Chronic obstructive pulmonary disease, medically referred to as COPD, has become a growing concern as a chronic and multifaceted disease. It is reported that about 210 million people worldwide suffer from COPD, and more than 3 million people died from the disease in 2005, equivalent to 5% of global deaths that year. It currently ranks as the 4th leading cause of death worldwide. It has become an important social and public health problem. Therefore, it is very important to provide long-term and standardized education and management of COPD patients for prevention and treatment. Achieving prevention and control measures from hospital to society and family, from passive to proactive, is directly related to the goals of reducing acute exacerbations, maintaining disease stability, improving survival quality and reducing medical burden on patients.
For patients with obstructive emphysema, bronchial asthma and chronic bronchial, respiratory training is a necessary medical step for rehabilitation, which, together with long-term oxygen therapy, has an important rehabilitation value.
When a person breathes calmly, about 500 ml of air is inhaled each time, except for 140 ml that stays in the invalid cavity, the effective ventilation of alveoli is 360 ml, and 1/3 of alveolar gas can be replaced with each breath. In terms of the efficiency of gas exchange, deep and slow breathing is more effective than rapid and fast breathing within a certain range. Respiratory training for patients with chronic obstructive pulmonary disease can improve the contraction and endurance of respiratory muscles, prevent and stop respiratory muscle fatigue, especially abdominal breathing gymnastics, which can enhance and exercise the activities of diaphragm, abdominal muscles and lower chest muscles, improve their contraction function, prompt the residual air in the lungs to exhale, eliminate the impurities accumulated in the lungs, increase the lung capacity and fully supply the oxygen needed for physical activities. Therefore, the method of breathing exercise, especially abdominal breathing training with the contraction breathing method can change the past chest breathing type, increase the breathing depth and breathing volume, improve breathing efficiency, as long as the training persistently, you must achieve good results.
Breathing training notes.
1, breathing gymnastics must be through the nasal inhalation and oral exhalation. Inhalation through the nasal cavity can make the inhaled gas can be warmed, moistened and nasal hair filtration, reduce the inhalation of gas irritation, to avoid the opportunity to cause bronchospasm. Exhalation through the mouth can change the breathing resistance.
2, to do deep slow breathing, because deep slow breathing can reduce the invalid lung volume, increase the effective lung volume during calm breathing, improve respiratory efficiency.
3, to use the mouth contraction breathing method, mouth lip contraction like whistling, slow exhalation, this breathing method can delay the expiratory airflow down, improve the airway pressure, slow down the airway power compression, so that the isobaric pressure point moved to the central airway, to prevent the early closure of the airway and cause a large amount of gas retention in the lungs, significantly improve the ventilation and ventilation function.
4, do abdominal breathing to exhale first and then inhale, breathing gently contract the abdomen, so that the gas from the lips of the mouth slowly blow out, exhalation should be gentle, not overly hard, exhalation time than inhalation time is longer, starting 1:2, 1:3, 1:4, gradually extended, exhalation is twice as long as inhalation. Inhale when the diaphragm position down to the abdominal cavity to make pressure, when the abdomen bulge.
5, practice should choose a place with fresh air, both indoors and outdoors, but pay attention to warmth, avoid direct blowing wind, especially cold wind. Do not force exercise in an unsuitable environment, there should be physical discomfort to stop exercise, timely rest, avoid the impact of harmful factors, to practice exercise after the chest and abdomen relief, the spirit of happiness as degree.
6, treat chronic diseases to be optimistic, maintain a good calm state of mind. When doing exercises to be loose body intention quiet, focus on the mind, pay attention to breathing.
7, breathing exercises can be appropriate choice of action, sitting or standing can be, strict grasp of the principle of gradual progress, the action gradually increased, the number of times from less to more, short to long, not fatigue after exercise, not forced, the body comfortable, natural breathing is appropriate.
The first part of the preparatory posture
1, head and neck relaxation: two feet open, hands crossed waist, head and neck to the left and right slowly turn, the upper body and waist do not turn, the idea of a “loose” word, from the top of the head – eyes – face – neck. Relax 10-20 times one by one.
2.Shoulder and back relaxation: both feet open, hands crossed, torso slightly forward, elbows bent 90 degrees shoulder, chest and back relaxation, both upper arms and shoulder joints from front to back repeated from back to front alternately do circular motion, the action should be slow and gentle. 10-20 times.
3, swing arm relaxation: two feet open, two arms relaxed natural hanging, upper limbs relaxed natural hanging and then slowly swing, the amplitude from small to large and then slowly reduce, 10-20 times.
4, thoracic lumbar sacral relaxation: two feet open slightly wider than shoulder width, both hands first rub the palm of the hand, the back of the hand, and then fork the waist thumb in front, both hands force from the waist – sacral – hip down massage. Waist from the left to the back, right, front to do pirouette action. And then changed to from the right to the back left front gyration, both legs always straight, knees do not bend, with hands to waist not too hard, the circle of gyration to gradually increase, chest waist hip relaxation.
5, the whole body relaxation: posture static, both arms naturally down, eyes lightly closed, mouth naturally closed, the tip of the tongue against the palate, breathing should be adjusted evenly and smoothly. Inhale to meditate on the word quiet, inhale to meditate on the word loose, while consciously relaxing the whole body, time until the whole body relaxation.
The second part of breathing gymnastics
1.Swinging arm movement: two feet open slightly wider than shoulder width, two natural arms down. Both arms swing back and forth – both arms swing forward – both arms swing back and forth at the same time – both arms swing inside and outside the front and back cross. First upright position swing, skilled then forward leaning position swing.
2.Circle movement of cantilevered arms: two feet open slightly wider than shoulder width, two arms naturally hanging down. Two arms crossed 360 degrees, the diameter of the circle since the small gradually increase.
3, turn the neck movement: two feet open hands forked thumbs forward. Neck relaxation eyes on the target, from the right hip – right shoulder – left hip – left shoulder – right hip slowly turn repeatedly several times.
4, shoulder movement: two feet open slightly wider than the shoulders, the two arms hang naturally, head slightly back. Both shoulder blades close inward, while inhaling deeply, hold your breath for a few seconds, relax while exhaling slowly.
5, arms open and close movement: two feet open, two palms across the front, palms outward, fingers slightly curved, elbows slanted outward. After the first step: the two palms simultaneously separated to the left and right, palms gradually clenched into a virtual fist, the two forearms gradually vertical to the ground, chest outward as far as possible. The second step: both arms are still bent at the elbows, the two fists are released into palms, and the chest and back are included in the restoration. Inhale when separating, exhale when restoring; pull away when the two arms are stretched out parallel, should not sag, the shoulders and palms and fingers slightly harder. The action should be slow and gradually pull back, so that the chest out, shoulder blades clenched.
6, the hands of the tripod: two feet open and shoulder width, both arms bent at the elbow, hands virtual fist flat in front of the chest. After the first step: two fists gradually loosen the palm upward, two arms softly upward straight lift, eyes follow the two palms upward and look upward. The second step: both hands gradually descend, gradually clench into an imaginary fist as they descend, and return to the preparatory position with a slight force on the fingers. Inhale when lifting up, exhale when descending.
7, bending and arm movement: two feet open, two hands crossed in front of the chest. After the first step: legs straight, the body bent forward. Two arms straight, two hands crossed in front of the chest, eyes on the two hands. Straight waist two hands crossed
Fork up to the top of the head like climbing upward, try to make the tendons stretch, the body straight. The second step: the two arms apart to the sides, resume the preparatory posture, waist bending exhale straight waist when inhaling.
8, side bending movement: two feet open and shoulder width, hands crossed waist. Lateral bending of the waist left and right, the right side of the bend when the right arm to the bottom, the left side of the bend when the left arm to the bottom, exhale when the side bend, straight waist when inhale.
9, pressure belly exhale: sitting position with two feet open, the same width as the shoulders. Deep inhalation when the head slightly upward, both hands placed in front of the abdomen, when the end of exhalation hands press the abdomen to help exhale.
10, folding body breathing: sitting, standing position can be, arms flat in front. Exhale when bending over, arms crossed behind the thighs, while the abdominal muscles contraction, inhalation straight waist arms back to the front planks, waist slightly backward abdominal muscles relaxed diaphragm down, abdominal augmentation.
The third part of the respiratory muscle exercise
1, lower rib breathing or lung segment breathing: sitting, standing position can be, hands easily placed on the lower ribs to assist deep breathing. In deep breathing start only one hand pressure assisted deep breathing, and then maintain a certain pressure resistance inhalation, the other side repeat the above exercise until the unilateral pressure can be fully controlled after the bilateral pressure. This method allows full expansion of the lung segments in the region, generally in the lateral, intercostal, apical and posterior base segments of the lung.
2, diaphragmatic breathing: sitting or standing position is possible, with both hands on the abdominal wall below the rib-diaphragm angle. To active diaphragmatic deep breathing, inhalation so that the diaphragm moves to focus attention on abdominal movements, abdominal relaxation bulge, at this time placed below the angle of the rib diaphragm hands gently pressurized, breathing hard, while the abdominal muscle tension diaphragm rise, hands to assist in giving the abdomen to pressure, so that gas as far as possible to exhale.
The fourth part of the exercise exercise
1, walking exercise, should choose to feel comfortable place to carry out, when there is shortness of breath should stop to rest.
2, climbing step training, start two steps, two minutes each time every day – ten steps for ten minutes.
Exercise should be mainly to adapt to the premise that no gas tightness, do not force forced exercise. Otherwise, it will aggravate the damage to lung function, which is not beneficial. If the tightness of the air is aggravated after the activity, it is better not to exercise.
The fifth part of the phlegm removal method
Lip contraction breathing: can improve the narrowing of the trachea and reduce shortness of breath.
Way: Before practice, pay attention to relax the shoulders; move slowly and exhale the air as much as possible.
1.Relax the muscles of neck, shoulders and back, inhale slowly through the nose, mentally recite: 1,2.
2.Close your lips until there is a gap left, like whistling, exhale slowly and carefully through your lips, silently chanting: 1,2,3,4.
Abdominal breathing: to improve the frequency of breathing, and to relieve shortness of breath, breathing difficulties and other symptoms.
Before practicing, choose a comfortable position, put your hands on your abdomen and try to relax your tense body and mood.
1.Inhale: the abdomen rises slightly, silently recite: 1,2.
2, exhale: abdomen slightly retracted, silently recite: 1,2,3,4.
Sputum expulsion method: the method is call-cough-compression breathing method, function: keep the airway open and expel the sputum in the lungs. This method needs to be combined with lip contraction breathing or abdominal breathing, and the exercise is repeated 2-4 times a day, and spit out when you feel phlegm.