Amasu Okwelapha Ngokuzivocavoca Ukwandisa Amandla Amaphaphu
Umthamo omuhle wamaphaphu udlala indima enkulu ekugcineni amandla, ikhwalithi yokulala, kanye nekhono lomzimba lokusebenza ngaphandle kokukhathala. Ngeshwa, abantu abaningi babhekana nokwehla kancane kancane kwamandla amaphaphu ngenxa yokuphila ngokungahlali phansi, ukubhema, ukungcola komoya, ukuguga, kanye nezimo ezithile zezokwelapha ezifana ne-asthma, i-COPD (Isifo Esingapheli Sokuvimbela Amaphaphu), noma izifo ezithathelwanayo ngemva kokuphefumula. Yilapho i-physiotherapy yokuphefumula (i-physiotherapy yokuphefumula) idlala khona indima ebalulekile. Ngamasu okuzivocavoca aqondiwe kanye nokungenelela, i-physiotherapy ingasiza ekuthuthukiseni ukusebenza kahle komoya, ukuqinisa imisipha yokuphefumula, ukuthuthukisa amaphethini okuphefumula, nokukhulisa ukubekezelelana kwemisebenzi.
Lesi sihloko sixoxa ngamasu ahlukahlukene okwelapha umzimba avame ukusetshenziswa ukwandisa amandla amaphaphu, kokubili ukuvimbela, ukululama, kanye nokuthuthukisa ukuqina komzimba.
1. Qonda “amandla amaphaphu” kanye nemigomo ye-physiotherapy
Kalula nje, amandla amaphaphu abhekisela ekhonweni lamaphaphu lokubamba umoya nokushintshanisa umoya-mpilo kanye ne-carbon dioxide ngempumelelo. Emtholampilo, leli khono lihlolwa kusetshenziswa imingcele eminingana, njengomthamo womoya ojwayelekile (ukuphefumula okuvamile), amandla okuphila (inani lomoya elingakhishwa ngemva kokuphefumula okuphezulu), kanye nomsebenzi wokuphefumula (isib., i-FEV1 ku-spirometry).
Ukwelashwa nge-physiotherapy akugcini nje ngokugxila “ekwandiseni amaphaphu”, kodwa futhi naku:
- Khulisa ukwanda kodonga lwesifuba kanye nokuqina kwezicubu
- Kunciphisa umsebenzi wokuphefumula ukuze ukuphefumula kuzwakale kulula
- Kuqinisa imisipha yokuphefumula kanye neyokuphefumula (i-diaphragm, i-intercostals, imisipha yesisu)
- Kuthuthukisa ukuhlanzwa koketshezi (amafinyila) ukuze kwenziwe kube lula ukuphefumula
- Khulisa ukubekezelela imisebenzi ngokuzivocavoca okuhleliwe kwe-aerobic
Ngakho-ke, ukwanda kwamandla amaphaphu okubonwa yiziguli kuvame ukwenzeka ngenxa yokuhlanganiswa kobuchwepheshe bokuphefumula obuthuthukisiwe, ukufaneleka komzimba, kanye nokusebenza kahle kokusetshenziswa komoya-mpilo.
2. Ukuzivocavoca kokuphefumula kwe-diaphragmatic
Lokhu kuvivinya umzimba kuyisisekelo se-physiotherapy yokuphefumula ngoba kufundisa ukuphefumula okuphumelelayo kusetshenziswa i-diaphragm, hhayi imisipha yesifuba engenhla kuphela. Ukuphefumula kwesifuba okungajulile kuvame ukwandisa umsebenzi wokuphefumula futhi kukhathaze umzimba ngokushesha.
Indlela yokwenza:
1. Isimo sokulala: ulele ngomhlane noma uhleli kancane, amahlombe ekhululekile.
2. Beka isandla esisodwa esifubeni sakho kanye nesandla esisodwa esiswini sakho.
3. Phefumula kancane ngekhala lakho kuze kube yilapho isandla esiswini sakho siphakanyiswa phezulu, kuyilapho isifuba sakho sihlala singanyakazi.
4. Khipha umoya kancane (ungakwenza lokhu ngezindebe ezigoqiwe).
5. Phinda imizuzu emi-5-10, ka-1-3 ngosuku.
I-Manfaat:
- Khulisa ukuphefumula kwamaphaphu aphansi
- Kunciphisa ukuphelelwa umoya ngenxa yokuphefumula okungajulile
- Yehlisa ukucindezeleka kwemisipha yentamo nehlombe
3. Ukuphefumula Ngezindebe Ezicindezelwe
Le ndlela ithandwa kakhulu yiziguli ezine-COPD, kodwa futhi inenzuzo kunoma ubani ophelelwa umoya ngesikhathi sokuzivocavoca. Ukuphefumula ngezindebe ezigoqiwe kwandisa isikhathi sokuphefumula, kusiza ukuvimbela ukudilika kwemigudu yokuphefumula emincane, futhi kunciphisa ukubanjwa komoya.
Indlela yokwenza:
1. Phefumula ngekhala lakho ubale izikhathi ezimbili.
2. Hlanza izindebe zakho njengokungathi ucima ikhandlela.
3. Khipha umoya kancane kancane izikhathi ezine (isikhathi eside kunogqozi).
4. Kwenze uma uphelelwa umoya, noma njengokuzivocavoca okuvamile kwemizuzu emihlanu.
I-Manfaat:
- Yehlisa imvamisa yokuphefumula
- Kuthuthukisa ukulawula ukuphelelwa umoya
- Kusiza ukuhlanza umoya ophuma emaphashini ngempumelelo enkulu
4. Ukuzivocavoca Kokukhulisa Isifuba
Lokhu kuzivocavoca kuhlose ukwandisa ukuhamba kwezindonga zesifuba, ukuthuthukisa umoya ophumayo, nokuvimbela ukuqina kwezimbambo nemisipha yokuphefumula—ikakhulukazi kubantu asebelele phansi isikhathi eside, ngemva kokuhlinzwa, noma asebehlale phansi.
Izibonelo zokuzivocavoca:
– Phefumula kakhulu ngenkathi uphakamisa izandla zombili phezulu noma uvula izingalo zakho eceleni (uvula isifuba sakho).
– Bamba imizuzwana emi-2-3, bese ukhipha umoya kancane.
– Phinda izikhathi ezingu-5–10 ngeseshini ngayinye, izikhathi ezingu-2–3 ngosuku.
I-Manfaat:
- Kusiza ekutholeni ama-alveoli (ama-air sacs)
– Isekela ukuvimbela i-atelectasis (iphaphu eliwile kancane)
- Thuthukisa ukuma komzimba okuthinta amaphethini okuphefumula
5. Ukuzivocavoca okuphumelelayo kokukhwehlela nokufutha
Ezimweni ezithile (isib., ukukhiqizwa ngokweqile kwe-phlegm, i-bronchitis, noma ngemva kokutheleleka), inkinga eyinhloko akuyona nje amandla amaphaphu, kodwa nezindlela zokuphefumula ezivinjwe uketshezi. I-Physiotherapy ifundisa amasu okuhlanza umoya ukuze kuthuthukiswe ukuphefumula.
Ukukhwehlela okusebenzayo:
– Phefumula kakhulu, ubambe imizuzwana engu-1-2, bese ukhwehlela ngamandla izikhathi ezingu-1-2.
Ukukhwehlela (Ukukhwehlela Okukhulu):
– Phefumula kancane, bese ukhipha umoya ngokushesha nangamandla umlomo wakho uvulekile njengokungathi ufaka ingilazi enomoya (“ha, ha”).
– Ngokuvamile banobungane kakhulu ezigulini ezikhathala kalula noma ezizwa ubuhlungu kunokukhwehlela okunamandla.
I-Manfaat:
- Kusiza ukususa amafinyila ngaphandle kokukhipha amandla amaningi
- Ivula izindawo ezazingenawo umoya owanele emaphashini
6. Indlela Yokusebenza Yokujikeleza Kokuphefumula (i-ACBT)
I-ACBT iwuchungechunge lwezindlela ezihlanganisa ukuphefumula okukhululekile, ukukhulisa isifuba, kanye nezindlela zokufutha. Isetshenziswa kabanzi ezigulini ezikhiqiza i-phlegm.
Izingxenye ze-ACBT:
1. Ukulawula ukuphefumula: phefumula kancane, phumula imizuzwana engama-20-30.
2. Ukwandiswa kwesifuba: ukuphefumula okujulile okungu-3-5, bamba imizuzwana engu-2-3.
3. Ukukhwehlela/ukufutha: Ukufutha okungu-1–2 ukukhipha uketshezi.
Lo mjikelezo ungaphindaphindwa izikhathi eziningana kuze kube yilapho ukuphefumula kuzwakala kukhululekile.
7. Ukuqeqeshwa kwemisipha okuphefumulela (IMT)
I-IMT isebenzisa idivayisi ekhethekile yokumelana (isb., i-threshold IMT) ukuqeqesha imisipha ephefumulayo ukuze ibe namandla futhi ihlale isikhathi eside. Le ndlela ivame ukusetshenziswa ezigulini ezine-COPD, abasubathi, noma labo abanobuthakathaka bemisipha yokuphefumula.
Izimiso zokuzivocavoca:
– Phefumula ngethuluzi ngomthwalo othile.
– Ngokuvamile imizuzu eyi-15-30 ngosuku, izinsuku ezi-5-7 ngesonto, kanye nokuqhubeka kancane kancane ngokuya ngokuhlolwa kochwepheshe be-physiotherapist.
I-Manfaat:
- Kunciphisa umuzwa wokuphelelwa umoya ngesikhathi semisebenzi
- Khulisa amandla e-diaphragm
- Thuthukisa ukusebenza kokuzivocavoca kwe-aerobic
8. Ukunyakaza, ukuzivocavoca nge-aerobic, kanye nokuqeqeshwa kwamandla
Abantu abaningi bacabanga ukuthi ukwandisa umthamo wamaphaphu kwenzeka kuphela ngokuzivocavoca kokuphefumula. Kodwa-ke, ukuqina komzimba kwenhliziyo nokuphefumula kuthuthuka kakhulu ngokuzivocavoca okulinganiselwe kwe-aerobic, njengoba umzimba uba ngcono kakhulu ekusebenziseni umoya-mpilo.
Izibonelo zezivivinyo eziphakanyisiwe:
– Ukuhamba ngokushesha, ukugibela ibhayisikili okungaguquki, ukubhukuda okulula (njengoba kuvunyelwe)
– Isikhathi sokuqala imizuzu eyi-10–20, kancane kancane sanda sibe yimizuzu engama-30–45
- Imvamisa izikhathi ezi-3–5 ngesonto
Ukuqeqeshwa kwamandla (isib. ukugoqa kancane, ukuzivocavoca umhlane namahlombe) nakho kusiza ukuma kahle kanye nokusebenza kahle kokuphefumula, njengoba i-pelvis nomgogodla ozinzile kwenza imisipha yokuphefumula isebenze kahle kakhulu.
9. Amasu okukhipha amanzi emzimbeni kanye nokubeka indawo
Kwezinye izimo, izikhundla ezithile zomzimba zisiza ekukhipheni uketshezi futhi zithuthukise ukuphefumula. Isibonelo, ukulala ngohlangothi noma ukuthambekela kungasiza ekusabalaliseni umoya ngokulinganayo ezindaweni ezithile zamaphaphu. Kodwa-ke, lezi zindlela kudingeka zilungiselelwe isimo sesiguli, ikakhulukazi uma kunezinkinga zenhliziyo, i-reflux, noma izinkinga zomfutho wegazi.
10. Amathiphu okusebenza ngokuphepha nokuthi kufanele uthintane nini nodokotela
Amasu okwelapha ngokuphefumula kufanele enziwe kancane kancane. Yeka ukuvivinya umzimba uma uzwa isiyezi esikhulu, ubuhlungu besifuba, ukuphelelwa umoya okuya ngokuya kuba kubi, izindebe eziluhlaza okwesibhakabhaka, noma ukushaya kwenhliziyo okungalawuleki.
Kungcono ukubonana nodokotela noma nodokotela uma:
– Ukuphelelwa umoya kuvame ukwenzeka ngisho noma umsebenzi ulula
- Unomlando we-asthma/COPD, isifo senhliziyo, noma ngemva kokuhlinzwa
– Ukukhwehlela okune-phlegm ehlala isikhathi esingaphezu kwamasonto amabili kuya kwamathathu
- Ngiye ngabhekana nokwehla kokugcwala komoya-mpilo
Isiphetho
Amasu okwelapha ngokuzivocavoca umzimba ukwandisa umthamo wamaphaphu afaka phakathi izivivinyo zokuphefumula ze-diaphragmatic, ukuphefumula ngezindebe eziqhutshwa ngamandla, izivivinyo zokukhulisa isifuba, ukususwa kokukhipha (ukukhwehlela okuphumelelayo, ukufutha, i-ACBT), ukuqeqeshwa kwemisipha ephefumulelayo (i-IMT), kanye nezivivinyo zokuqinisa imisipha nge-aerobic kanye ne-muscle ngentuthuko elinganisekayo. Isihluthulelo sempumelelo sisekuhambisaneni, ubuchwepheshe obufanele, kanye nokulungiswa kohlelo ngokusekelwe ezimweni zomuntu ngamunye. Ngesiqondiso sobungcweti, i-physiotherapy yokuphefumula ingasiza ekuthuthukiseni ukuphefumula, ukwandisa umsebenzi, kanye nokuthuthukisa kakhulu ikhwalithi yokuphila.
