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PULMONARY REHABILITATION

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PULMONARY REHABILITATION TRI DAMIATI .P, Dr.Sp RM PHYSICAL MEDICINE AND REHABILITATION FKUP/RSHS 2011 Abdominal Muscles Exercises Upper Extremity Exercises ... – PowerPoint PPT presentation

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Title: PULMONARY REHABILITATION


1
PULMONARY REHABILITATION
  • TRI DAMIATI .P, Dr.Sp RM
  • PHYSICAL MEDICINE AND REHABILITATION
  • FKUP/RSHS
  • 2011

2
DEFINITION
  • COMPREHENSIVE TEAM APPROACH THAT PROVIDE
    PATIENTS WITH THE ABILITY TO ADOPT TO THEIR
    CHRONIC LUNG DISEASE, IT INCLUDES MEDICAL
    MANAGEMENT, TRAINING AND COPING SKILLS AND
    EXERCISE RECONDITIONING
  • AGUSTA ALBA CONCEPT IN PULMONARY
    REHABILITATION, BRADDOM

3
DEFINITION OF RESPIRATION
  • PROCESS OF MOVING OXYGEN FROM THE AIR TO ALVEOLI
    OF THE LUNGS BY A MASS MOVEMENT OF AIR AND
    REMOVING CARBON DIOXYDE FROM ALVEOLI BY THE SAME
    MOVEMENT
  • THE CIRCULATORY SYSTEM PROVIDE THE TRANSPORT OF
    OXYGEN BETWEEN LUNG AND THE TISSUE
  • H.FREDERIC HELMHOZ,JR, HENRY H.STONNINGTON

  • PULMONARY
    REHABILITATION, KRUSEN

4
PHYSIOLOGICAL BASIC OF DISORDERS OF RESPIRATION
  1. INADEQUATE TRANSPORT OF OXYGEN IN AND CARBON
    DIOXYDE OUT OF THE LUNG
  2. RETENTION OF CARBON DIOXYDE
  3. LACK OF OXYGEN

5
THE CAUSE OF THE RESPIRATORY DISORDERS
  1. MUSCLE WEAKNESS OR INEFFICIENCY OR INCREASING OF
    ELASTIC COMPONEN
  2. INCREASE RESISTANCE TO AIRFLOW THROUGH THE
    TRACHEOBRONCHIAL TREE

6
  • ELASTIC COMPONENTS ARE
  • LUNGS
  • THORACIC CAGE
  • DIAPHRAGM
  • ABDOMINAL COMPLEX
  • ACCESSORY MUSCLES

7
THE RESPIRATORY DISORDERS ARE CLASSIFIED AS
  • RESTRICTIVE DISORDER
  • OBSTRUCTIVE DISORDER

8
RESTRICTIVE DISORDERS ARE CHARACTERIZED BY
  1. AN INCREASE IN ENERGY REQUIREMENT TO OVERCOME
    ELASTIC RECOIL OF LUNG OR CHEST STRUCTURES AT ANY
    GIVEN VENTILATION
  2. REDUCED VITAL CAPACITY

9
OBSTRUCTIVE DISORDER CHARACTERIZED BY
  1. RESISTANCE TO AIRFLOW ---? AIRFLOW STOP BEFORE
    EMPTYING IS COMPLETE ---? AIR TRAPPING
  2. FIXATION THE CHEST IN A POSITION LARGER THAN THE
    NORMAL END-EXPIRATION LEVEL
  3. INCREASE IN THE FUNCTIONAL RESIDUAL CAPACITY AND
    RESIDUAL VOLUME

10
OBSTRUCTIVE DISORDER CHARACTERIZED BY
  • 4. FLATTENING OF THE DIAPHRAGM
  • 5. LESSEN THE USE FULLNESS OF THIS MUSCLE IN
    INSPIRATION

11
PULMONARY REHABILITATION GOALS
  • IMPROVEMENT IN CARDIOPULMONARY FUNCTION
  • PREVENTION AND TREATMENT OF COMPLICATION
  • RECOGNITION AND TREATMENT OF STRESS AND
    DEPRESSION, WHICH CAN INTERFERE WITH COPING
    MECHANISM AND INDEPENDANCE

12
PULMONARY REHABILITATION GOALS
  • 4. FACILITATION OF COPING MECHANISM TO
    OVERCOME ANY SENSE OF LOSS, LOSS OF CONTROL OF
    PERSONAL AND SOCIAL RELATIONSHIP, SELF ESTEEM, OR
    SENSE OF SELF WORTH
  • 5. PROMOTION OF INCREASING PATIENT
    RESPONSIBILITY FOR HIS OR HER OWN CARE AND
    WELL-BEING

13
  • 6. DECREASE NUMBER OF EXACERBATION , EMERGENCY
    ROOM VISIT AND HOSPITALIZATION
  • 7. TO UNDERSTANDING THE DISEASE SO THAT PATIENTS
    AND FAMILLY CAN CONFRONT IT REALISTICALLY

14
PULMONARY REHABILITATION GOALS
  • 8. RETURN TO WORK AND/OR A MORE ACTIVE ,
    PRODUCTIVE, AND EMOTIONALLY SATISFYING LIFE FOR
    THE PATIENT AND HIS FAMILY

15
COMPONENT OF PULMONARY REHABILITATION FOR
OBSTRUCTIVE DISORDERS
  • MEDICATION (MOST OF THEM ARE DONE BY
    PULMONOLOGIST)
  • EDUCATION
  • CHEST PHYSICAL THERAPY
  • UPPER EXTREMITY EXERCISES
  • RECONDITIONING
  • PSYCHOSOCIAL SUPPORT

16
COMPONENT OF PULMONARY REHABILITATION FOR
OBSTRUCTIVE DISORDERS
  • 2. EDUCATION
  • - THE MOST IMPORTANT IS SMOKING CESSATION
  • - CHANGING IN LIFESTYLE TO ADAPT THE
  • DISEASE
  • - UNDERSTAND THE DISEASE
  • - UNDERSTAND THE GOALS AND THE BENEFIT OF
  • THE REHABILITATION PROGRAM

17
COMPONENT OF PULMONARY REHABILITATION FOR
OBSTRUCTIVE DISORDERS
  • 3. CHEST PHYSICAL THERAPY
  • A. APPLICATION OF PHYSICAL METHOD TO THE
    RESPIRATORY CARE OF PATIENS WITH PULMONARY
    DISEASE
  • B. THE COMPONENTS ARE
  • 1. CONTROL BREATHING
  • - RELAX POSITION
  • - BREATHING EXERCISE
  • PURSEDLIPS BREATHING
  • SLOW DEEP BREATHING
  • DIAPHRAGMATIC BREATHING
  • SEGMENTAL BREATHING

18
  • The Aim of Control Breathing
  • A. HELP THE PATIENTS RELIEVE AND CON- TROL
    BREATHLESSNESS
  • B. IMPROVE VENTILATORY PATTERN
  • C. PREVENT DYNAMIC AIRWAY COMPRESSION
  • D. IMPROVE GAS EXCHANGE

19
  • The aim of Pursed-lips and Diaphragmatic
    Breathing
  • A. SLOW EXPIRATORY PHASE
  • B. MAINTAIN THE AIRWAY PRESSURE
  • C. DECREASE THE RR
  • D. INCREASE TIDAL VOL

20
COMPONENT OF PULMONARY REHABILITATION FOR
OBSTRUCTIVE DISORDERS
  • 2. CLEARENCE OF SECRETION
  • - POSTURAL DRAINAGE
  • - CHEST PERCUSION AND VIBRATION
  • - CONTROL COUGHING
  • 3. TRUNK FLEXIBILITY
  • - NECK
  • - COMPONENT SHOULDER GIRDLE
  • - TRUNK

21
COMPONENT OF PULMONARY REHABILITATION FOR
OBSTRUCTIVE DISORDERS
  • 4. UPPER EXTRIMITY EXERCISES
  • A. STRENGTHENING OF THE UPPER BACK MUSCLES
  • B. STRENGTHENING OF THE UPPER EXTRIMITY MUSCLES
  • C. RANGE OF MOTION EXERCISE OF THE
    SHOULDER-GIRDLE COMPLEX

22
COMPONENT OF PULMONARY REHABILITATION FOR
OBSTRUCTIVE DISORDERS
  • 5. RECONDITIONING
  • AEROBIC EXERCISES
  • INTENSITY DEPENDS ON THE EXERCISE TESTING
  • DURATION 20 30 MINUTES
  • FREQUENCY 3 4 TIMES AWEEK
  • WALKING, JOGGING, CYCLING, ERGOCYCLE,TREADMEAL,SW
    IMMING, ETC

23
  • 6. PSYCHOSOCIAL SUPPORT
  • IS PROVIDED BY WARM AND ENTHUSIASTIC STAFF WHO
    CAN COMMUNICATE EFFECTIVELY WITH PATIENTS AND
    DEVOTE THE TIME AND EFFORT NECESSARY TO
    UNDERSTAND AND MOTIVATED THEM

24
  • FAMILY MEMBER SHOULD ALSO BE INCLUDE SO THAT
    THEY CAN UNDERSTAND THE DISEASE AND HELP THE
    PATIENT TO COPE

25
  • PATIENT SELECTION
  • SYMPTOMATIC LUNG DISEASE
  • STABLE ON STANDARD THERAPY
  • FUNCTION LIMITATION BECAUSE OF DISEASE
  • MOTIVATED TO BE ACTIVELY INVOLVED IN AND TAKE
    RESPONSIBILITY FOR OWN HEALTH CARE

26
  1. NO OTHER INTERFERING ON UNSTABLE MEDICAL
    CONDITION
  2. NO ARBITRARY LUNG FUNCTION OR AGE CRITERIA

27
WHEN ARE THE PATIENTS REFERED TO THE PULMONARY
REHABILITATION?
  • MOSTLY
  • PATIENTS WITH DIFFICULTY IN CLEARING SECRETION
  • PATIENTS WITH DYSPNEA AND HYPOXIC PANNIC
  • PATIENT WITH PULMONARY CHRONIC DISEASE
  • PRE AND POST THORACIC SURGERY

28
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29
DONT PANIC CONTROL YOUR
BREATHING
30
DONT PANIC RELAX YOURSELF
31
CONTROLED BREATHING ACTIVITY
32
ACCESSORIES MUSCLES RELAXATION
  1. Neck muscles
  2. Shoulder muscles
  3. Chest flexibility

33
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34
Abdominal Muscles Exercises
35
Upper Extremity Exercises
36
Postural Drainage
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