Pulmonary Rehabilitation - Weaknesses Addressed

Weaknesses Addressed

• Ventilatory limitation
  • Increased dead space ventilation
  • Impaired gas exchange
  • Increased ventilatory demands due to peripheral muscle dysfunction
• Gas exchange limitation
  • Compromised functional inspiratory muscle strength
  • Compromised inspiratory muscle endurance
• Cardiac dysfunction
  • Increase in right ventricular afterload due to increased peripheral vascular resistance.
• Skeletal muscle dysfunction
  • Average reduction in quadriceps strength decreased by 20-30% in moderate to severe COPD
  • Reduction in the proportion of type I muscle fibres and an increase in the proportion of type II fibres compared to age matched normal subjects
  • Reduction in capillary to fibre ratio and peak oxygen consumption
  • Reduction in oxidative enzyme capacity and increased blood lactate levels at lower work rates compared to normal subjects
  • Prolonged periods of under nutrition which results in a reduction in strength and endurance
• Respiratory muscle dysfunction