Energy

Conservation
Techniques
ADLs
Training can improve breathless-
ness and SaO2
Use of work simplification
techniques and aids such as
trolleys, high walking frames and
household gadgets.
ADL Techniques
Prioritize activities, eliminate
non-essentials
Plan in advance, allow time,
alternate hard and easy
chores, spread energy-
demanding tasks over the
week, pace activities and
work in stages
Organize chores by location
to avoid multiple trips
ADL Techniques
Coordinate breathing
Move smoothly, avoid
extraneous movements
Lean on shopping
trolleys
Organize work space to
reduce clutter and
minimize reaching and
bending
ADL Techniques
Ensure that work surfaces
are the correct height
Keep heavy items on top of
the work surface
Rest elbows on worktop for
arm activities
Develop economic lifting
methods using leg power
rather than back and
shoulders
ADL Techniques
Slide pots and pans along
the worktop rather than
lifting them
Prepare large one-dish
meals
Soak washing up
Use a stool for kitchen
work and ironing, as this
can save 24% of energy
ADL Techniques
Sit to dress, put on two
items at once
Reduce bending
Avoid aerosols or strongly
scented perfumes
For bed-making, have a
raised bed on casters away
from walls, unfold sheets
on the bed, make only
one trip round the bed
ADL Techniques
Use non-iron clothes,
electric toothbrush,
long-handled sponge,
soap-on-a-rope,
towelling bathrobes,
slip-on shoes or Velcro
closures
ADL Techniques
Plan ahead for socializing because the
energy expenditure can equal that of
walking

Stress Reduction
Stress is physiologically detrimental
People with chronic lung disease suffer
muscle tension from breathlessness, stress
and the body positions needed to ease their
breathing.
Stress Reduction
A rhythmically active muscle such as the
diaphragm is in particular need of relaxation in
order to return to its resting position after
contraction especially when it is being overused to
maintain hyperinflation.
Some have become accustomed to muscle tension
and forget how it feels to be relaxed. Relaxation
helps breathing and breathing helps relaxation. It
should be taught early and reinforced throughout.

Relaxation Techniques
Daily practice of relaxation is needed
Degree of relaxation is integrated into everyday
life by identifying stressful situations and
practicing in different positions
Relaxed walking
Relaxation Techniques
Activities like circle dancing or Tai Chi provide
rhythmic exercise with a meditative effect, which
emphasizes trunk rotation and improve balance,
posture, immune function and conditioning
Relaxation is facilitated by positioning, sensitive
handling and the provision of information to
reduce anxiety
Relaxation Techniques
Patients should be warm, comfortable and have
adequate fresh air.
A technique should be chosen, such as the
physiological method which does not entail
breath holding or strong muscle contraction
Complementary Therapies
Complementary therapies may help ease
breathlessness and stress, depending on
the practitioner
Complementary Techniques
Yoga incorporates breathing techniques,
meditation and postures that consume minimal
energy and induce physiological effects
characteristic of deep relaxation
Yogic breathing promotes breathing awareness,
nose-breathing and 'complete breathing', which
begins with abdominal breathing, then expands
the lower chest and finally the upper chest
Complementary Techniques
Meditation clears interfering thoughts from the
mind, reducing RR, HR and BP
The Alexander technique inhibits muscle
tension, which reduces WOB and can improve
objective measures such as peak flow and
respiratory muscle strength
The Feldenkrais method uses the principle of
least effort and is useful for energy conservation
Complementary Techniques
Massage can reduce BP
Biofeedback reduce muscle tension allows the
sensation to be recognized and control gained
over it
Imagery uses visualization of peaceful scenes,
which can achieve a relaxed alpha brain wave
state
Hypnotherapy reduces the metabolic rate
through deep relaxation
Complementary Techniques
Acupuncture works directly on reducing the
perception of breathlessness and has shown
increased exercise tolerance
Patients contemplating aromatherapy need to be
aware that different oils can affect breathing
positively or negatively

Mechanical Rest
For chronically fatigued patients, non-
invasive ventilation at home may be part of
rehabilitation.