Physical Activity and Chronic Pulmonary Diseases - Pulmonary Rehabilitation in Hospital

Prema definiciji, plućna rehabilitacija niz je personaliziranih intervencija kod kroničnih plućnih bolesnika na osnovi kojih se određuju individualna terapija vježbanja, ali i edukacija o bolesti te promjeni ponašanja, a sve radi poboljšanja fizičkog i psihičkog stanja bolesnika s kroničnom plućnom bolesti. Vježbanje je esencijalna komponenta programa plućne rehabilitacije. Opća načela vježbanja bolesnika s kroničnom plućnom bolesti ne razlikuju se od onih zdravih pojedinaca ili čak sportaša. Da bi program vježbanja bio djelotvoran, ukupno opterećenje treninga mora biti prilagođeno pojedinačnim specifičnim zahtjevima i prelaziti opterećenja u svakodnevnom životu radi poboljšanja aerobnog kapaciteta i snage mišića uz poboljšanje kapaciteta vježbanja u određenom razdoblju. Optimalan tip vježbanja za bolesnike s kroničnim plućnim bolestima nije utvrđen i može se razlikovati od pojedinca do pojedinca. Najčešće se primjenjuje trening izdržljivosti u obliku vožnje stacionarnog bicikla ili hodanja po pokretnoj stazi. Nordijsko hodanje sa štapovima tijekom jednog sata na dan pokazalo se vrlo uspješno u povećanju dnevne hodne pruge i dnevnih aktivnosti. Za vrijeme provedbe programa svakog bolesnika valja pratiti i reagirati na simptome povezane s netolerancijom napora, povišenim krvnim tlakom, povećanim brojem otkucaja srca, padom saturacije. Program treba biti nadziran i personaliziran te prilagođen mogućnostima i ograničenjima pojedinog bolesnika. U sklopu programa mora se preporučiti i vježbanje kod kuće. Pritom valja definirati realne ciljeve za bolesnika da bi on vidio napredak i bio motiviran. Bolesnik treba i nakon završena programa nastaviti vježbati, promijeniti životne navike i povećati fizičku aktivnost, a sve radi što bolje kvalitete života.According to the definition, pulmonary rehabilitation programme for chronic pulmonary patients provides a range of personalized interventions used to determine individual exercise therapy, as well as education on the disease and behavioural change, for the purpose of improving physical and mental condition of patients with chronic pulmonary disease. Exercise is an essential component of the pulmonary rehabilitation programme. General principles of exercising in individuals with chronic pulmonary disease do not differ from the principles in healthy individuals or even athletes. For the exercise programme to be effective, the overall training workload has to suit specific individual requirements and exceed everyday workload in order to increase aerobic capacity and muscle strength, with an improvement of exercise capacity over a period of time. Optimal type of exercise for patients with chronic pulmonary diseases has not been established and may vary from individual to individual. Most commonly used mode of exercise is endurance training in the form of cycling on a stationary bike or walking on a treadmill. Nordic walking for one hour per day has proved to be a very successful type of training for an increase in the daily walking distance and overall daily activity. Each patient’s reactions to symptoms associated with exertion intolerance, increased blood pressure, increased heart rate or decrease in saturation are monitored throughout the programme. The programme is supervised and personalized, and it is individually tailored to the capabilities and limitations of each patient. Patient’s visible progress and continued motivation require recommended home exercise and reasonable goals set as part of the programme. After completing the programme, the patient should continue exercising, change lifestyle and increase physical activity for the purpose of improving the quality of life