How does RespiRehab deliver improved lung capacity and reduce breathlessness: The Maths behind it
RespiRehab is a structured pulmonary rehabilitation program designed for online digital delivery. It delivers significant improvement in breathing, lung function and quality of life for post COVID patients and patients with other lung issues. How does it do that? We explain it here.
The magic ingredient for its effectiveness is that RespiRehab follows the basics of breathing and improves each component of breathing. The program improves all the key areas of the breathing process step-by-step. When taken all together, the overall impact is significant: relieving shortness of breath, reduce dyspnea and fatigue and faster recovery after Covid or any other lung disease.
The oxygen management system of human body or breathing, simplistically is a three-part process. First part is exhalation and inhalation, second part is absorption of oxygen in the blood stream and third part is oxygen management by the body. A structured pulmonary rehabilitation program would aim to improve each of these parts and thus help in faster recovery, faster weaning from supplemental oxygen cylinder / oxygen concentrator.
This is how RespiRehab does it:
Part 1: Improving the air flow within your lungs [Inhalation & Exhalation]
There are specific muscles in human body which help in inhalation and exhalation – these are called expiratory and inspiratory muscles. There are specific exercises and techniques which help in strengthening these muscles. Yes, many pranayama practices also target these muscle groups but what a Respiratory Therapist does is to assess the current strength of these muscles, correlate it with patient’s condition and decide on the right set of exercises with right amount of dosage (how much you should do) to get them to the desired level. By delivering ‘exercise as medicine’, this first part of RespiRehab works on strengthening your breathing. When we use devices like spirometer/ acapella – it basically tests the inhalation/ exhalation capacity.
Part 2: Improving how oxygen is absorbed in the lungs
Covid and many other pulmonary infections cause mucus in the respiratory system. A sticky, slimy substance which covers the lungs and reduces the surface area available for exchange of gases (discharge of Carbon dioxide, CO2 and absorption of Oxygen). Even if you breathe well, but when your lungs are covered with mucus – the blood would not be able to absorb the right amount of oxygen. For this to happen, the mucus or phlegm needs to be cleared. RespiRehab includes coughing techniques like ACBT, Huff and Cough, Autogenic Drainage and Postural drainage which are very helpful in clearing the mucus and phlegm. Videos of most of these techniques are available on youtube, but please note that these are medical interventions and should ideally be done after a consultation with a respiratory therapist or a doctor. Right techniques and right dosages are very important to achieve right results with safety.
Part 3: Improving how body utilizes the absorbed oxygen
This is about general cardio vascular efficiency of the body. How much work can our muscles do with a given amount of oxygen in our blood stream. With the same amount of oxygen, a person with fitter cardiovascular system and muscles would be able to do more work (run, swim, lift etc) than someone with a poorer system. RespiRehab improves the oxygen efficiency by improving the general strength and endurance by guided exercises with gradual progression [1]. This also helps in fighting with fatigue, which is one of the key complaints of post COVID patients.
When a patient has been in ICU or a ventilator or just admitted in hospital for many days, there can be a significant loss of muscle mass and general deconditioning of cardiovascular system. That’s one of the reasons why physiotherapy for patients in hospital is so important. Physiotherapists can help reverse the deconditioning and improve the capacity of the cardiovascular system through progressive targeted exercises. Once the system is reconditioned, the patients can do lot more work with same amount of oxygen.
BONUS:
Now there is a fourth part as well. Various dos & don’ts, techniques to manage with limited oxygen and overall motivation to reach the desired level of wellness. This also includes techniques to manage dyspnea, improve oxygen saturation etc. Proning is one of the well-known techniques, but there are many more.
Also, Motivation and Guidance is a standard part of every physiotherapists’ toolkit. In a pandemic scenario when patients have very limited social interactions, this too plays a crucial role in recovery.
The Maths behind Oxygen and Breathing
Now the most interesting part is the mathematics of it. The extent of improvement which a respiratory therapist delivers in each of the four areas, do not add – they multiply. Hence most of the patients would start seeing a significant difference from second session onwards.
If the improvement in inhalation/exhalation is 15%, improvement is absorption is 20%, cardiovascular efficiency is improved by 25% and Techniques helps 10%, the improvement in patients quality of life is (115%X120%X125%X110% -1) = 89.8% improvement in overall breathing capacity.
Such improvement helps in faster weaning off from supplemental oxygen and overall breathing capabilities. This makes patients lot more mobile and confident, which has a host of other benefits attached to it. And most importantly, because the improvement is driven through exercise which patients are taught, the benefits are long term and retained by patients.
Of course, this is a simplistic representation; and human anatomy and body systems are lot more complex and dynamic. However, we do hope that this provides a picture of how RespiRehab helps patients with compromised lungs – whether the cause is COVID, COPD (Chronic obstructive pulmonary disease) or ILD (Interstitial lung disease).
You may also like: Rehabilitation after Covid-19 (Telerehab): Patient Experience
Like this post? Click on the social buttons and share it with your friends and family on Whatsapp / Facebook.