1.Breathing exercise
(1) Lip retraction and exhalation.
The method is the patient shut up through the nose inhalation, and then shrink lips (whistle-like mouth shape) slowly exhale for 4 to 6 seconds, the degree of its shrink lips size by the patient’s own choice to adjust, do not be too large or too small, to exhale airflow can make 15 cm ~ 20 cm from the lips of the candle flame tilt and not extinguished as appropriate. Exhalation may or may not be accompanied by abdominal muscle contraction. Breathing due to activity caused by the difficult use of lip contraction exhalation can quickly relieve breathing difficulties and relieve their tension, panic.
(2) Breathing in head down or forward position.
Many patients will unconsciously adopt head-down or forward leaning position to relieve dyspnea when their condition has progressed to a certain level. It is more effective when applied in combination with lip retraction and expiration. In the head-down position, the patient is placed on his back on a reclined bed or flat bed with the foot of the bed raised. In the forward tilt position, the patient is seated with the torso tilted forward 20° to 45°. To maintain balance, the patient can support himself on his knees or on a table with his hands or elbows. The forward tilt position can also be used for exercise when standing or walking.
(3) Slow and deep breathing.
It is not easy for patients to do and can easily lead to respiratory muscle fatigue. However, this can be used to correct rapid breathing when the patient is tense or anxious.
(4) Abdominal breathing.
Also known as diaphragmatic breathing exercise, it can increase the contraction capacity and contraction efficiency of the diaphragm, increase the tidal volume and relieve dyspnea. Combined with lip retraction and exhalation, forward leaning position, etc., it can make the greatest improvement in dyspnea. This exercise should be demonstrated and instructed by medical personnel at the beginning, and trained twice a day for 10-15 minutes each time, increasing the number and duration of exercises after mastering the method, and striving to become an unconscious habitual form of breathing for patients.
(5) Bone muscle relaxation exercise.
Muscle relaxation exercise, that is, maximum relaxation or muscle first in the premise of maximum contraction, and then maximum relaxation. Specific method: The patient can comfortably lie flat on the bed or sit on a chair, or can also take the standing position, so that all the muscles are as relaxed as possible, slowly inhale and exhale with a narrow mouth shape. When sitting, tilt the trunk forward about 20°, bend both elbows 90°, relax the shoulders, make circular movements of both upper arms and shoulder joints back and forth, the movements should be gentle and moderate, and rotate the head slowly from side to side. Change to standing position, feet apart, shoulder-width apart, arms naturally dropping and relaxed, then slowly swinging back and forth, torso slowly rotating from side to side. Each of the above actions should be done 10-20 times. Take the prone position and exercise the following parts.
① foot: first the foot and toe force Flex for 5 seconds, and then relax, alternating between the left and right foot.
②Lower extremities: lift the lower extremities off the bed, keep the lower extremities on that side tense for 5 seconds, then put them flat on the bed and relax the muscles, alternating between the left and right lower extremities.
③Pelvis: Abdominal and hip muscles are forcefully contracted for 5 seconds, and then relaxed.
④Abdomen: slowly and deeply inhale and then hold the breath, so that the chest and back muscles remain tense for 3 seconds, and then relax, and contract the lips and exhale slowly, inhale through the nose and exhale from the mouth, breathing gas should be slow and even.
⑤ Upper limbs: stretch the upper limbs forward and make a fist, keep the upper limb muscles tense for 5 seconds, then relax flat on the bed.
⑥Shoulders: shrug both shoulders for 3 seconds, then relax;
⑦Neck: jaw close to the chest wall, keep the neck muscles tense for 3 seconds, then lightly swing the head from side to side to relax the neck muscles.
⑧Face: close your eyes tightly, frown, clench your teeth, and then relax.
2.Movement exercise methods
(1) Walking exercise.
The method is simple and can be chosen. Walking speed can be determined according to the patient’s heart function, slow 60-80 steps per minute, medium speed 80-100 steps per minute, fast 100-120 steps per minute. Walking can be combined with upper limb chest expansion type of auxiliary action to increase the effect. At present, the 12-minute walking test is mostly used, i.e., the longest distance that the subject can walk on flat ground by doing maximum effort in 12 minutes.
The 12-minute walking distance increases with the increase in whole-body activity. The intensity of the exercise was determined according to the patient’s subjective degree of dyspnea and palpitations, combined with objective indicators such as respiratory rate, heart rate, and pulmonary ventilation. The assessment of the efficacy is mainly based on the 12-minute walking distance and the changes in respiration and heart rate before and after exercise.
(2) Stair climbing.
Stair climbing exercise with respiratory training is also a form of exercise, first inhale through the nose, then narrow the lips of the mouth and exhale, and breathe once for every 2 steps of the stairs.
(3) riding tricycles.
Riding a lightweight tricycle, and carry an oxygen bottle to absorb oxygen; can maintain a comfortable chest forward position, which is conducive to breathing and exercise muscle strength.
(4) Swimming exercise.
For patients with mild disease and good health, swimming exercise is advocated in summer, which can not only increase the ability to withstand cold, but also enhance the strength of the whole body and improve respiratory function.
3.Health care breathing exercises
(1) nose massage.
① use the index finger of both hands to massage the “Ying Xiang” points on both sides of the nose and the bridge of the nose about 10 to 20 times.
② with the right hand palm massage the tip of the nose “polygon” point, the direction of the team right to left, about 10 ~ 20 times, and then from the opposite direction massage 10 ~ 20 times.
(2) chest expansion.
① left foot out half a step to the left (the same width as the two shoulders). Raise both arms upward, while
Inhale with force;
(2) arms back to the chest, while exhaling forcefully, the left foot back to the original place still set up a correct posture.
③ first left and then right, left and right alternately repeat the above actions; even do 4 times (according to their physical strength increase or decrease.
(3) press the abdomen.
① left foot half a step to the left (the same width as the shoulders). Both arms raised sideways. Palms up, head slightly back, while inhaling hard;
② two arms quickly retracted according to the abdomen (with the right hand to cover the left hand), the upper body slightly bent forward, while exhaling forcefully;
③ left foot back, two hands down is still set up positive posture;
④ first left and then right, left and right alternately repeat the above actions, and do it four times.
(4) clenched fist.
① two hands clenched fist flexed arm in front of the chest (fist heart inward), both arms swing upward and backward at the same time for 3 times in a row, with the two arms swinging at the same time hard inhalation;
② according to the above action, the two arms to the opposite direction (i.e., down the front) swing, continuous flying times, while exhaling forcefully;
③ two arms down to resume the upright position;
④ in accordance with the above sequence and then do 3 times.
(5) squat.
① left foot half a step to the left (the same width as the shoulders), two arms up from the front to the side, while breathing in;
② two arms slowly down from the front (palm down) and squat, while exhaling hard;
③ Xu Xu stand up, the left foot back still set up a positive posture;
④ in accordance with the above sequence and then do 3 times, first left and then right alternately.
4.Taijiquan
Taijiquan can be used for the rehabilitation of patients with chronic bronchitis and emphysema. Through exercise patients can breathe smoothly and evenly, symptoms improve, lung function improves. The selected exercises are based on the inverted roll humerus and cloud hand.
(1) left and right inverted humerus: the right hand down through the abdomen before the back above the arc, flat lift and right ear flush, arm slightly flexed, the left hand followed by fist up, the left toe pointing to the ground. Both eyes with the right turn body flat look right in front. When the right arm is flexed, the right hand is pushed forward from the side of the right ear. At the same time, the left leg is lifted to the left back, the weight shifts to the left leg, and the right toe points to the ground in a false step. The left hand follows the push out of the right hand to the left side of the rib cage. Both eyes are flat in front.
(2) Cloud Hand: The body turns right, the weight shifts to the right leg, the left toes buckle, the left hand arcs up to the right through the front of the abdomen to the front of the right shoulder with the palm facing backward, the right hand changes into a palm with the palm facing the right front. The eyes take into account the right hand, the center of gravity moves to the left leg, the left hand on the top with the rotation of the waist from the right front to the left front, palm from backward gradually Zhezhi turned to the left front, the right hand from the lower right through the abdomen before the left arc to the front of the left shoulder, palm backward.
At the same time, the right foot is collected one step to the left horizontally, and the two feet stand parallel to each other, 10 cm to 20 cm apart. The eyes take into account the left hand. The center of gravity moves to the right leg, the right hand on the rotation with the waist from the left front to the right front, palm from backward gradually turned to the right front; left hand from the left under the abdomen in front of the right up arc to the right shoulder front, palm backward. At the same time, the left foot crosses one step to the left. The eyes take into account the right hand.