becomes harder for these air sacs to deflate like normal lungs as trapped air makes it increasingly difficult to get fresh air into the lungs, making breathing more challenging.

Causes include smoking, long term exposure to second-hand smoke, air pollution, dust or workplace fumes and biomass exposure. In developed countries COPD is caused mainly by cigarette smoking where over 25% of smokers develop COPD in their lifetime (Mannino, 2002). On the other hand in In developing countries, the leading cause is exposure to biomass fuel. An uncommon genetic disorder called alpha 1-antitrypsin deficiency is also sometimes associated with COPD. Respiratory infections such as influenza and Pneumonia can worsen symptoms therefore it becomes more important to obtain these vaccinations.

DIAGNOSIS:

Typically people with COPD possess all of the symptoms stated above and spirometry is the most effective way to determine airway obstruction caused by this disease. Patients inspire maximally before forcefully expiring; the total exhaled volume of air in one second (forced expiratory volume in one second, FEV1) and the total exhaled volume (forced expiratory vital capacity, FVC) are measured. (Yu et al., 2013). In 90% of COPDsufferers, two successive tests at short time increments display similar FEV1 values, differing from less than 225 mL between them (Salvi and Barnes, 2009).

In Ireland there are approximately 110,000 people who have been diagnosed with COPD, however it is estimated that there are around 2 00,000 undiagnosed sufferers of this disease as many believe their symptoms are mainly as a result of “smokers cough” and fail to seek professional help. It is one of the most prevalent respiratory diseases nationally and in most cases sufferers are people over the age of 35 (HSE.ie, 2019). One in five Irish adults smoke daily this is roughly equal to 714,000 people with the highest prevalence being in men aged between. 25 and 34 years old. (HSE.ie, 2019). COPD is the fourth leading cause of death in the United States, succeeding heart disease, cancer and cerebrovascular disease. Death rates from this disease doubled within 32 years from 1970 to 2002 and the amount of people who are affected and die from this disease are on the rise. COPD patient death rates from exacerbations in the US are approaching 60% at one year for those over the age of 65 (Devine, 2008). Multitudes of patients endure COPD for many years, eventually passing away prematurely as a result of its complications.

EXERCISE AS MEDICINE:

The nature of exercise training an individual patient needs is based on their own physiological condition. Exercise is very important for healthy people and for COPD patients as it’s a critical element of the pulmonary rehabilitation programme and exercising regularly improves quality of life and general health. The PR programme trains one to breathe more effectively , start at what capable of

At present, pulmonary rehabilitation (PR) is recommended by the prese