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Exercise and Chronic Obstructive Pulmonary Disease (COPD)
Respiratory diseases are one of the most common diseases in Singapore. There are many common respiratory conditions that Singaporeans suffer from, namely chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis, pulmonary fibrosis etc.

The patients suffering from long standing respiratory diseases have reduced ability to breathe well, activities of daily living such as bathing, cooking, marketing and affect quality of life. Although medication is a treatment of choice in acute stage of illness, research has shown that structured exercise programme called Pulmonary Rehabilitation can be a choice of management for the patients in stable stage of the disease.

What is Pulmonary Rehabilitation
Pulmonary Rehabilitation is an exercise based, educational program, directed to the patient and the family, which aims to achieve and maintain the individual's maximum level of independence and functions in the community.

Pulmonary Rehabilitation can consist of a 12 weeks programme, during which the patient is required to come to the hospital/nursing home for structured exercise and education programme at least 3 times a week. The programme starts with assessment of the patient;s respiratory status and the ability to exercise and patient's perception of his respiratory impairment. On the basis of this assessment an individualized exercise program is designed.

Pulmonary rehabilitation helps to control and reduce the symptom of breathlessness, assist patient to achieve optimal level capacity to carry out activities of daily living, improve quality of life, promote independence and self reliance, increase exercise tolerance, decrease number of hospitalization and also decrease anxiety and depression. It also helps in the return to gainful employment for younger group of patients.

Many patients can benefit form this exercise programs, such as patients COPD, as well as patients with other respiratory disease. It is important that the patient should stop smoking to get the maximum benefit from the pulmonary rehabilitation programme.

Where to go for Pulmonary Rehabilitation program in Singapore
Many hospitals conduct this programme in Singapore, such as Tan Tock Seng Hospital, Singapore General Hospital. Orange Valley Nursing Home, Clement also conducts pulmonary rehabilitation program for the patients who get discharged from the hospital to nursing home before heading home.

Exercises at Home
It is also important to the patient with respiratory conditions such as Chronic Obstructive Pulmonary Disease to continue exercises at home despite of discomfort while exercising. Most patients do not exercise due to breathlessness, which lead to weakness of muscles of the body, leading to further breathlessness during exercises. It is essential to do exercises at least 45 minutes a day to reap the benefit.

Sandeep Kumar
Senior Physiotherapist
M Sc (Cardio-respiratory) physiotherapy, UK
Manager, Physiotherap Orange Valley Nursing Homes
Director, Rehab Asia Pte Ltd
Member, Education committee, Singapore Physiotherapy Association