Lungs: Understanding their structure and function
Humans have a pair of lungs in the chest and both the lungs have tubes which transport air to smaller air passages called bronchi which in turn open into sacs called alveoli. These small sacs help in diffusion of gases from lungs to blood and vice versa.
Our lungs diffuse oxygen in the body via blood and remove other gases, such as carbon dioxide etc. from the body. This happens as many times as we breathe. For optimal performance of lungs, the air passage and sacs need to be patent during, breathing in and out. Also, they need to be devoid of inflammation (swelling) and abnormal amounts of mucus (secretions).
Impact of COVID 19
This COVID 19 pandemic has struck the respiratory system more than other organs. Blow to the lungs has resulted in a turmoil within the population about the prognosis of this disease. Various complications of this respiratory illness like exertional dyspnea, confusion, shortness of breath, rapid breathing, cough with mucus etc. have popped up. These are basically a resultant of both inflammatory changes and mucus collection.
People experience a whole lot of symptoms and rehabilitation aims at reducing the severity and after effects of the disease. A few set of problems occasionally observed and it’s rehabilitation aspects are mentioned:
- Breathlessness: It is a common symptom in people with COVID-19. Lungs usually get inflamed resulting in more effort during normal breathing. You may be breathing fast and shallow.
Now, breathing control helps in reducing the rate of breathing. It is done by adopting a comfortable position and breathing in and out at a ratio of 1:2, for example, aim at breathing in for 2 seconds and out for 4 seconds. This will slower down the rate of breathing and provide adequate time for oxygen transfer.
- Mucus (secretions): pooled secretions in the airways are a hindrance in transportation of air from lungs to the blood.
In order to clear these secretions proper technique of airway clearance results in removing mucus with minimum effort and conserves the energy also. Active Cycle of Breathing Technique is one of such maneuver. In this technique one has to find a comfortable sitting position followed by deep breathing. After that hold your breath for 2-3 seconds then huff which is exhaling through an open mouth like you are trying to blow a candle. It is done to bring out the collected mucus effectively. This entire cycle is repeated 2-3 time.
- Areas of poor air entry: Due to inflammation and scarring, certain areas of lungs might not work effectively in gas exchange and are left redundant. Hence, these areas require specific workout to initiate their normal functioning. Certain group of exercises like thoracic expansion, segmental, diaphragmatic breathing are known to aid in achieving optimal lung function.
- Expansion exercises like one mentioned below help in expanding and assist those areas.
First sit in a comfortable position and place hands over lower ribs or upper abdomen, breathe out while applying firm pressure against the ribs and abdomen with hands. Then exhale through pursed-lips followed by inhalation, while pushing the lower ribs outward against the hands. Gradually increase resistance, as tolerated. Repeat the same process 10-15 times.
Active role of breathing exercises and pulmonary physiotherapy has been described and approved by European Respiratory Society, NHS- UK and APTA- USA. In order to target a streamlined approach towards this pandemic, various guidelines have been issued as a crux of research by eminent organizations. Studies are being conducted by various researchers to find out more effective methods of rehabilitation and assist mankind in the best possible way.
By: Dr. Lakshay Bhakhtiani (Sr. Physiotherapist)