Smoking and Bronchitis in Chronic Obstructive Pulmonary Disease (COPD): Physiotherapy Management


COPD is an umbrella term which includes a combination of symptoms such as chronic bronchitis, emphysema and some chronic cases of asthma.

COPD required continual treatment or management of symptoms through therapy or medication.Initially it is hard to detect because of similarities with other respiratory conditions. In severe condition, it required quick access to oxygen therapy and inhalers.

People with COPD find it difficult to stay outside home for a very long time,as they need oxygen and are dependent on the nasal cannula and face mask.



The major cause of COPD which affects the lungs and airways is cigarette smoke(in smokers and non smokers) and according to some researchers more than one in ten of smokers have this condition. In non-smokers, physicians diagnosed 5% of COPD. Long term exposure to air pollution including traffic, burning or other general pollution can cause COPD. Alpha-one deficiency as a genetic risk for COPD development

1. Smoking

The relationship of COPD and smoke is connected to loss of functional lung volume.A device called a spirometer is used to calculate the functional lung volume.

According to Physiouk,the efficiency of breathing and functional lung volume decline as a person gets older.So for non-smokers the decline rate is 25 milliliter per year and in smokers with COPD the decline rate will lose around 60mililiter in a year.

When cigarette burns it release more than 7000 chemicals including tar, carbon monoxide, oxidizing chemicals,metals and many radioactive compounds.Nicotine is also an addictive substance, the harmful toxins weakens the lungs,narrow airways, swollen or destroy air sacs, irritate trachea and larynx and other lung infections.

How these chemicals effect on lung:

Normally the sticky mucus present on lungs swept out the lungs through cilia,these cilia are on epithelial cells of trachea, bronchi and bronchioles. Cigarettes containing harmful chemicals attack on these cells leading to increase of mucus production which result in irritation of bronchi and thus cause cough.

Damage alveoli walls cause decrease in gas exchange efficiency,at the end, the person feel difficulty in breathing.

2. Bronchitis

is long term inflammation or infection of main airways(bronchi) in which mucus thickened ,also cough and sputum produce in this condition.

  • Acute bronchitis(als known as chest cold) is due virus that cause cold or other respiratory infection.
  • Chronic bronchitis is due to smoking, dust,or air pollution when there’s constant irritation of lining of bronchial tubes.

In acute conditions,the mucus can clear.While in chronic condition it’s quite difficult. Cessation of smoking may result in reduction of COPD symptoms.

Physiotherapy Management(Pulmonary Rehabilitation)

Pulmonary rehabilitation is a domain of physiotherapy that helps to learn how to breathe easier and manage lung disease like COPD. Doing exercise and avoiding a sedentary lifestyle is important to keep yourself fit, active, healthy and strong.In this rehabilitation, physiotherapists measure functional lung capacity and provide treatment plan according to patient’s symptoms. Pulmonary rehabilitation is a great option for anyone diagnosed with lung disease e.g COPD. It involves breathing exercises, techniques of airways clearance and inhalation therapy to clear phlegm.

In some conditions physiotherapists also collaborate with pulmonologists to prescribe breathing machines like continuous positive airway pressure (CPAP), non-invasive positive pressure (NIV) or bilevel positive airway pressure (BiPAP).


  • Shortness of breath
  • Exercise tolerance
  • Gas exchange
  • Removal of airways mucus secretion
  • Control disease and help to carry out daily life activities


  • Aerobic exercise e.g walking, jogging, swimming
  • Manual assistance (including chest percussion, vibration and shaking)
  • Turning for lung expansion
  • Deep breathing exercises (control respiratory rate)
  • Postural drainage

Education and Counseling

  • Avoid air pollution and smoking
  • Disease causes and progression
  • Medication management
  • Importance of exercise and pulmonary rehabilitation