Usually a breathing disorder can be noticed as it develops. Chronic disorders such as emphysema and asthma are conditions associated with Chronic Obstructive Pulmonary Disease (COPD) and are commonly diagnosed as respiratory dysfunctions. Chronic bronchitis is among the most common. Chronic bronchitis is an inflammatory condition caused by persistent production of sputum due to a thickened bronchial wall, which in turn creates a reduction of airflow. Emphysema is a disease of the lungs that affects the small airways. An enlargement of air spaces accompanied by the progressive destruction of alveolar capillary units leads to elevated pulmonary vascular resistance, which in most cases can contribute to heart failure. Asthma is usually brought on by a spasmodic contraction of smooth muscle around the bronchi that produces swelling of the mucosal cells lining the bronchi and an excessive secretion of mucous. Constriction of airway paths associated with asthma results in attacks that may be caused by allergic reactions, exercise, air quality factors and stress.

Pulmonary diseases affect the respiratory system’s ability to transport oxygen during exercise to the tissue level via the cardiovascular system. The systematic breakdown that occurs as a result of inadequate oxygen supply creates a greater than normal demand on the function of the cardiorespiratory system, in some cases markedly reducing exercise tolerance.

The major signs or symptoms of COPD include the following:

It is important for personal trainers to understand these signs and symptoms. If an individual exhibits these signs or symptoms, it is the role and responsibility of the personal trainer to take appropriate action, and if you are ever unsure of what the appropriate action is, refer your client elsewhere.

As we all know, exercise has many benefits. It makes your heart and circulatory system stronger, helps control blood pressure and improves the heart’s ability to pump blood, which in turn means more oxygen and energy. The lack of oxygen and sufficient calorie intake (as stated before) may lead to a loss of muscle mass and strength. This is why exercise is such a critical component of a comphensive treatment plan for any severity of COPD. Aerobic exercise like walking or riding a stationary bike helps to bring more oxygen into the body and tone the muscles. This kind of conditioning has been shown to reduce symptoms like shortness of breath and improve overall quality of life, no matter the severity of your client’s COPD. A regular exercise regimen improves sleep quality, which increases energy and promotes better posture, balance and flexibility. The list of positives for regular exercise in COPD sufferers goes on and covers everything from emotional to physical strength and everything in between.

Every effective exercise program needs to take into consideration proper regression and progression. With clients who have COPD, every exercise should be a regression (the level of regression will be dependent on the individual's fitness level). The following aerobic exercises are listed in order from LEAST to MOST likely to induce an attack such as exercise-induced asthma or exercise-induced bronchitis.

 Walking

Low Intensity - It is very easy to keep the heart rate consistent when walking.

Cycling

Low to Moderate Intensity - The intensity can be easily controlled while cycling. Treadmill Running

High Intensity - The body needs more oxygen for this activity, so you most progress to this point.



Outdoor Running

High Intensity - A lot of oxygen is needed to run outdoors, plus the outside temperature could cause an attack. This is the last aerobic progression.

Any progression beyond this could be to increase the intensity further by introducing weight training. The key is to pay close attention to your client's breathing. The weight training program to follow looks like this: