COVID-19 directly effect the LUNG. It is important to save the LUNG by increasing its capacity
There is no vaccination available till now to fight against COVID-19. The whole world is suffering due to this. We know the virus attack human body and lung becomes the worst effected organ. Patients of COPD, bronchial asthma, renal disease, cancers are in high risk to get affected by COVID-19.
We have to increase our Lung Capacity to fight against COVID-19. Total lung capacity (TLC) differ person to person. Among healthy adults, the average lung capacity is about 6 litters. Age, gender, body composition, and ethnicity are factors affecting the different ranges of lung capacity among individuals. There are several breathing exercises and pranayama to increase the lung capacity. I have mentioned the most effective exercises which increases the lung capacity if can be practice regularly.
All the muscle should relaxed specially the muscles of thorax and shoulders. Be calm & relax so you can do the exercise properly.
You should be in comfortable position in which gravity assists the diaphragm, such as a semi- Fowler’s position. So you have to be in approximately 45 degree elevated position as shown in picture.
Procedure: Place your hand on rectus abdominis muscle, so hand will be on upper abdomen shown in picture.
Hand supposed to give gentle pressure on your abdomen (above the diaphragm).
Breath in through your nose slowly & deeply and exhale through mouth slowly, maintain the pressure over the diaphragm throughout the procedure. This can be practiced for 4 to 5 times.
Progression: once the previous exercise done, your hand should be directed upwards while inspire through nose and draw back when you are exhaling through your mouth. This also can be practiced for 4 to 5 times.
Segmental breathing target the lateral and posterior segments of the lower lobes. However, segmental breathing techniques also may need to be directed to the middle and upper lobes if there is accumulation of secretions or insufficient lung expansion in these areas.
Lateral costal expansion
Procedure: Hook-lying position; later progress to a sitting position. Place your hands along the lateral aspect of the lower ribs to direct the movement of lung.
Take your position, lying/sitting and then breathe out, and feel the rib cage move downward and inward. As you breathes out, place pressure into the ribs with the palms of your hands. Plece your hands in the position shown in picture where the therapist hand is placed.
Apply light manual resistance or you can use towel to the lower ribs to increase sensory awareness as the patient breathes in deeply and the chest expands and ribs flare. Then, as the patient breathes out, assist by gently squeezing the rib cage in a downward and inward direction.
Posterior basal expansion
It emphasize the posterior segments of the lower lobes.
Sit and lean forward on a pillow, slightly bending the hips. Place your hands over the posterior aspect of the lower ribs, and follow the same procedure just described for lateral costal expansion.
Pursed-lip breathing is a strategy that involves lightly pursing the lips together during controlled exhalation. This breathing pattern often is adopted spontaneously by patients with COPD to deal with episodes of dyspnoea (difficult breathing).
Procedure: (see the video)
Assume a comfortable position and relax as much as possible. Breathe in slowly and deeply through the nose and then breathe out gently through lightly pursed lips as if blowing on and bending the flame of a candle but not blowing it out. You can do it in sitting position.
Box Breathing/four square breathing
This is a very popular method for relaxation and mental calmness. It is also known as four – square breathing.
Procedure: (see the video)
Sitting is the best position to do this exercise. 1st step is to exhale and empty your lung in 4 seconds. Then hold it for 4 seconds. Inhale in 4 sec and hold the breath for 4 sec, then again exhale in same period of time and repeat the cycle for 10 times.
This is a manoeuvre used to move secretions, mobilised by deep breathing/thoracic expansion exercises, downstream towards the mouth2. A huff is exhaling through an open mouth and throat instead of coughing. Huffing helps moves sputum from the small airways to the larger airways, from where they are removed by coughing3 as coughing alone cannot remove sputum from small airways4.
Procedure: (see the video)
You can do it in sitting position. You have to exhale forcefully with repeated manner. Forceful exhalation should be shorter period of time. It increase the lung capacity by mobilizing the secretion of the lung.
There are several pranayama to increase the lung capacities, here we will describe some of them.
Procedure 1: (see the video) Sit straight in the ground, deep breath in with your nose and breath out with your mouth. Now what you have to be careful over here that breath in and breath out should be in same duration, if you are taking time of 5 sec to breath in then you have to breath out in 5 sec. The progression of this exercise will be breath in (eg. 5sec), hold (5sec) and then breath out (5 sec).
Procedure 2: (see the video) Stand straight and place your both hand just beside the nipple along with your rib cage as you are holding your rib cage. Now inhale deeply with your nose and draw back your both elbow backwards simultaneously. Once you have complete inspiration, decrease the holding force of your hand, repeat this for 8 to 10 times.
Procedure 3: (see the video) Stand straight and place your hand above your head. Inhale deeply in that position and start exhaling, bend down and touch your knee at the time of exhaling. Once exhalation complete come to your starting position (hand above your head) by inspire through your nose. Repeat this for 8 to 10 times.
Points to ponder:
Mobilize your thorax: you have to do some exercises to mobilise your thorax to enhance the capacity of the lungs. These exercises can be done in free hand basis. This exercise includes back bending, rotation and side bending of thorax. Apart from this you can do shoulder and neck free hand exercises and can add some stretching exercises.
Posture: maintain a good posture while you are sitting or standing to get maximum efficiency of your lung. Try to avoid sleep on your tummy which compromise the lung function.
Meditation: those who are in practice of meditation can do these exercises in better manner, so practice meditation.
Diet: try to have lots of vegetable and fruits and maintain your wellbeing which also has great impact on your lung.
Smoking: it is a established fact that smoker usually have less lung capacity than others. COVID-19 is a warning for smokers to quit it.
See the full version of the video of breathing exercise in Bengali