How should COPD patients incorporate daily rehabilitation exercises? Both breathing regulation and whole-body muscle conditioning are crucial, and Chinese Tai Chi excels at addressing both these key points!
Experts note that COPD prevalence continues to rise, emphasizing the need for heightened awareness of early diagnosis and treatment. It is hoped that within the next few years, COPD recognition rates will reach levels comparable to those of hypertension and diabetes.Simultaneously, dual bronchodilator therapy is gaining increasing attention for COPD patients. When using inhalers for treatment, patients must not only strictly follow medical guidance but also thoroughly learn the correct inhaler technique to enhance treatment efficacy and reduce risks of acute exacerbations and disease progression.
COPD is difficult to detect in its early stages
Recommend adding lung function tests to physical exams
COPD is extremely common worldwide. According to incomplete statistics, the number of COPD patients in China has reached 100 million and continues to rise.A nationwide survey conducted last year by the research team of Zhong Nanshan, an academician of the Chinese Academy of Engineering, revealed that over a decade, the prevalence among individuals aged 40 and above increased by 67%. Surveys on disease awareness indicate that only about 3% of patients are aware they have COPD, with the majority unaware of their condition.
In China, COPD diagnosis is categorized by severity. In the early stages of disease progression, particularly Stage I, symptoms are virtually nonexistent, while Stage II presents only mild, subtle symptoms. In many top-tier hospitals, patients diagnosed with COPD are typically in Stages III or IV—meaning they are already moderate to severe cases. Few seek medical attention in the early stages, and doctors often do not consider treatment necessary. Consequently, very few patients receive early diagnosis and treatment.
Zhong Nanshan's team conducted community-based screenings in Guangzhou to identify asymptomatic early-stage COPD patients and persuade them to undergo treatment. After two years of therapy, these patients showed significant improvement in lung function, with one-fifth achieving near-normal levels.
Encouragingly, awareness of COPD's dangers and prevalence is gradually increasing.With the attention of medical scientists and collaborative efforts across sectors, China's government policies have undergone significant changes. The National Health Commission has proposed establishing comprehensive chronic disease prevention and control demonstration zones, including screening and early diagnosis for chronic conditions such as cardiovascular diseases, cancer, diabetes, and COPD. Simultaneously, there is strong advocacy for incorporating lung function tests into routine physical examinations, which holds great significance for the early diagnosis and treatment of COPD.
Latest Guidelines Recommend
Combined Use of Two Bronchodilators
Zhong Nanshan explained that for a considerable period, the primary treatment for COPD, especially symptomatic patients, has been inhaled corticosteroids combined with bronchodilators—specifically beta-2 agonists—as the cornerstone therapy.However, extensive evidence-based medicine has demonstrated that this approach is not entirely suitable as a primary treatment. Respiratory physicians are now focusing on inhalation techniques that maximize drug delivery to the lungs.For patients with stage III or IV COPD, monotherapy—either β2-agonists or anticholinergics—was previously the norm. Clinical practice revealed that monotherapy proved inadequate for severely symptomatic patients, failing to effectively relieve symptoms while increasing the frequency of acute exacerbations.Surveys indicate that 73% of stage III and IV dyspneic patients on monotherapy experience 1–2 exacerbations annually. Each COPD exacerbation causes a decline in lung function; more frequent exacerbations lead to greater functional loss. Patients with three or more exacerbations per year have a five-year survival rate of only 50%, highlighting the significant harm to patients.
It is reported that the latest 2018 and 2019 guidelines for medication in stable-phase moderate-to-severe COPD patients have moved beyond the previous single-drug approach. They now explicitly recommend the concurrent use of two bronchodilators (β2-agonists and anticholinergics).Practice has demonstrated that this approach yields superior outcomes, reducing the frequency of acute exacerbations while markedly improving quality of life, dyspnea, and lung function during stable periods.
Patients should diligently learn
the correct usage of inhalation devices.
Professor Chen Rongchang, Director of the Shenzhen Institute of Respiratory Diseases and Chair of the Respiratory Disease Committee of the Chinese Medical Association, emphasizes that inhalation therapy is a crucial treatment modality for respiratory diseases.Inhalation allows drugs to reach target organs directly, achieving high local concentrations and rapid onset. Simultaneously, systemic requirements are low, necessitating smaller total doses and reducing side effects. Thus, inhalation therapy offers unique advantages in treating respiratory diseases. Unfortunately, incorrect use of inhalation devices remains widespread among patients.Some fail to tilt their heads back sufficiently during use; others do not fully exhale before inhaling; some lack adequate inhalation force or hold their breath too briefly after inhaling, resulting in insufficient drug retention time... These issues occur across commonly used inhalation devices, with at least 30% of patients using them incorrectly. Even experienced users may still make these mistakes.Improper inhaler use compromises disease control, significantly increasing risks of breathlessness, severe exacerbations, and even death. Zhong Nanshan also noted that many elderly individuals, particularly women, struggle with traditional inhalers, resulting in high error rates. Some powder-based inhalers face similar issues, requiring forceful inhalation. Thus, selecting an appropriate nebulizing device is crucial for achieving therapeutic goals.
Experts remind COPD patients that beyond prioritizing treatment and adhering to medication regimens, correct device usage is paramount. After receiving prescriptions, patients must diligently learn proper techniques from doctors or nurses.
While synergistic effects from combining two bronchodilators are widely recognized, previous formulations did not integrate both drugs into a single device.With advances in medical technology, numerous new bronchodilator drugs have emerged alongside innovative research. These developments now allow combining both medications into a single device, accelerating onset and prolonging duration to maximize therapeutic efficacy. Rehabilitation: Practicing Tai Chi proves highly beneficial. Zhong Nanshan explains that COPD-related shortness of breath stems from respiratory distress, emphasizing the critical importance of breath regulation for patients.Additionally, COPD is a systemic disease that triggers inflammatory responses in the muscular system and may even lead to muscle atrophy. For daily rehabilitation, common international approaches include breathing exercises and slow walking. In China, patients are also advised to practice Tai Chi, as most of its postures involve a half-squat position.Medical experts have discovered through quadriceps strength testing and respiratory center assessments that the half-squat position provides thigh muscle training comparable to walking. Furthermore, Tai Chi emphasizes posture control and breath regulation—precisely these two elements make it highly effective for COPD rehabilitation.