In a recent review on exercise and COPD published in the Polish Archives of Internal Medicine, entitled “They can’t bury you while you’re still moving: a review of the European Respiratory Society statement on physical activity in COPD,” it was shown that there are challenges in identifying physical activity in COPD patients, benefits of exercise in improving the physical activity in COPD patients, and effects of COPD exacerbation on physical capabilities in those suffering from COPD. The review underscores the need for focusing on physical exercise as a means of managing patient outcomes for this with COPD.
The review outlined the challenges of determining physical parameters in exercise. Devices such as accelerometers and pedometers can be used to determine the amount of physical activity a COPD patient engages in, but these are not very accurate measurements of physical activity. What researchers have determined, however, is that by using these devices, COPD patients tend to partake in much less physical activity than those without COPD. Whether it is because COPD patients cannot exercise as much as those with COPD or if it is because a lack of physical exercise contributes to COPD symptoms is not yet clear.
The review also points to findings that patients with COPD tend to drastically reduce their level of exercise during exacerbations of COPD and that this reduction in exercise level usually lasts for up to two months following the exacerbation. Some of this prolonged lack of activity may be related to comorbidities, such as having weakness of the leg muscles from having to rest for so long or by having heart problems that interfere with exercise, especially when not exercising during an exacerbation. COPD patients also suffer from other comorbidities in addition to their COPD, which further confuses the picture in determining why COPD patients do not exercise.
COPD patients who don’t exercise tend to die sooner and from respiratory causes when compared to those who do not have COPD. Conversely, those who exercise tend to do better than those who don’t exercise, experience better patient outcomes, and an improved quality of life. In the review, the difference between increased physical activity and “exercise” was established. Exercise involves getting the heart rate up for about 30 minutes per day five days a week, whereas physical activity is just getting up and moving around more. Exercise allows a person to do more physical activity, but the converse is not true, making exercise critically important.
The European review looked at all areas of exercise as it relates to COPD patients, finding that, despite difficulties in identifying the degree of exercise a COPD patient undergoes, the relationship between physical activity and physical health in COPD patients is a positive one and more exercise means a better COPD outcome.
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