Chronic Obstructive Pulmonary Disease is progressive and irreversible respiratory condition characterized by persistent airflow limitation leading to dyspnea and reduced functional capacity.
Pulmonary rehabilitation along with different technqiues of breathing exercises reduces dyspnea and enhance functional capacity by improving ventilatory efficiency, respiratory muscle control and overall exercise tolerance in patients with COPD.
Age between 40-65 years
Both genders (male and female)
Grade 1-3 on mMRC scale of dyspnea
COPD mild stage according to global initiative for chronic obstructive lung -disease (GOLD) classification; Mild = FEV1 greater than or equal to 80% predicted
Patients having acute exerbation of COPD
Patients diagnosed with acute infection (pmeumonia, T.B)
Any orthopedic or neuromuscular condition that hinders participation in exercise training program
Patients unable to follow command and instructions
Parallel
Short term Pulmonary Rehabilitation
Other interventionPatients in this group will receive short term pulmonary rehabilitation along with pharmacological management. A total of 3 weeks protocol will be followed in which 2 seesions per week will be supervised by physiotherapist. Short term pulmonary rehabilitation includes: Warm-up(5-7min): light walking Aerobic training: mild-moderate intensity (40-60% of MHR) cycling or walk on treadmill/over ground Strength training: Exercises for major muscle groups (upper limb, lower limb and trunk) using body weight based on 1RM. Upper limb: upright row, shoulder press, bicep curls Lower limb: sit-to-stand, mini knee lifts, 3 steps calf raises Core: Seated abdominal contraction, back extension Perform 1-2 sets of 5-10 repetitions for each exercise, resting 1-2 mins between sets. Breathing exercise: pursed-lip breathing (1-3 sets of 5-10 reps) Cool down: (5-10min) Pharmacological management: Patient will receive medications as per prescribed by pulmonologist
Box breathing with short term pulmonary rehabilitation
Other interventionPatients in this group will receive box breathing with short term pulmonary rehabilitation along with pharmacological management. A total 3 weeks protocol will be followed in which 2 sessions per week will be supervised by physiotherapist and box breathing will be performed daily. Patient will receive short term pulmonary rehabilitation including: Warm -up (5-7 min): light walking Aerobic training: mild-moderate intensity (40-60%of MHR) cycling or walk on treadmill/over ground. Strength training: Exercises for major muscle groups (upper limb, lower limb and trunk) using body weight based on 1RM. Upper limb: upright row, shoulder press, bicep curls Lower limb: sit-to-stand, mini knee lifts, 3 steps calf raises Core: seated abdominal contractions, back extensions Perform 1-2 sets of 5-10 repetitions for each exercise resting 1-2 min between sets. Breathing exercise: pursed-lip breathing (1-3 sets of 5 -10 repetitions) Cool down: (5-10 min) Box breathing: The patient will be instructed
Dyspnea
Evaluation will be performed using the Modified Medical Research Council (mMRC) Dyspnea Scale, a clinician-administered scale ranging from 0 to 4, where: 0 indicates breathlessness only with strenuous exercise 4 indicates severe breathlessness (too breathless to leave the house or breathless while dressing) Higher scores represent worse dyspnea severity and poorer functional status.
Functional Capacity
Evaluation will be done by using 6 minute walk test
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