Chronic Obstructive Pulmonary Disease (COPD) –

COPD is a chronic, progressive lung disease characterized by airflow limitation that is not fully reversible. It primarily includes chronic bronchitis and emphysema.
Causes / Risk Factors
Smoking (most common cause)
Long-term exposure to air pollutants, dust, or chemical fumes
Genetic factors (e.g., Alpha-1 antitrypsin deficiency)
Repeated respiratory infections during childhood
Occupational exposure to irritants
Pathophysiology
Inflammation of the airways → mucus hypersecretion and airway narrowing
Destruction of alveoli (emphysema) → loss of elastic recoil
Leads to air trapping, hyperinflation, and reduced gas exchange
Clinical Features
Persistent cough with sputum production
Shortness of breath (dyspnea), especially on exertion
Wheezing
Fatigue
Barrel-shaped chest (due to hyperinflation)
Cyanosis in advanced stages
Diagnosis
Spirometry – key test
↓ FEV₁ (Forced Expiratory Volume in 1 second)
↓ FEV₁/FVC ratio (<70%)
Chest X-ray / CT scan – shows hyperinflated lungs
ABG (Arterial Blood Gas) – may show hypoxemia, hypercapnia
Medical Management
Smoking cessation – most important step
Bronchodilators (e.g., salbutamol, ipratropium)
Inhaled corticosteroids
Oxygen therapy (in chronic hypoxemia)
Vaccinations – influenza and pneumococcal
Pulmonary rehabilitation
Physiotherapy Management
Goals:
Improve ventilation and oxygenation
Reduce dyspnea
Enhance exercise tolerance and quality of life
Treatment Techniques:
Breathing Exercises
Pursed-lip breathing – reduces breathlessness
Diaphragmatic breathing – improves ventilation efficiency
Airway Clearance Techniques
Active Cycle of Breathing Technique (ACBT)
Huffing / Coughing to clear secretions
Postural Drainage – helps in mucus clearance
Chest Physiotherapy – percussion and vibration as indicated
Aerobic Exercise Training
Walking, cycling, or treadmill training
Start low intensity, gradually increase
Strength Training – especially for lower limbs
Education
Energy conservation techniques
Correct inhaler use
Avoidance of triggers