Pulmonary rehabilitation refers to structured, usually multi-disciplinary programs that aim to reduce the symptoms, disability and handicap arising from long-term respiratory disorders and to help patients reach and maintain a good level of functioning in the community. Pulmonary rehabilitation is mostly offered to patients with moderate to severe COPD, but can be applied to people with any long-term respiratory disorder characterised by dyspnoea.
Pulmonary rehabilitation has been demonstrated to improve exercise tolerance, work capacity, and quality of life whilst decreasing the perception of dyspnoea and health-care utilization. The ATS (American Thoracic Society) has included pulmonary rehabilitation as an important component in the comprehensive outpatient management of COPD.
Pulmonary Rehabilitation aims to:
- Improve exercise capacity
- Reduce work of breathing
- Reduce dyspnoea
- Improve participation in activities of daily living
- Decrease disability
- Improve ability to cope with chronic respiratory impairment
- Improve efficiency of energy expenditure
- Improve nutritional state
- Improve emotional well-being
- Support smoking cessation
- Improve long-term survival
- Decrease health-care utilization
Pulmonary Rehabilitation is indicated in an individual with chronic respiratory impairment who despite optimal medical management has (ATS 1999):
- Anxiety engaging activities
- Breathlessness with activities
- Limitations with:
- Social activities
- Leisure activities
- Indoor / outdoor chores
- Basic ADLs
- Loss of independence
Participants need to:
- Be clinically stable for at least 4 weeks prior to commencing the program
- Be optimally managed medically
- Have intact cognitive function
- Have no other medical condition that could place the participant at risk during exercise training (e.g. unstable angina, unstable heart failure, syncopy) or other limitations to their exercise tolerance (EEG, severe arthritis)
- Be referred by a respiratory physician
The program runs twice a week, for 6 weeks. Each session lasts 2 hours - 1 hour is dedicated to exercise, the other to education, which include the followin