Living life with Pulmonary Fibrosis

An exercise program supervised by an accredited Kinesiologist

Defining Pulmonary Fibrosis

Pulmonary fibrosis (PF) is a lung condition characterized by extensive scarring of the lung. In patients with PF, the lung tissue becomes scarred and stiff, and over time may become more widespread. The lungs from scarring and stiffening of the interstitium, loses their ability to transfer oxygen to the bloodstream, resulting in shortness of breath and vital organs being deprived of the necessary oxygen to survive.

Symptoms of PF may include:

Shortness of breath, particularly during or after physical activity
Spasmodic, dry cough
Gradual, unintended weight loss
Fatigue and weakness
Chest discomfort
Clubbing, or enlargement, of the ends of the fingers (or sometimes the toes) due to a buildup of tissue
Leg pain

Types of PF:

PF is a category of major respiratory diseases that causes lungs to become thick and stiff over time, group of disease is called interstitial lung diseases (also known as ILD).

Idiopathic fibrosis, a type of fibrosis without any known cause. Example: Idiopathic pulmonary fibrosis (IPF) and idiopathic non-specific interstitial pneumonia (NSIP). IPF more commonly affects people from 50 – 70 years old.

IPF is a fast-progressive irreversible evolution and disabling to the adult. The average survival is approximately 3-5 years from diagnosis (1). The diagnosis is often delayed and not reported until advance stages. IPF may affect over 10,000 people in Canada.

Unclassifiable pulmonary fibrosis, a type of fibrosis without clear identity.

Hypersensitivity pneumonitis, a type of fibrosis caused by repetitive exposure to an antigen.

Rheumatologic condition and immune diseases can cause inflammation and fibrosis in the lungs.

1. Vainshelboim B. Exercise training in idiopathic pulmonary fibrosis: is it of benefit? Breathe (Sheff). 2016 Jun;12(2):130-8. doi: 10.1183/20734735.006916. PMID: 27408631; PMCID: PMC4933618

Importance of exercising for individuals with PF

Including and targeting the following things in an exercise program can help enhance self-efficacy during, and improve the ability to participate in activities of daily living. It will improve the cardiovascular conditioning and ability of muscles to utilize oxygen and may help decrease symptoms of shortness of breath.

Posture Training
Stability and Fall Prevention
Proprioception & Coordination
Improve ability to perform daily tasks
Agility training

Special Consideration

When an individual with PF is exercising it is very important to focus and monitor their shortness of breath (SOB). This breathlessness can affect their ability to complete daily activities. It is important that the kin practices breathing techniques with the individual. Each person is different and some may desaturate quicker than others.

Performing and prescribing chair exercises are a better form of exercise for this population. It may take them longer to progress exercises. Therefore a kin must be vigilant when progressing exercises and may need to digress at times.

Topics covered during the Pulmonary Fibrosis program

Pursed lip breathing (PLB) during exercise
Posture training
Energy conservation principles
Breaking the anxiety-breathlessness cycle
Importance of maintaining an exercise routine (possible barriers)
The "Healthy Plate" and potential problems to eating right
Stability and fall prevetion
Proprioception and barefoot training
Stretching, Range Of Motion (ROM)

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