COPD and Rehab

COPD – disease, therapy and rehabilitation

COPD is more common than asthma, but is less known to many patients. Narrowing of the airways leads to coughing and shortness of breath. The disease is not curable. Therefore, the focus of therapy is on symptom relief and measures that make life easier. Learn everything about the disease, treatment and rehabilitation here.

COPD: General

COPD (chronic obstructive pulmonary disease, USA: chronic obstructive pulmonary disease) is associated with permanent inflammation of the respiratory tract. Because smoking is the main cause, the symptoms of the disease are sometimes belittled by patients, but also doctors, as “smoking cough”. However, it is a serious and life-threatening illness. In contrast to asthma, the respiratory flow in COPD is permanently restricted. The therapy can only partially reverse the symptoms.

According to the World Health Organization (WHO), between 10 and 15 percent of all adults suffer from COPD. In the ranking of the ten diseases that cause the most deaths worldwide, COPD is the only one whose frequency is constantly increasing. It is currently in fourth place in the statistics. Experts believe that it will be in third place from 2020, right behind the causes of heart attack and stroke.

COPD: causes

There are several risk factors that can lead to COPD. Cigarette smoke has by far the greatest influence. This accounts for 80 to 90 percent of all COPD diseases.

Smoking and secondhand smoke

About one in two long-term smokers gets chronic bronchitis. One in five develops a COPD. Men are affected three times more often than women. The effects of this lung disease can, however, occur earlier and more severely in women than in men because of the usually smaller lung volume. Passive smoking also favors lung diseases. Due to smoking bans, this influence is decreasing in USA.

Genetic causes

Genetic causes play a role in some COPD patients. With alpha-1-antitrypsin deficiency, the liver cannot produce sufficient amounts of the enzyme alpha-1-antitrypsin. This disease triggers various clinical pictures. This also includes the COPD.

Pulmonary pollutants

Lung diseases can be promoted not only by cigarette smoke, but also by other pollutants. Anyone who is exposed to harmful vapors, smoke or gases over a long period of time without adequate protective measures has an increased risk of COPD. Air pollution and fine dust also play an important role.

COPD: appearance/symptoms

A healthy lung cleans itself. Inhaled pollutants and small particles stick to the lung secretions (mucus) and are transported to the outside by cilia. If the lungs are exposed to harmful substances such as nicotine for a long time, chronic inflammation develops. In response, the lungs secrete more mucus. The inflammatory processes damage the walls of the respiratory tract and the cilia over time. As a result, the cleaning function is lost. The airways narrow. Breathing becomes more difficult and the increasingly produced mucus is increasingly difficult to cough up.

A COPD begins slowly. Gradually, cough, expectoration and shortness of breath appear more and more. Whistling or buzzing noises when breathing and a prolonged exhalation are also typical. The reduced lung function means that less oxygen gets into the blood. This leads to cyanosis, the blue coloring of the lips, skin or fingers. Long-term consequences are recurrent infections, pneumonia and a certain form of heart failure (cor pulmonale). In advanced stages, COPD is a life-threatening illness that is associated with a significantly reduced life expectancy.

There are generally two clinical pictures that are responsible for the symptoms that occur in COPD: chronic obstructive bronchitis and pulmonary emphysema. Both can be available separately or in combination.

Chronic obstructive bronchitis

According to the WHO, chronic bronchitis occurs when coughing and expectoration occur for at least three months in two years. Symptoms of bronchitis are in the foreground in some patients. They suffer especially from tough mucus, coughing and lack of oxygen, but less from shortness of breath.


Damage to the lungs causes the walls of the alveoli to become more unstable. Air can no longer be exhaled completely. It is said: the lungs are inflated. Medically, this hyperinflation is called pulmonary emphysema. Patients with emphysema suffer particularly from shortness of breath. Breathing becomes very exhausting and requires so much muscle strength in the advanced stage that the disease “wears out” and the person concerned loses weight.

Batch worsening (exacerbation)

Typical of the appearance of COPD is the worsening of the condition (exacerbation). It is often a result of infections and can be associated with chest pain, water retention, fatigue and fever. A severe exacerbation is life-threatening. It can lead to extreme shortness of breath and lack of oxygen or even loss of consciousness.

COPD: Examinations & Diagnosis

If you suspect COPD, the doctor first asks you about your medical history: How often do you cough? When and how often does breathlessness occur? Do you smoke (or did you smoke)? The lungs are monitored with a stethoscope. If there are specific indications of a lung disease, the doctor will usually refer you to a pulmonologist. A more in-depth investigation is possible there.

Lung function test

Certain tests give the doctor information about lung volume. When breathing through a spirometer, the pressure and amount of breathing air are measured. This examination can be done in a closed cabin that looks like a small phone booth. By measuring your breathing air and the air in the cabin, the doctor gets even more precise values. This makes it possible to differentiate between the two similar diseases asthma and COPD.

Blood test

The oxygen content in the blood is measured with a blood gas analysis. This procedure shows very precisely how effectively the lungs are working. If the patient has pulmonary emphysema, the concentration of alpha-1-antitrypsin is often also measured. It is used to prove whether COPD is caused by a genetically determined deficiency in alpha-1 antitrypsin.

COPD: Therapy & Rehabilitation

COPD is one of the few lung diseases that cannot be cured. With the right therapy, however, progression can be avoided or at least slowed down. Rehabilitation plays a very important role in the treatment and correct treatment of the disease.

Prevention: Avoid COPD and worsening

In chronic bronchitis or COPD, the first and most important measure for smokers is to stop smoking. If you continue to smoke, the progression of the disease cannot be stopped and the process is accelerated. With immediate cessation of smoke, the transition from chronic bronchitis to COPD can often still be avoided. If COPD already exists, the damage cannot be reversed. In chronic bronchitis or COPD, you should avoid lung effects. This includes passive smoking, frosty winter air and every exposure to pollutants at work. Experts recommend regular vaccinations against flu and pneumococci (triggers of pneumonia), because these infections can lead to worsening episodes.

Drug therapy for COPD

Since COPD is not curable, the disease is treated permanently. To alleviate breathing difficulties, active ingredients are used that expand the narrowed airways. This includes drugs that work immediately and are intended for emergencies and acute shortness of breath. Others appear slower and are suitable for long-term use. If necessary, active ingredients such as cortisone help against inflammation of the lungs. Expectorants make it easier to cough up with tight secretions.

Surgery and lung transplant

If all measures such as medication and rehab are exhausted in severe COPD, surgery can be considered. Certain surgical techniques can make breathing easier. In the worst case, lung transplantation is the last option. Your doctor will discuss operational options with you very precisely if necessary and weigh the benefits against the risks.

Rehabilitation at COPD

The disease often leads to a vicious circle: due to the increasing difficulty in breathing, patients move less. This leads to muscle breakdown, which means that performance continues to deteriorate. Affected people become less mobile and take more care of themselves. This leads to further physical degradation, but sometimes also depression or the restriction of social contacts.

The rehab at COPD therefore starts here and breaks this cycle at several points: It shows those affected how muscle mass is prevented, how they can counteract breathing difficulties and how they can stay mobile with COPD. You can of course also use accompanied smoking cessation or psychological care and clarify all important questions about your medication in consultation with the specialists.

Rehabilitation is one of the most important pillars of treatment for COPD. It conveys the necessary knowledge and the right techniques so that those affected slow down the COPD and can live better with it in everyday life. Rehabilitation makes a significant contribution to improving the quality of life and often also to extending life expectancy.

movement training

Physical training should be an integral part of the daily routine of COPD patients. In rehab, you will learn the right exercises for endurance, strength and breathing together with specially trained therapists. The program is individually adapted to the severity of your illness and your fitness.

Diet and weight

Depending on the type of COPD, being overweight or underweight can be a problem for those affected. In rehab, nutritionists explain how you can support your immune system with a healthy diet and what foods you can use to counter muscle loss or achieve weight loss. In order for the body to defend itself against inflammatory processes with a powerful immune system, optimal nutrition is always an important tool of therapy.

Breathing techniques and management of breathlessness

Breathing exercises are an essential part of rehab. You will learn basic techniques such as exhaling with the lip brake. Experts will also show you how to cough up phlegm effectively and gently. In training courses you will learn everything about various breathing-relieving postures, such as the coach seat, which you can use to prevent breathing difficulties or to catch your breath when you are short of breath.

Dealing with inhalation systems and oxygen therapy

Dosage aerosol, powder inhaler or nebulizer: in rehab, experts will show you how medication with the right inhalation technique works optimally. If long-term therapy with oxygen is required, you will learn all about it in rehab and get helpful tips on how to use the devices and aids on a daily basis.

Dealing with COPD in everyday life

With COPD climbing stairs, household chores or personal hygiene can be a challenge. In rehab, you will not only learn how to move in a way that saves energy and air. You will also learn about a few tools such as shower chairs, extensions for shoehorns or walking aids that will make your daily life easier.

Chances of recovery and benefits of rehabilitation

The success of therapy with COPD depends to a large extent on non-drug measures. Even if a cure is not possible, those affected can do a lot to improve their quality of life and prevent the disease from progressing. These measures can be learned in rehab and optimally adapted to each individual patient. That is why rehab in COPD is a key part of therapy.

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