Catherine: Great to be here this afternoon. Let's get started. I am really hoping that, at the end of this course, you can immediately start to apply some of these techniques.
COPD
Chronic obstructive pulmonary disorder is a progressive disease. It makes it hard to breath, and it is progressive and impairs over time. COPD causes coughing that produces large amounts of mucus, wheezing, shortness of breath, chest tightness, and other symptoms. Cigarette smoking is the leading cause of COPD. Most people, who have COPD, smoke or used to smoke at some point in their life. Also, long term exposure to other lung irritants, such as air pollution, chemical fumes and dust, may also contribute to COPD.
When a client starts to feel breathless, typically a little bit of panic typically sets in. Not being able to get their next breath it is a terrible feeling. When our clients start feeling breathless, typically they avoid activities that will make them breathless. This leads to them doing less. When they do less, their muscles weakness, and then it makes it easier to become breathless, and so on. This can lead to depression. When you are depressed, again you avoid activities again. Our clients get into a repetitive cycle of deterioration (shown in Figure 1).
Figure 1. Repetitive cycle for COPD.
We need to do is step in as early as possible, and give them some options for breaking this cycle. When I worked on the Pulmonary Unit, by the time I saw the clients, 90% of them were on oxygen therapy and were very debilitated. I really wished I could have gotten in earlier when they were first diagnosed in the doctor's office. I think that would be a fantastic place to begin if possible. I would encourage you to go out to these pulmonary doctors and see if you could set up a yoga class or start something in their offices, before they get to a point where they are coming in for rehab.
Let's look at the typical, counterintuitive posture of our clients as noted in Figure 2.
Figure 2. COPD posture.
We see them hanging forward, elbows on knees, or on the arms of the wheelchair. You start seeing the curvature of the spine come in with their shoulders resting on legs while they gasp for breath. They have the typical barrel chest, which begins to happen as the muscles deteriorate and weaken. Structurally, they have issues on top of their posture. This impacts their ability to breathe even further. As they are hunched over and curled down, they are rolling their shoulders in to their chest. We need to work on getting them to draw up, sit straighter, and open up their chest. A number of the yoga postures I am going to teach you today, work toward that chest opening. Of course, our goal is upright posture with an open chest, to increase their ability to expand the lungs.
OccupationalTherapy.com has some excellent courses that support this course. One of them is the Complementary/Alternative Medicine and Occupational Therapy course. I have also done an Introduction to the Therapeutic Use of Yoga, which gives a history and background of what we are going to be talking about.
Impact of Yoga on COPD
There are many impacts of yoga on COPD (Figure 3).
Figure 3. Overview of the study of The Impact of Yoga on COPD.
It was concluded that yogic breathing exercises improve diffusion capacity. Yoga therapy is beneficial to COPD patients and can be used as an adjunct therapy with conventional occupational therapy therapy. Patients with COPD, who practice yoga, can improve their lung function, according to a study by researchers at the All India Institute of Medical Sciences, Department of Pulmonary Medicine and Sleep Disorders. The study, presented at CHEST 2013, the annual meeting of the American College of Chest Physicians (ACCP), found that lung function, shortness of breath, and inflammation all showed significant improvement after patients completed 12 weeks of training.
An estimated 24 million Americans may have COPD, which includes chronic bronchitis, emphysema, or both. Patients with COPD have trouble pushing used air out of their lungs, making it difficult to take in healthy new air. Although there is no cure for COPD, a patient’s quality of life can be improved by controlling symptoms, such as shortness of breath. COPD, most commonly caused by cigarette smoking, affects both men and women, and often, symptoms are seen in people in their 40s.
The study investigated whether simple, structured yoga training affects the level of inflammation, shortness of breath, and quality of life in patients with stable COPD. This study included 29 stable patients with COPD, who received yoga training in a format that included the use of physical postures (asanas), breathing techniques (pranayama), cleansing techniques, (kriyas), meditation, and a relaxation technique (shavasan) for 1 hour, twice a week, for 4 weeks. Following the 4-week period, patients were trained for 1 hour every 2 weeks, with the remaining sessions completed at home. Patients were evaluated on assessment of lung function, breathing, quality of life, and inflammation status. A repeat assessment was done at the end of the 12-week training session. All parameters showed significant improvement at the end of the 12-week period. According to Dr. Guleria. “We found that yoga can be a simple, cost-effective method that can help improve quality of life in patients with COPD.”
When I started 20 years ago, that was not the case. We taught our clients to maximize what little they had left. Now we are have seen, yoga can improve lung function. They are able to inhale and get the oxygen in, but it is the muscle structure (diaphragm) that forces the air out, and removes the toxins so that fresh oxygen can come in. This is where the gas exchange starts to break down.
