South Florida Sun-Sentinel (Sunday)
Benefits of pulmonary rehab
Q: My father has had COPD for years, but he was hospitalized for worsening symptoms. His health care provider advised that he should begin a pulmonary rehabilitation program. He is unsure of what to expect. What are the benefits of pulmonary rehabilitation in people with COPD? Do you recommend it for people with other lung conditions? A: Pulmonary rehabilitation is a medically supervised program that includes exercise training, health education, behavior modification, nutritional counseling and the learning of breathing techniques for people who have certain chronic respiratory diseases or lung problems. Pulmonary rehabilitation seeks to improve the physical and psychological condition of people with chronic respiratory disease, and educate these people on how to maintain behaviors that will benefit their health for years to come.
Pulmonary rehabilitation is beneficial for people with chronic obstructive pulmonary disease, or COPD. It has been shown to reduce symptoms of breathlessness, improve physical function and enhance quality of life. Research has shown that people who start pulmonary rehabilitation within three months of hospitalization for COPD-related issues are at significantly lower risk of death after one year, compared to those who start pulmonary rehabilitation later or those who do not take part in pulmonary rehabilitation. More evidence is emerging that pulmonary rehabilitation improves symptoms, exercise capacity and quality of life in people with conditions such as interstitial lung disease, asthma, pulmonary
hypertension and cystic fibrosis, as well as in people before and after surgery for lung cancer, lung volume reduction or a lung transplant.
Although pulmonary rehabilitation is traditionally performed in a clinic or hospital setting under direct medical supervision, increasing evidence suggests that home-based pulmonary rehabilitation, particularly home-based exercise training, is safe and possibly just as effective. Such home-based rehabilitation may be more convenient for participants.
Exercise training is central to pulmonary rehabilitation. An individualized exercise training plan often is based on the information gathered from exercise tests performed before starting the program. Exercise training, which combines aerobic exercise, such as treadmill walking or riding a bike; strength training; and exercises that improve balance and flexibility, is designed to improve strength and stamina, and reduce breathlessness, fatigue and tiredness. The rehabilitation team may recommend using medication to open up the airways before exercise or teach
people how to adjust their regular oxygen therapy during exercise to maximize the benefits gained.
Participants also may learn specific breathing techniques such as diaphragmatic breathing, pursed lip breathing or yoga breathing. These techniques can help people with lung conditions better control their breathing, and help them better cope with stressful situations and avoid feeling out of breath.
Education and counseling are also key parts of pulmonary rehabilitation. Participants may receive education on how to more effectively take their medicines and manage their disease; develop a plan to quit smoking, if applicable; and discuss how routine daily tasks can be modified to minimize breathlessness. Overall, participation in pulmonary rehabilitation is a critical component in managing COPD.