People today are often unable to fully stretch their chest cavity when breathing due to poor posture. Patients with pulmonary obstruction, asthma, pulmonary fibrosis and other lung diseases experience shortness of breath, affecting their quality of life.
But lung rehabilitation exercises can strengthen the respiratory muscle groups, improve lung function, and relieve lung disease symptoms.
Diseases that Weaken Lung Function
There are two common types of lung diseases that can weaken lung function.
Obstructive pulmonary disease: The patient is unable to expel all the air from his or her lungs. Examples include lung injury or narrowing of the airways due to chronic obstructive pulmonary disease (COPD), asthma, or bronchiectasis.
Restrictive lung disease: There is a decrease in the total volume of air that the lungs are able to hold. For example, pulmonary fibrosis, interstitial lung disease, scoliosis, and obesity can result in stiffness of the lungs, tightness of the chest cavity, and weakness of the respiratory muscles.
The common symptoms of these two groups of patients are strained breathing and shortness of breath. Since whenever the patients move they wheeze, they try to avoid moving even more. This causes a vicious cycle, and their physical performance slowly declines.
In fact, exercise is the best rehabilitation treatment for lung disease. Lung rehabilitation exercises can improve the endurance and strength of the respiratory muscles and surrounding muscles, which in turn can enhance lung function and improve symptoms such as shortness of breath.
“For instance, for patients with pulmonary fibrosis, if their lung function is only three-fourths, pulmonary rehabilitation can improve the remaining function to four-fifths or five-sixths,” said Jen-Ting Lee, physiotherapist at the Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital in Taiwan.
3 Major Lung Rehabilitation Exercises to Improve Lung Function
- Aerobic exercise
Aerobic exercise is a rhythmic movement of the large muscles in the entire body, which can improve muscle oxygen intake and cardiorespiratory function.
Calisthenics, walking, jogging, and cycling are all exercises that we can do frequently. The exercise duration should be at least 20 to 40 minutes at a time.
However, some lung disease patients cannot do exercises for 20 minutes at a time; they may do exercises multiple times a day, for the total exercise time to be added up to 20 minutes. Visible results will show after they do exercises three to five times a week for eight to 12 weeks.
- Strength training
Strength training can improve muscle endurance and muscle strength, thus enhancing respiration intensity and exercise tolerance.
Respiratory muscles are mainly composed of diaphragm muscles. However, strengthening the diaphragm muscles alone is not enough. If you want to breathe more easily during exercise, you also need to train other accessory respiratory muscles.
“These accessory respiratory muscles are all located in the upper body. So for patients with lung diseases, it’s important to train the upper body muscles,” said Lee.
You can use dumbbells, elastic bands, and other tools to increase the weight during exercise. The starting strength of the training is 50 percent to 60 percent of the one repetition maximum (1RM). 1RM is the maximum weight that a person can bear at one time. For example, if a person can’t lift a dumbbell of 20 pounds a second time after lifting it once with all his strength, then 20 pounds is the person’s 1RM. You can increase the strength gradually as the training progresses.
- Breathing exercises
Chest breathing, abdominal breathing, localized breathing, and full breathing can all train the lungs.
Speaking of breathing exercises, people first think of abdominal breathing. Abdominal breathing is indeed the best way of gas exchange, but some people are not suitable to do this exercise, such as patients with obstructive lung disease. If you don’t feel comfortable with abdominal breathing, it is equally effective to use other breathing methods.
Put your hands on your abdomen, inhale slowly through your nose, and feel your abdomen bulge. After inhaling to the fullest, exhale slowly through your mouth.
“Many people do it wrong, because they push their abdominal muscles too hard,” Lee pointed out. When the body relaxes and allows the lungs to hold the air, the diaphragm will press down, and the stomach will naturally bulge.
People with obstructive lung disease are unable to exhale all the air in their lungs. They can use the “round lip exhalation” method, which is exhaling while puckering the lips. Round lip exhalation can increase positive pressure in the airways to help discharge the air.
Put your hands on your chest, slowly inhale through your nose, feeling the air filling your chest cavity, and your hands will slightly lift up along with your chest. After inhaling to the fullest, exhale slowly through your mouth.
When breathing, pay attention to the relaxation of your shoulder and neck muscles, especially that your shoulders should not be raised.
Place both hands on your ribs, and your fingers will slightly part due to rib cage expansion as you breathe in to the fullest. It is better to do this exercise while lying down, because your shoulders are relaxed when lying down, so it is not easy to use the shoulder strength. And the effect will be better.
The most important accessory respiratory muscles are the intercostal muscles. There are 12 ribs, with the first to sixth ribs being the upper ribs, and the seventh to twelfth ribs being the lower ribs.
When you breathe in to the fullest, the upper ribs expand forward to increase the space between the front and back of the chest cavity; and the lower ribs open upwards and to the sides to increase the left and right spaces of the chest cavity. As a result, the entire thorax opens up.
Localized breathing trains the intercostal muscles, allowing the thorax to expand more fully during breathing. This training is very important for patients with restrictive lung disease.
Full Breathing (i.e. Chest Breathing + Abdominal Breathing)
Place one hand on your chest and the other on your abdomen. When inhaling, your abdomen will bulge naturally, then deliberately inhale a little more, so that your chest will also bulge slightly. Then exhale. If you can’t expel all the air in your lungs, you can lower your head slightly to exhale all the air.
The way people normally breathe is full breathing. However, full breathing training is more intense than normal breathing.
When doing breathing exercises, you can combine them with thoracic exercises, to expand your chest cavity more fully.
The way to do this is to open your arms to the sides of your body when inhaling, and to fold your arms like holding a ball when exhaling. And then cross your arms in the lower front of your body, with your eyes looking towards your navel. Thoracic exercises are also beneficial for people with tight chests and poor breathing.