Scott Marlow, Pulmonary Rehabilitation Director at the Cleveland Clinic, demonstrates several breathing exercises for people with COPD that will help you get moving again.
Pulmonary rehab is a multidisciplinary approach to helping people with chronic lung disease optimize their functional capacity and their ability to do things. Many times, people with chronic lung disease get short of breath doing things, and it starts to limit their activity or their ability to do things. What we try to do is get to those patients quite early in the disease process, or if it's later, and help them improve their capacity to function.
What are the best breathing exercises for a patient to do who has chronic obstructive lung disease, COPD? One in particular is pursed lip breathing. We teach them, when you start to get short of breath, breathe in through your nose and out through pursed lips, like you're blowing out a candle. You want to extend that exhalation two or three times at least longer than you breathe in. The reason you do that is the air is trapped in your lungs, and we need to let you get rid of the bad trapped gas. When you purse your lips like this, you create a little back pressure in your lungs and it holds open the smaller airways to allow you to empty the bad trapped gas a little bit better.
What we try to do is teach them to use their diaphragm more. It's retraining your diaphragm to breathe again. Now this one's a little more difficult for COPD patients. We typically will have them rest a hand on your chest and one on your abdomen, and we'll have you lean back a little bit because this actually works better if you're reclined. What you do is have them relax and breathe in. A lot of patients with COPD will breathe in where their chest comes out and their stomach goes in, kind of the opposite, because over years, their diaphragm tends to flatten out a little bit. That flattening is less efficient.
Patients with chronic lung disease, some will have difficulty with secretions or coughing up things. They have a very productive cough. What we do also teach them are certain things that may help them to clear their lungs, certain coughing techniques. We have devices that help that, different things that you blow through to create a little back pressure to help clear those secretions.
One thing you do is we will have them take a breath in, hold their breath, let it out easy. Have a series of breaths like that to loosen up the mucus. Then we will have them do something called a huff cough, where they breathe in through their mouth or their nose, hold their mouth open and ... This is called a huff cough. You breathe in again, open up your mouth ... Then you take a deep breath in and three short coughs to try to clear your airway.
One of the great things about when they get into the program, they start at a certain level and advance to another level. Subsequently, when they come back for physician visits, we will always see them and say, "Okay. What are you doing?" We're trying to invest ourselves in helping them for the long term.