POCs and Exercise: A Winning Combination

Exercise plays a key role in helping oxygen patients live longer and enjoy life more.

Franck Rahaghi, MD, MHS, FCCP, a Florida based pulmonologist, is a firm believer that patients on oxygen who exercise improve their chances of living longer.  “We know,” says Rahaghi, ‘that physical exercise as part of pulmonary rehab has been shown in large studies to improve survival. Some exercise/oxygen studies showed survival, other studies failed to show survival.  But if you put them all together, they actually show longer survival and that pulmonary rehab was shown to improve mortality.  How much is hard to say—the studies really comment on the probability of improving mortality—not how many weeks or months.  But that’s a big deal on its own.”

Rahaghi is the Cleveland Clinic Chairman, Weston, FL Department of Pulmonary and Critical Care Medicine.  He is the director of the clinic’s Advanced Lung Disease Program and director, of its Pulmonary Hypertension Clinic.

Rahaghi says that POCs provide patients with more possibilities for fun and extended benefits from more exercise.  “I can tell you a lot of patients require their POC to do a particular activity.  And we have recently shown that exercise with oxygen results in a stronger outcome… meaning you can exercise more and better if you do it with oxygen.  That’s a recent finding, believe it or not.”

Rahaghi spends 80% of his time seeing patients and 20% on respiratory related research.  In general, the patients he sees are advanced in lung disease, very advanced COPD, very advanced pulmonary fibrosis and very advanced pulmonary hypertension and major diseases.

Some MD’s see the main value of exercise as strengthening the heart muscle—not so much the lungs.  Rahaghi takes a wider view.  “Exercise offers multiple benefits to the patients I see,” he says.  “Exercise has to do with cardiovascular strength, but it also has to do with the ability of your tissue to extract oxygen.  So, exercise is actually a multifaceted benefit that is cardiac, muscular, pulmonary and organ—meaning muscles, brain and everything else related,” said Rahaghi.

Getting out of the house more and being active around people is a big boon to people on oxygen.  POCs promote the ability to exercise beyond the house to be translated into improving oxygen patient functionality.  “A person on a POC out socializing with friends or family is going to get a lot more exercise and movement than someone on oxygen just sitting at home and watching TV,” says Jason Flanigan, General Manager of OxyGo, Westlake, OH.

Rahaghi says that rehab specialists tell patients to start with recommended oxygen levels for exercise. But if they need more oxygen, patients should feel free to increase it.  “If these patients notice their saturations are going down, that’s OK,” says Rahaghi.  “We have no evidence that lower saturations while exercising, meaning that if you go beyond your POCs capability, that would actually hurt you.  So, we basically encourage patients to exercise as much as they want, unless they get lightheaded or they feel they are about to pass out.  So, there is no real set limit to exercise.”

Rahaghi says that pulmonary rehab specialists are the true experts at helping patients combine oxygen and exercise for an overall improvement in quality of life.  “I generally send my patients to pulmonary rehab and they teach them exercises that they need and then these patients go back and do some of the same exercises at home.  Some oxygen patients can use weights, do some leg exercises at home without the need of going to pulmonary rehab.  Those are the simple things that if not improving mortality, improve a patient’s quality of life,” Rahaghi says.

Christiana da Silva RRT, BS, a respiratory therapy coordinator who works with Dr. Rahaghi at the Cleveland Clinic, FL, echoes some of the same thoughts on the value of POCs in helping patients benefit by increased movement.

Says da Silva, “Regarding POCs I have noticed that patients are willing to exercise more, even basic exercise such as walking, grocery shopping, and using oxygen more frequently if they have a POC versus a tank.  Tanks are cumbersome, heavy, and hard to maneuver (removing regulator/conserving device). Patients are also willing to wear their prescribed oxygen when a POC is ordered since they can carry it like a bag.  Many patients are requesting a POC that is lightweight and easier to recharge to do their chores, walk and go out more frequently if that is readily available versus tanks.”

da Silva explains how she works at the Cleveland Clinic to educate oxygen patients: “Our pulmonary rehab meets twice a week for 2 hours each class, some patients will get up to 36 classes or if necessary, we transition them to a maintenance program for up to 36 more classes.  During pulmonary rehab they learn how to manage oxygen requirements, improve endurance during exercise by staying active, be more open to talk in a group session about pulmonary diseases, ask questions and have a pulmonary education (breathing technique, inhaler teaching, coupons meds, etc.). Those patients are assessed pre, mid and post rehab for a 6-minute walk and have a monthly meeting with pulmonary physician to demonstrate increase in walk distance and show improvement in quality of life.  We always have a group discussion (10-15 minutes) at the end of each session that will allow patients to freely speak about their disease process, concerns or questions.  Patients will come into classes with their POC but during rehab will use tanks provided by Cleveland Clinic that is a continuous flow, many of our patients are not able to maintain saturation above 88% on pulse dose devices.”

Moving more, whether by walking, biking, lifting or any other form of exercise, is without question a benefit to patients on oxygen.  POCs, because of the flexibility they offer patients, have become important tools that help increase muscle strength and make daily activities easier.  In promoting exercise, they promote longevity.  “There’s very few things in smoker’s lung disease and COPD that actually improves your life expectancy.  Exercise is one of them.  Oxygen is one of them,” concluded Rahaghi.  He cited vaccination, smoking cessation and lung volume reduction surgery as others that came to mind.

If you or someone you know requires medical oxygen, ask your local provider if OxyGo is right for you.  Learn more at www.oxygo.life.