your breath by practicing pranayamas, you will feel more comfortable and confident to start practicing asanas.
Asanas, physical postures, recommended for COPD patients are:
Standing Mountain Pose
This is a straightforward pose, from which all other standing poses are performed. It requires you to stand tall, either with your arms raised or left hanging loosely at your sides. It teaches you to align your spine and balance the weight of your body, while focusing on your inner self. Your chest will open up and breathing will become easier.
Standing Back Bend
This pose is performed from the Standing Mountain Pose by placing your hands on your lower back with the fingers pointing down and arching your spine back. It helps to release tension in your neck and shoulders and opens up the respiratory system.
Standing Side Bends
These bends not only improve your posture by standing taller, it also regulates your breathing. The basic standing side bend is easily performed from the Standing Mountain pose. By exhaling with each bend, you stretch alternately to the left and to the right. This calming pose improves the flexibility of your rib cage and helps to strengthen your diaphragm to make breathing easier.
Seated Forward Bends
There are several seated forward bends, performed from either a chair or the floor. These poses calm the brain, stimulate the organs and stretch the spine and the shoulders to give more room to your lungs and help you to relax.
These are only a few examples of pranayamas and asanas that you can practice to help improve your lung condition. If reading this story triggered your enthusiasm to give it a try, do take some precautions before you begin. Things to consider are for example:
– Consult with your doctor or respiratory therapist about what is possible in your condition
– Always join a recognized yoga school, don´t go practicing by yourself without any coaching
– Be sure the yoga teacher of your choice is qualified, also for training special groups like COPD patients
– During class, always keep your inhaler or oxygen supply at hand
– Don´t overexert yourself, take a rest if you get exhausted or experience shortness of breath
With these precautions in mind and a good yoga teacher, you will surely be able to experience the benefits that can yoga give you, a fitter body and a mind more at ease.
Websites consulted: http://www.healthline.com/health/copd/yoga#1 http://yogachicago.com/2014/03/yoga-for-chronic-obstructive-pulmonary-disease-copd/ https://www.doyogawithme.com/yoga_breathing
Can Yoga Help When You Have COPD?
Many people who suffer from COPD find it hard to exercise. But not exercising worsens their lung condition rapidly, which makes it even more difficult to perform any kind of activity. This way they find themselves in a vicious circle where they feel there is no escape from. Especially for these people yoga is the best exercise, as it is a low impact activity that improves your physical as well as your emotional health. It reduces stress and anxiety, increases relaxation and self-confidence, and improves fitness in general.
Yoga can help relieve the symptoms of COPD
Yoga has its roots in Eastern philosophy, and many people still think it is mainly a spiritual and religious experience. But most yoga classes for people with health problems do not focus on this at all. It is mainly a “mind-body practice”, as the National Center for Complementary and Alternative Medicine describes it., which is especially beneficial for people with COPD. The American Journal of Therapeutics published a study performed in 2012, that showed these benefits clearly. In this study a group of 33 COPD patients followed a yoga class given by a certified yoga therapist for six weeks in sessions of one hour, three times a week. They were taught yoga postures, breathing exercises and meditation techniques. After the six weeks, the medical tests showed an improvement in lung function and the patients themselves reported that their overall quality of life had improved significantly.
Yoga offers various benefits for people with COPD
First of all, it is an easy way to exercise. Most exercises are stationary and performed sitting or standing. These physical postures, also called asanas, encourage your flexibility and build up your physical strength, thus helping you to increase your exercise tolerance. Yoga classes set up for COPD patients do not contain complicated poses, but just gentle stretching and bending exercises, designed especially with the health needs of people with COPD in mind. Together with the breathing exercises, the so-called pranayamas, which will teach you how to manage attacks of breathlessness, they will give you all the tools you need to effectively manage both your physical and your emotional well-being. All the techniques are normally easy enough to also practice at home.
Second, there is the social interaction you will be able to build up with your fellow students. You can exchange experiences with others in the same or similar condition as you are, so the feeling of isolation, being one of a kind, will reduce. And the mere fact of spending time with other people on a regular basis will undoubtedly help improve your overall mood, as it does to all of us. This makes it a fun sociable activity, which should be easy to keep up!
And last, but may be not least, it can be a big help to those COPD patients that, despite their disease, cannot manage to quit smoking. Trying to stop this habit can lead to stress and anxiety, which does not help the condition of especially COPD patients, and may even have an adverse effect. Practicing yoga can be a big help in relieving these stress symptoms caused by smoking cessation and increase the chance of a successful attempt to quit. This is a suggestion endorsed by the American Lung Association.
Yoga is a safe way of exercise for people with lung diseases
Especially for people suffering from emphysema, chronic bronchitis, and other lung diseases that are generally known as COPD, yoga is one of the best ways to keep a health condition as good as possible through exercise. Of course, before you begin, consult with your doctor and ask his advice. Maybe he or she will also know certified yoga teachers in your neighbourhood with good credentials for training COPD patients. And always remember to keep your inhaler at hand, just in case. With these precautions taken, nothing stands in your way to improve your physical and mental wellbeing with the aid of yoga!
We all know that a healthy lifestyle can help us lose weight, get more energy and give us a better quality of life in general. But it is little known that good exercise and healthy food is especially beneficial for the well-being of your lungs also, both for people who still have healthy lungs as for people who suffer from any lung disease already.
Exercising doesn’t necessarily mean exhausting yourself
For people who have a lung disease, like asthma or COPD, exercising often seems just bridge too far. But exercising does not have to be strenuous. A small research with COPD patients doing mild exercises in a bath filled with warm spring water showed a remarkable reduction of their symptoms and improvement of the condition of their lungs as well as their oxygen saturation. Also special training like yoga or tai chi have seen to be very wholesome for COPD patients, and can even slow down the progression of diseases like emphysema.
For asthma patients, especially those suffering from exercise-induced asthma, a simple exercise as blowing in a bottle regularly, can improve their lung function significantly. This was demonstrated by a research where 212 patients were asked to blow into a bottle every 4 hours, during 4 months. After this period their FEV (Forced Expiratory Volume, which is the amount of air that can be blown out in a one second forced exhalation) showed a stable improvement of their lung function. Apart from that they needed to use their inhalers a lot less during this period. 65-75% of the improvement remained for over half a year, even without blowing in the bottle.
It seems only logical that, if these simple exercises are so beneficial to already damaged lungs, they would be just perfect to keep your still healthy lungs in tip top shape. So don’t wait until it is too late, start exercising and let your lungs absorb the oxygen to energise your body. No need for exhausting exercises, a nice walk in the fresh air, that you can breathe in deeply, is sufficient and may be even the best!
Eat vegetables and fruits to keep your lungs in the best possible condition
More and more scientists and researchers emphasise the importance of eating ample fruit and veggies, around 400 grams daily, to keep our bodies healthy. Specific research has recently shown that especially our lungs also benefit from this kind of diet. A researcher from the section Health & Environment from the University of Washington in Seattle found that frequent consumption of vegetables and fruits reduces the chance to develop COPD or other lung diseases, while for people already suffering from COPD, it improved their lung function significantly. Other research found that eating fruits and vegetables offers protection against lung cancer.
If possible, try to get biological products, as these contain more anti oxidants than the regularly grown vegetables and fruits. Furthermore, the biological varieties contain more polyphenols. Both anti oxidants and polyphenols are known to have anti inflammatory and anti carcinogenic properties.
Ref: Medisch dossier, Sept. 2016; Wikipedia
A team of researchers in America have developed and are currently testing out a table that may be able to help patients that suffer from the effects of COPD.
The team consists of people from all disciplines that have come together to pool their knowledge of COPD and patient’s pulmonary care and treatment to help these patients to improve their breathing.
The table is based on a gravity-powered approach to improve ventilation as well as helping to clear mucus. The table appears stable but in fact rocks forward and backwards with weight. The person on the exercise table lifts and pulls a bar while rocking the table forward
As the person pushes away the table then rocks backward resulting in the person’s feet being higher than their head. This movement forces air out of the lungs, which is normally difficult for a COPD patient to do and therefore reduces the difficulty of breathing for the patient. This approach also uses gravity to help the tiny hairs in the lungs to move the mucus along the trachea as well as the gravity also helping to move the lymphatic fluid out of the lungs. The movement of the abdominal viscera also moves the diaphragm which also reduces the effort of breathing.
The table not only aids the lungs and breathing but also benefits the rest of the body. The gravity effect on the body results in the drainage of lymphatic fluid from the arms and legs, improving circulation and reducing swelling.
One of the founders of the company is himself a COPD sufferer and says that the table has alleviated his symptoms greatly but the table is currently being vigorously tested in trials.
COPD patients are often prescribed opioids such as codeine, oxycodone and morphine to provide relief from common symptoms such as muscoskeletal pain, insomnia and respiratory issues. However it has been shown by researchers in Toronto, Canada that opioids can induce additional respiratory side effects and that new opioid users have 5 times a greater risk of death compared to non-opioid users. These results raise serious safety concerns about the use of opioids for older adults with COPD.
“This is a population that has a chronic lung disease, with symptoms that can sometimes be challenging to manage,” said Dr. Nicholas Vozoris, lead author of the study. “This class of drugs may offer some relief; however, there is also evidence suggesting that opioids can adversely affect breathing and lung health in people who already have chronically compromised lungs.”
Previous studies reported that opioids were safe for patients with advanced COPD but the results were not reliable due to study limitations.
In this new study over 130,000 patient records were examined from multiple healthcare databases to try to ensure the results were more generally applicable and reliable.
“Previous research has shown about three-quarters of older adults with COPD have been prescribed opioids, which is an incredibly high rate of new use in a population that is potentially more sensitive to narcotics,” Vozoris said. “Our new findings show there are not only increased risks for respiratory-related death associated with new opioid use, but also increased risk of visits to emergency rooms, hospitalizations and needing antibiotics or steroid pills.”
The team found that those who used opioids had an increased risk of 14% or ending up in the emergency department and nearly 3 times the risk of COPD or pneumonia-related mortality. They even have an overall mortality risk of 76% compared to non-opioid users. Opioids were however found to decrease the risk of respiratory exacerbations by 12%.
The higher risks were found in patients using stronger or higher dosage opioids however many risks were unaffected by dosage if you were a new user.
Opioids can impact COPD patients in several ways such as respiratory depression, reduced mucous clearance from cough suppression, and immunosuppressive effect.
To lower the risks of adverse events doctors may prescribe less potent or lower dosage opioids but the results of the current study showed increased risk of complications and even death regardless of dose amount among new opioid users. Vosoriz said the finding is important because lower doses were long considered safe.
“Sometimes patients are looking for a quick fix for chronic pain or breathing issues and physicians may believe opioids can offer them some relief,” he added. “The trade-off becomes explaining that there are risks to patients and making sure they understand that potentially alleviating their symptoms could come at a higher cost to their health.”
An individual multi-disciplinary approach is better as a treatment plan rather than just prescribing opioids. Making use of pulmonary rehabilitation, supplemental oxygen therapy, exercise and lifestyle changes in conjunction with medication is best way forward for COPD patients.
References: http://copdnewstoday.com and http://lungdiseasenews.com
Despite there being excellent medications for COPD patients, such as bronchodilators which are continually improving in both potency and in delivery there is still a huge proportion of the COPD patient population who continue to experience deterioration in their symptoms and poor quality of life. There are however many non-pharmalogical treatments that can provide huge relief for many patients. They may work alongside your pharmalogical treatment or you may decide that they are better used instead of, but always consult with your doctor. Smoking cessation is the most important of these. It has been shown and still being proved in continuous research how cigarette smoke harms not just your lungs but also the rest of your body. It the primary cause of COPD and the chemicals have been shown to affect your cells right down to its DNA and causes abnormalities, inflammation and permanent damage which greatly worsens your symptoms and respiratory ability. There are lots of different ways you can be aided in stopping, with patches, gum and electronic cigarettes. Its always best to support your method with counselling or support groups. Telemedicine allows patients with COPD to connect electronically with a specialized care consultant. Telemedicine can be used to collect information from the patient and track his or her progress on a daily basis, if necessary. It has been used to alert the medical team to the early onset of acute exacerbation of COPD thereby avoiding emergency department visits and hospital admissions. However, more evidence is needed as some studies state that “telemonitoring for COPD is not yet proven and further work is required.” There are many devices already out in the market which are easy to use and allows the user to feel more in control and to monitor their respiratory vitals on a daily basis and adjust their regime quickly when alerted to avoid unnecessary attacks and deterioration. Pulmonary rehabilitation is important in order to sustain your mobility and quality of life. It aims to counteract the loss of skeletal muscle that is common in COPD and to improve exercise tolerance. There are a variety of methods including exercise training, nutritional supplementation, and psychosocial support. Although it is not yet proven to have direct links to increased survival or lung function, there have been improvements in health-related quality of life, dyspnea, and exercise tolerance. There has also been a tendency for any accumulated improvements to deteriorate with time unless the methods are continued. Long-term oxygen therapy is also an option for some patients with COPD. Short-term use of oxygen during exercise or strenuous activities in patients with any degree of hypoxemia has long been known to improve dyspnea and increase exercise tolerance, although is not proven to extend survival. For patients who are chronically hypoxemic long-term oxygen therapy where the patient uses it constantly through the day, not only improves exercise performance and quality of life but also improves survival rates. There are many different devices depending upon your lifestyle and requirements and can be obtained via the NHS or from private companies. They are much more compact, lightweight, discrete and portable than ever and still allows the patient to move around easily both in their home and outdoors so as to allow the patient to have a significantly increased quality of life and eliviate respiratory symptoms. Noninvasive positive pressure ventilation (NIV) has been effective when treating COPD patients that suffer from acute exacerbations. Gas exchange and respiratory abilityes are improved, resulting in decreases in intubation rates, shortening hospitalizations, and improving mortality. However, its long-term role in managing COPD has not been demonstrated and its unclear as to whether nocturnal NIV will signoificantly improve lung function, gas exchange, or sleep efficiency.
Patients with severe emphysema typically have bullae. These are growing air spaces that occupy space within the thorax but do not provide much gas exchange. They are more likely to impair the function of less diseased lungs by occupying dead space within the thorax and contributing to air trapping and ventilation/perfusion problems. The aim of surgical lung volume reduction is to remove nonfunctional lung and thus improve lung physiology and symptoms. A large study showed that this treatment is only truely beneficial to patients with predominantly upper lobe disease and low prior exercise tolerance. Other subjects tended to have higher mortality. The procedure is rarely performed today, but there are attempts to achieve a similar outcome, by less invasive methods. These employ the placement of one-way valves in the lung airways that allow gas to leave bullae but not return. The valves are placed bronchoscopically into the lungs. In general, some improvement in lung function, less dyspnea, and improvements in exercise capacity have been obtained, but there has usually been an increase in adverse effects, including acute exacerbations of COPD and pneumothorax, sometimes requiring removal of the valve(s). Lung coils are another method proven to be very succesful. Doctors insert special flexible scopes through the patient’s mouth to place metal coils into the damaged tissue of the patient’s lung. The coils return elasticity to the diseased tissue, allowing the lungs to work in a more normal way. Other experimental lung procedures with the same aim have attempted to collapse the most emphysematous lung regions by closing the airways to those regions by other means, but development of these methods is incomplete. Lung transplantation has been an option for patients with severe COPD since 2000, with 50% survival being in the region of 5 years and steadily improving. It should be considered only in patients with end-stage COPD, only when all other therapies have been tried and failed to provide relief. Primary graft failure, chronic rejection, and infection are common problems, however, there can be successes where lung function and quality of life can markedly improve, and outcomes are improving with time.
A recent study proposed the idea that damage to our DNA at the telomeres contributes to lung ageing, continuing damage and worsening COPD symptoms. Also that cigarette smoke increases and encourages such damage to the telomeres.
Telomeres are specialized structures at the ends of chromosomes within our DNA that protect it from deterioration and prevent fusing with nearby chromosomes. COPD has long been associated with accelerated lung aging and abnormal cell division. Telomeres shorten with each cell division, therefore the more the cell divides the less protection the DNA strands have.
In a newer study they investigated telomere dysfunction in lung airway cells from patients with COPD using lung aging mouse models exposed to cigarette smoke. They found that there was no difference in telomere length between control patients and COPD patients, which contradicts the previous study although they say that this could be due to a small sample size and will need to be repeated with a larger amount of samples.
With age they observed an increase in telomere dysfunction and that this was also increased with exposure to cigarette smoke. They found that the cigarette smoke accelerated the telomere dysfunction by increasing levels of reactive oxygen species (free radicals) and aided in the secretion of inflammatory cytokines.
As a result, the team highlighted that their findings suggest that telomeres are particularly susceptible to damage triggered by cigarette smoke, and that this may lead to an accelerated decline of lung function in both aging and COPD patients. So whether you have COPD or have normal respiratory health, exposure to cigarette smoke will trigger telomere dysfunction, affecting the DNA within the cells and causing damage to the cells in your lungs. And thereby reducing respiratory function in the elderly and worsening symptoms in COPD patients. This study suggests that the elderly and patients suffering from respiratory illness should not only stop smoking but also not be around other smokers in order to preserve their respiratory health. References: http://copdnewstoday.com
Researchers have found that the key to an inherited genetic deficiency that causes COPD could originate from the Vikings. Archaeological excavations of Viking pits in Denmark have shown that the Vikings used to suffer from massive work infestations. For populations living in these areas their genes developed in such a way as to protect their vital organs from diseases caused by the worms and this same trait can now lead to lung disease in our time.
COPD affects nearly 5% of the global population and the only inherited risk factor is alpha-1-antitrypsin (A1AT), which is compounded if the individual smokes.
A1AT protects the lungs and other organs like the liver from enzymes called proteases. These enzymes are produced by our immune system but also by parasitic worms. If you are deficient in A1AT then these enzymes are then allowed to break down lung tissue, which can lead to COPD.
A1AT deficiency means that you have an altered form or deviant of A1AT and are very common in Scandinavia, where they evolved in Viking populations more than two thousand years ago.
Professor Richard Pleass said: “Vikings would have eaten contaminated food and parasites would have migrated to various organs, including lungs and liver, where the proteases they released would cause disease.”
The deviant forms of A1AT bind to an antibody called Immunoglobulin E (IgE) that prevents the antibody molecule from being broken down by the proteases from the worms. Therefore Viking populations became protected by the deviant forms of A1AT which protected them for the worms.
“Thus these deviant forms of A1AT would have protected Viking populations, who neither smoked tobacco nor lived long lives, from worms.” Continued Professor Pleass, “it is only in the last century that modern medicine has allowed human populations to be treated for disease causing worms. Consequently these deviant forms of A1AT, that once protected people from parasites, are now at liberty to cause emphysema and COPD.”
It has often been wondered how and why A1AT deficiency has occurred and now it seems there are some pieces to the puzzle found among the Vikings. Therefore if you have Viking descendants it could be more possible that you have inherited the trait and have a higher risk of developing COPD. Now that we live longer and some of us smoke this now means that something which developed over generations to protect people from death by worm is now the same factor that causes COPD.
A machine has been developed that can recondition a set of lungs outside of the body in order for them to improve and make them healthier ready for transplant into a recipient. The machine is known as ‘the box’ and it ventilates lungs after their removal from the donor. It also infuses them with a mix of fluid, drugs and steroids which allows the lungs to dry out and get them into a better shape before being transplanted.
“It allows the lungs to stay alive… and allows us as providers to assess the function of the organ in a unique, well-controlled environment,” said Dr. Varun Puri.
The machine is made up of a ventilator to help simulate breathing and a bypass machine to perfuse the lungs with drugs and fluid In order to improve their function and generally helps to mimic the body with one major helpful difference. The lungs normally undergo a lot of stress in the body constantly exchanging gases with every breath, however in this box that stress factor is removed and gives the lungs a chance to heal.
This machine will hopefully help to improve lung transplant statistics and aid in improving the long-term survival rates of those that suffer from respiratory diseases like COPD. Currently fewer than 20% of donor lungs are considered suitable for transplant and 25% of candidates dies whilst waiting for a transplant. Even the survival rate post-transplant is 50% to survive 5 years. This device could aid in increasing the donor pool as the machine can take lungs that were previously deemed as unsuitable and give them a chance to heal and improve, making them then viable lungs for transplantation. With more lungs available for transplant fewer patients will die waiting and if the lungs are healthier when transplanted then hopefully the survival rates for lung transplants will also improve with further research.
“I am sure in the future we will be able to do things like gene therapy to the lungs in a controlled environment or utilizing specific anti-inflammatory agents to prevent short term and long term rejection of organs.” said Dr. Varun Puri.
Michele Coleman, 63, credits ‘the box’ with saving her life. A former smoker, she was diagnosed with chronic obstructive pulmonary disease and doctors asked if she would participate in a clinical trial.
“You don’t want to, but you kind of lose hope because when you are sick like that you know how fast you are going downhill,” Coleman said. “It’s scary, but anything that they could give me was going to be better than I had, and actually I figured I wouldn’t make it to the end of the year,” she said. The transplant for her was a huge success and she is still doing well with her ‘reconditioned’ lungs.
There is also hope of being able to do the same with other organs to improve transplantation survival rates across the board. Hopefully ‘the box’ brings a little light to those with severe respiratory diseases where their lungs are failing them.
References: http://www.foxnews.com and http://www.trunews.com