Pulmonary Rehab: Daily Fitness & Exercise


Hello, I am Dr. Ken Chapman, Director of the
Asthma & Airway Centre of the University Health Network and Director of our Pulmonary Rehab
Program at Toronto Western site. I am delighted to be able to introduce this
DVD of Basic Pulmonary Rehab Exercises. How are you going to use this DVD? First,
you consult with your physician and make sure that you can do the exercises described. You
want to be sure there is no other medical problem: a heart problem, a joint problem
that would prevent from doing some of the things we describe.
When you are given that green light you want to begin these exercises gradually until you
build up to the maximum which is your maximum. Once you’ve achieved this level of fitness,
you want to remember to keep on exercising to maintain that fitness.
Is this a complete program of exercises? No, but we hope that once you have developed that
exercise habit, you’ll be able to consult with professionals and perhaps find other
exercises that are helpful to you. This is gonna be a basic guide, something
that will keep you exercising using correct technique and a bit of a companion along the
way. What can you expect of all this effort? If
your breathing is a bit limited, it will probably not going to change these numbers very much,
but we do know that we can make those exercising muscles more efficient, stronger. It will
improve your balance, and as a result, you will be able to do more day to day.
Patients tell us, that once they’ve been through the program, they enjoy life more,
because they can do more. So by all means start your exercise program. At least thirty minutes of endurance exercise
daily is ideal. Sometimes, thirty minutes is difficult to do so it is important to pace
yourself and start slow. Great examples of endurance exercise include walking, cycling,
swimming or simply repeated leg walking exercise while seated. Other exercises that focus on
balance, strength and flexibility are equally important. Never do strength training on the
same muscle groups two days in a row. Your muscles need a day of rest in between in order
to rest and recover and also to minimize the risk of injury. Always take care and listen
to your body. Hi , my name is Meeran Manji and I work at
the Pulmonary Rehabilitation Clinic at the Toronto Western Hospital,, part of the University
Health Network. Join us as we take you through a program that includes warm up, breathing
exercises, arm exercises, abdominal strengthening work, upper body strength training, lower
extremities based balance and flexibility exercises and finally a brief cool down.
Let’s first start by reviewing proper pursed lip breathing technique. Breath in through
your nose and simply exhale softly through your mouth through pursed lips as if you are
whistling through soft exhalation. Let’s try it.( DEMO) Remember to breathe out slowly
and not to be forceful as you exhale. Exhaling slightly longer than the time you took to
inhale is also important. It is important to incorporate pursed lip breathing technique
in your daily activities remember to always exhale on effort. This technique will help
you decrease the work of breathing, some what reduce your shortness of and also help with
overall relaxation. Let’s begin. At least thirty minutes of endurance exercise
daily is ideal. Sometimes, thirty minutes is difficult to do so it is important to pace
yourself and start slow. Great examples of endurance exercise include walking, cycling,
swimming or simply repeated leg walking exercise while seated. Other exercises that focus on
balance, strength and flexibility are equally important. Never do strength training on the
same muscle groups two days in a row. Your muscles need a day of rest in between in order
to rest and recover and also to minimize the risk of injury. Always take care and listen
to your body. Hi , my name is Meeran Manji and I work at
the Pulmonary Rehabilitation Clinic at the Toronto Western Hospital,, part of the University
Health Network. Join us as we take you through a program that includes warm up, breathing
exercises, arm exercises, abdominal strengthening work, upper body strength training, lower
extremities based balance and flexibility exercises and finally a brief cool down.
Let’s first start by reviewing proper pursed lip breathing technique. Breath in through
your nose and simply exhale softly through your mouth through pursed lips as if you are
whistling through soft exhalation. Let’s try it.( DEMO) Remember to breathe out slowly
and not to be forceful as you exhale. Exhaling slightly longer than the time you took to
inhale is also important. It is important to incorporate pursed lip breathing technique
in your daily activities remember to always exhale on effort. This technique will help
you decrease the work of breathing, some what reduce your shortness of and also help with
overall relaxation. Let’s begin. Let’s start the warm up exercises. Sit up
in your chair, nice and tall. Place your hands at your mid abdomen. Inhale through your nose
and try to feel some movement at your diaphragm. Breathing out through pursed lips, just like
you’re whistling the air out softly. As you inhale, feel the abdomen rise with each
inhalation, exhale through pursed lip. Place one hand at your chest and the other at your
abdomen. You should feel more movement at your abdomen than your chest.Inhale deeply….and
exhale. Good, let’s switch to the other side, inhale exhale…
Place your hands are at the lower half of the rib cage and inhale deeply through the
nose… lift up that rib cage as you inhale. Exhale leaning forward pursed lip breathing.
Once again inhale… and exhale. Last one… inhale… exhale, pursed lip. Sit forward in your chair, clasp your hands
behind your back if you can. Inhale lifting those arms up get a good stretch in your arm
as well as across the rib cage. Hold … now exhale pursed lip, leaning forward. Once again
inhale… hold that stretch, don’t give into it… exhale as you lean forward. And
this is the last one; inhale lift those arms up get a good stretch and exhale pursed lip.
Sit up tall try not to lean into the chair. Bring that arm up and face your hand up to
the ceiling and feel the stretch right through your arms to the finger tips… and switch.
Switch sides…and last stretch. Good. Ok once again
you’re sitting up nice and tall with the chin tucked in and I want you to look down…
and gently look up… and look down …and look up look down… look straight ahead,
turn to the side… and gently turn to face the other direction. Face the side once again.
And now look straight ahead bring your arms up at chest level over to the side I want
you to inhale through your nose…exhale through your mouth, pursed lip. Once again inhale
and exhale… inhale and exhale …last one inhale…and exhale as you turn.
Bring those shoulders up as high as you can… and drop. once again. Inhale bring the shoulders
up hold… drop. Last one …and drop I want you to bring your arms up, level of
the chest elbows together, hands together, inhale… and exhale as you close your arms.
Inhale …exhale. Last one …and exhale. Extend your arms out and we’re going arm
circles, the movement is small and anticlockwise Inhale as you reach your arms up
and exhale as you bend forward to touch your
toes. Bring your hands out in front of you and open
and close your hands. Move your hand in a circular motion, opposite
direction Take your hand a tap your shoulders
Lets reach up and alternate side to side, 1,2,3,4 reach out at centre, 1,2,3,4, reach
down 1,2,3,4 Deep breath, pursed lip breathing Let’s repeat once again
Extend one leg up, point the toe and now flex Point your toes and let’s do toe circles
in one direction and now let’s switch to the opposite direction
Place your feet flat on the floor and we’ll have you lift your toes up and then your heels.
Once again the toes come up and then the heels. Nice little rocking motion that allows the
bottom of your feet to feel a nice stretch. Reach forward and tap your foot , switch to
the other Add box step , take left foot and tap at four
corners now switch to the other foot. Let’s start walking and pace your selves,
include arm movement if you are able to Hold on to the chair, place right foot forward,
ensure that you have a bend at your knees at the right leg, lean in to this stretch,
your left leg should be straight. Now switch to the other side, etc
Place your feet shoulder width apart, lean on to one side and now switch to the other,
etc Place your feet together, hold on to the chair,
Lift your heels up and release Last stretch Inhale bring you arms all the
way up. Exhale leaning forward just going as far as you can keep a slight bend in your
knee, this isn’t about toe touching this is about getting a good stretch. Ok inhale
exhale as you lean forward. Inhale…and exhale. Great. Forward and punch.(Counting… Seven…eight…nine…
and10. Arm jog now. Two…three four…five…six…seven…eight…nine…ten.
Reach up for marching soldier bring those arms up as high as you can and switch. Five…six…seven…eight…nine…and
ten. Lean over and your going bring those arms
back up for this is called pump the tire ok. Three…four…five…six…seven…eight…nine…and
ten. Bring your arms up and swing them over your
head side to side 5, 4, 3, 2,1 and now take a break, pursed
lip breathing, deep breath.., let the tension go from your shoulders.
Ready to climb the mountain? Reach up your arms up and alternate…3…2..1
Bring the arms up into criss-cross at chest level…4, 3, 2,1
Bring the arms up at chest level and push forward and release. This is a modified tai
chi move. Coordinate your breathing as you reach the
arms forward exhale, as you bring them back
towards you inhale.. 4,3,2,1, Lean forward and pull the weeds… 4, 3, 2,1
Bring those arms up into position and row the boat, 4,3,2,1
Let’s do upper cuts, punch…4,3,2,1 Let’s play the piano as we move to cool down
Stir the soup, it’s a big pot… five in one direction and now lets switch to the other
direction… great Place your hand on the chair, lift your knees
up and exhale. You should feel this action working your lower abdomen, 3,2,1
Lift your right knee up and bring your left elbow to your right knee and alternate. Make
sure to exhale pursed lip as you bring your knee up.
We’re going to start with the weight training segment. So, uncross your legs, feet flat
on the floor. Coordinate your breathing with your movements, so inhale initially…and
exhale as you lift your free weights. Weights are down by your
sides and start with shoulder shrugs Lift your shoulders up to your ears, exhale while
lifting up Inhale, now lift arms up and exhale, inhale
as you bring the weight down 4,3,2,1, loosen your shoulders
Inhale, now lift your right arm up to the level of your chest and inhale as you
bring the weight down, now switch to the other side,4,3,2,1
Lift weights to level of chest, inhale on the way up and exhale as you bring the weights
back down Sit tall with chin tucked in, lift your weights
above your head with free weights facing front bring your weights to your shoulder level.
Lift the weights up exhale, now inhale,4,3,2,1The weights are facing front parallel, lift up,
exhale, bring weight down, inhale , exhale,4,3,2,1 Bring your arms up, elbows together, hands
together, inhale, extend your arms apart, exhale, inhale as you bring your arms together
Start by inhaling, bring the weight up, bend at the elbows and exhale as you lift up Tuck your elbow by your waist, inhale, now
exhale while you push the weight down, 4,3,2,1. Let’s switch to the other side
Now , we will do triceps extension with both arms working, exhale pursed lip as we push the weight down
Sit back in your chair, legs uncrossed, feet flat on the floor. Cross your arms over your
chest, inhale, reach forward to stand while you exhale
Stand beside the chair and
hold on to the chair if you have weak balance,
inhale, lift your knee up and exhale. It is important to maintain proper posture. Now
switch to the other side Inhale, bend your legs back as you exhale
and switch to the other side Hold on to the chair, extend your arms, lean
forward and lift your leg straight back within the frame of your body, exhale, now switch
to the other side. Hold on to the chair and lift your leg
to the side now switch to the other side
Hold on to the chair if you wish, Inhale, reach
up on your toes and exhale as you come down Let’s begin by sitting tall, tuck in your
chin look down for a count of three and then up. Let’s repeat, now look straight ahead
turn your head to one side and now to face the other, once again.
Loosen your shoulder, bring your arms up to chest level, turn to one side, now let’s
face the other, once again. Clasp your hands in front of you, turn them
around, inhale as you lift up and exhale pursed lip as you bring them down to the sides, Once
again, inhale, now exhale. Sit forward in your chair, straighten the
leg as much as you can and lean forward , try and reach forward as much as you can, you
should feel a gentle tug at the back of your leg, now let’s try the other side, extend
your leg out reach forward and hold. Let’s repeat once more.
Now finally sit back in your chair, breath in deeply, exhale pursed lip. Give your self
a hug, hold, and now a pat on the back in you can.
This concludes your session for today. Have a great day and remember to keep up with your
exercise routine.

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