Sports activity and respiratory diseases

By Dr. Gianfranco De Angelis

A category of patients for whom physical activity could be a therapeutic aid for the doctor is that of chronic broncho-tires. In this type of patient the ability to perform aerobic work is very compromised; in fact, the maximum oxygen consumption is decreased, while the maximum anaerobic power is normal. On this basis, many authors state that with this type of patient only physiokinesis therapy should be performed.

On the other hand, other authors counter, bringing scientific evidence that controlled physical activity can take place in the physician's therapeutic armory. It has in fact been seen that in chronic bronchitics, following training, there is an increase in maximum oxygen consumption and an increase in pulmonary ventilation; the positive effects of physical activity in such patients should therefore be emphasized. Before saying what is the recommended physical activity in the presence of COPD, it must be premised that it must be dosed taking into account the age of the patient and above all the degree of illness, considering the functional capacity and the subjective symptomatology. In general, the symptomatic pneumatic bronchus subject must first perform respiratory gymnastic exercises to improve the diaphragm excursion and tone the respiratory muscles; then, after a specialist check, he can gradually start physical activity with a cycle ergometer. After these two phases, if the physical conditions allow it, he can practice real sports: the most suitable are tennis and swimming.

In physical programming, space must be given to excellent heating and cool-down, avoiding maximal or strenuous exercises. Personally, I believe that gradual weight training can be done, but this training program must consist of simple, light exercises. This is because the discontinuity of training allows the patient to rest well between one series and another; furthermore, weights must be limited and average repetitions 12-15; the number of low exercises; exercises that cause too much fatigue (like the Squat) are to be abolished, as it is to banish all forms of competition. Clearly everything must be measured taking into account the patient's condition, which can be highlighted with functional tests, clinical examination and subjective symptoms.