Exercise Safe, Feasible For Hospitalised AECOPD Patients - Expert

By Rafeaton Md Ali KUALA LUMPUR, Nov 15 (Bernama) -- Despite being the third leading cause of death worldwide, many Malaysians do not know that Chronic Obstructive Pulmonary Disease or COPD is actually preventable and treatable. According to Senior Lecturer at Universiti Teknologi MARA (UiTM) Faculty of Health Sciences Dr Fatim Tahirah Mirza, those with COPD who exercise regularly have the potential to reverse the negative consequences of the disease. ”Evidence show that a minimum twice weekly aerobic and resistance exercises can reduce breathlessness, fatigue, feelings of anxiety and depression, as well as improve health-related quality of life. The global prevalence of COPD of at least moderate severity is 10.1 per cent. Thus, in Malaysia, with a population of 33.4 million, approximately 3.4 million adults have COPD,” she said. She was speaking to Bernama in an interview recently in conjunction with World COPD Day that is celebrated annually on Nov 17 with this year’s theme “Healthy Lungs - Never More important”. The theme aims to emphasise that the burden of COPD remains in spite of the ongoing global COVID-19 pandemic. Unlike many other common chronic diseases, the prevalence and burden of COPD are predicted to rise due to continuous exposure to COPD risk factors such as smoking, air pollution and the ageing of the world’s population, she added. According to Fatim Tahirah the clinical course of COPD includes periods of clinical stability punctuated by periods of acute worsening, known as Acute Exacerbation of COPD (AECOPD) during which people with COPD experience a sustained worsening of symptoms for over 24 hours, that is acute in onset and necessitates a change in their regular medications. “Severe AECOPDs which necessitate hospitalisation have been demonstrated to impair exercise capacity, muscle strength and levels of physical activity, which all have been established as risk factors for future hospital readmissions,” she said. Fatim Tahirah and her team conducted a study on the safety and feasibility of exercise training initiated within 48 hours of hospital admission, dubbed Randomised Controlled Trial (RCT) at the Selayang Hospital and Institute of Respiratory Medicine, Kuala Lumpur, recently. She said the exercise study involved a walking programme and three functional resistance training on a group of patients, twice a day for a total of eight sessions throughout the hospitalisation stay until discharged. “The exercise training was found to be safe and feasible for patients who are hospitalised and able to increase their exercise capacity and muscle strength and more physically active compared to the other group who did not participate in the exercise programme,” she explained. Meanwhile, senior physiotherapist at Hospital Canselor Tuanku Muhriz (HCTM) Dr Katijjahbe Mohd Ali, who is also Special Interest Group president of Malaysia Physiotherapy Association (MPA), said physiotherapists play an integral role in the treatment of people with exacerbations of COPD, with high-level evidence that physiotherapy interventions can aid recovery and prevent recurrence of exacerbations. “Techniques such as chest physiotherapy, breathing exercises, exercise, can significantly improve functional status - defined as an individual’s ability to perform the normal daily activities required to meet basic needs, fulfill usual roles, and maintain health and well-being,” she added. Dr Katijjahbe, who is also Chair of Cardiovascular and Pulmonary Group (CVPG) of MPA, said in conjunction with World COPD day 2021, a webinar with the topic: Acute Exacerbation of COPD and Physiotherapy management: Evidence based practice will be held this Wednesday from 2pm to 4.30pm with free admission for MPA members. “The webinar is aimed at increasing awareness of physiotherapy role in managing patients,” she said adding that a Special Interest Group (SIG) of Cardiopulmonary will also be launched on that day. The group which consists of ten executive members specialising and/or with an interest in cardiopulmonary and vascular physiotherapy ranging from critical care, acute care settings to community services, was established on Oct 1, 2021.