Yoga for COPD. Increase breath awareness and depth, as well as asana to bring awareness to secondary muscles of respiration.

The goal is to implement a regular pranayama/asana practice that is accessible to the client, so they may increase the oxygen to the tissues and help remove the carbon dioxide from the lungs. Client will attempt to practice daily and look to the comfort of the breathing exercises to measure its success. Overall energy will also be assessed daily.

Male, 64 generally healthy, new diagnosis of COPD with some emphysema. Lifetime of cigarette and or marijuana smoking. He has a martial arts practice using some breathing exercises. He also walks 1-2 hours a day.

Centering with the breath, cue to feel parts of breath and notice as it deepens and lengthens. Let client know to remain comfortable in the depth or length of breath. Adjust if uncomfortable.
Cat/Cow to move ribs, scapula, spine with breath, cue active exhale using abdominal muscles, full inhale.
Lateral stretch lifting arm on In, lateral on Ex, on 4th rep stay, inhale, spreading ribs gently with breath.
Anuloma Ujjayi In ujjayi Ex alt L/R nostril Langhana breath few minutes

To bring awareness to the breath and help to expand the breath capacity for improved oxygen/carbon dioxide turnover, the plan is primarily Hatha, involving breath and some movement.
Progressively the plan is to add sound on exhale to a mantra. Thus incorporating japa.
Bhakti, Jnana and Raja are important for deeper answers to the path of life. COPD is thought of as a progressive disease and may bring thoughts about mortality. Self study may also help with the depths of disease and the willingness to stay on the path to better health. Using the willingness and work to quit smoking are examples of saucha and tapas that could open into discussions that lead to other Niyama and yama concepts.
Karma may be beneficial to help stop smoking. Like AA, addicts can do well to help other addicts. Maintaining a smoke free life is highly important.

I met this client online. He has a wife, primarily friendly relations, and a dog. He has a longtime relationship with marijuana and occasionally tobacco and alcohol comes and goes. He derives self worth from teaching martial arts and caring for his wife, who works and has had cancer twice. I feel this is an area to build happiness and further self worth. Doing service or additional teaching could help satisfy his more subtle koshas.
He is very motivated to improve his chances with emphysema. We reviewed his goals and went over his routine a few times to help create a practice he can do easily, maybe multiple times a day. He feels he could do the practice 2-3 times a day. He seemed excited to add a mantra on his exhale in the future.

For a client with new diagnosis and not severe disease manifestation, it might be helpful to add more movement and breath as he gains ability to do the practice. He will need to monitor his breath ie shortness of breath by comparing his daily walks to notice a difference. I suggested a notebook to write that down as well as any thoughts he might have during his day. ( My aim here is to try and encourage a bit of navel gazing, looking at his own breathing to what kind of thoughts he has.)The long term goal is to work towards increasing energy and having ease of breath as time goes on. He should continue any and all exercise, continue to eat a primarily vegan diet. He may have to wait til post COVID to do more service and teaching.

I did apply the plan, he seemed to find it easy and beneficial in that moment. talking to him 2 weeks later, he has been doing it 1-3 times a day and feels breathing is easier. He feels the stretch with the breath is helping to open his ribs and it feels good to have easier movement there. He notices slightly more energy. I hope to meet with him soon to bring in the idea of mantra. to do so will entail a deeper dive into his wishes for the future. Svadyaya and sankalpa to help determine his direction, motivation and support for his physical, mental. emotional and spiritual well being.

His plan was adapted in the sense that it was suited to his current condition COPD. In the future I hope he adds more movement with the breath to continue improving his lung ventilation. If he continues to smoke he may end up progressively getting worse. In fact his best hope is to take care of his lung health, by quitting, then add the healthy lifestyle and yoga.
As I know this client well, it seems that his diagnosis was still a surprise. I have just completed a paper on COPD and yoga therapy, it is lucky his doctor recommended the test even though he had mild symptoms. Now that he knows and it is early, he will be able to make changes to extend his life and have better energy. In this case, the most important issue is to stop smoking, and stay inside with an air purifier when there are fires around his home area. With the west coast wild fires this will also be challenging.

I would. My hope would be that the client would ask for more and practice regularly. As a yoga therapist I am cautious not to overwhelm the client and try to be as efficacious as possible with the first practice. In this case he was highly motivated by a scary diagnosis. He is healthy so it can hit hard, when a person is living well and exercising regularly a chronic diagnosis can be hard. I have found in 30 years of Naturopathic practice that those who have not been taking care of themselves, combined with a chronic disease, autoimmune or diabetes, can be harder to work with and jump on board, but if they do, they often have great results fast. I would add to his practice regularly to continue progress. COPD can seem silent at first, but it is almost always progressive, so maintaining progress in his practice may be essential to his overall prognosis. In this case he is healthy, eats well, exercises regularly and has a stable home life. I would encourage more joy through self success, he finds happiness teaching martial arts. Finding ways to capitalize on his attributes, is important in the Kosha sense. His self worth is in being a care taker for his wife and dog and teaching.