Pulmonary Rehabilitation

Pulmonary (PUHL-moh-ner-EE) rehab (short for pulmonary rehabilitation or PR) is a program for children with moderate or severe lung disease. It’s run by a team of doctors, nurses, respiratory therapists, exercise physiologists, and registered dietitian nutritionists. A pulmonary rehab program includes:

• Exercise training to make your child’s body stronger and give them more energy
• Education about your child’s lung condition and what your child can do to breathe easier, and what you can do to help them
• Support and counseling to help you deal with the difficulties that often come from raising a child with lung disease

Pulmonary rehab isn’t “one size fits all.” The rehab team will work with you to create a plan that is based on your child’s condition, needs, and goals. Our goal is to create a program that is designed to meet your child’s exact needs.

Pulmonary rehab is designed to be safe, with therapists checking your child’s comfort and symptoms. In rare cases pulmonary rehab may affect your child’s health in unexpected ways.

Pulmonary rehab brings a very small risk of:

• Abnormal heartbeat or blood pressure
• Lower heart function
• Chest pain
• Heart attack

Although your child will be fully monitored during the program, tell the rehab staff right away if your child complains about any symptoms. If your child has a health emergency during a rehab session, healthcare providers will be available to treat it immediately.

Studies show that pulmonary rehab programs make a big difference for children at all stages of lung disease. Specifically, the program can:

• Ease your child’s shortness of breath
• Build your child’s capacity for exercise and activity
• Reduce you and your child’s anxiety and depression
• Help your child stay out of the hospital

Doctors often prescribe pulmonary rehab for children with COPD (chronic obstructive lung disease), interstitial (IN-tuhr-STIH-shul) lung disease (sarcoidosis (SAHR-koi-DOH-sis) or hypersensitivity pneumonitis (NOO-moh-NYE-tis), for example), pulmonary hypertension, asthma, and other chronic lung diseases.

Pulmonary rehab can help your child:

• Ease shortness of breath
• Improve endurance and ability to exercise
• Build or maintain flexibility and strength
• Lower emotional stress
• Ease anxiety and depression

Stay healthier and avoid hospital trips

If your child is hospitalized with a breathing problem, your first visit to pulmonary rehab may happen during the hospital stay. This is inpatient pulmonary rehab. You may also choose an outpatient pulmonary rehab program for your child. Some people attend an outpatient program with their child for as little as a few weeks, or on an ongoing basis. Your child’s doctor can refer you to a program in your area.

How does the program work?

Each pulmonary rehab program is different. Yet, they all share these basic features:

• Initial assessment. The rehab staff examines your child’s condition, needs, and lifestyle. They’ll try to understand what limits your child and what concerns you have regarding your child’s daily life. Your child may have tests to check their physical abilities.
• Special planning. You’ll work with the rehab staff to design a plan that meets your child’s needs. Your child’s plan may include how often to come to the rehab center and an easy-to-follow exercise plan to use at home. Your child’s plan can be changed as needed.
• Ongoing communication with your doctor. Rehab staff will share your plans and your child’s progress with the doctor who referred you to the program.
• Classes and exercise sessions. These give you and your child the skills, knowledge, and ability to improve their health and well-being. They also give you a chance to share with other people who have children with lung disease — and who are also striving to improve.

What happens in the classes?

Living better with lung disease requires certain knowledge and skills. Pulmonary rehab classes include topics like:

• Your child’s lung disease. This includes learning about your child’s condition and why treatment is important, how it can help your child’s symptoms, and why you must actively follow your child’s treatment plan.
• Breathing techniques. You and your child will learn and practice specific techniques to ease shortness of breath, help your child relax, and clear your child’s lungs.
• Emotional impact of lung disease. Your child’s breathing is affected by their mood. You and your child will learn ways to reduce stress, seek support, and cope with the challenges of chronic lung disease.
• Nutrition. You and your child will get information on what and how to eat so that your child has better energy, stronger bones and muscles, and a healthy weight.
• Ways to make everyday activities easier. You and your child will learn tips and tricks for conserving your energy throughout the day.
• Exercising at home. Most people with lung disease need regular exercise. Rehab classes can give you advice for how to help your child follow an exercise plan at home.

What happens in the exercise part?

In pulmonary rehab, your child’s exercise program is uniquely designed for them. It lets your child start at their own pace, and helps them gradually increase activity as they are able.

As your child exercises at pulmonary rehab, the staff will watch to make sure your child is safe and keep track of their progress. They’ll also watch your child’s blood pressure, blood oxygen, weight, and exercise ability. If your child also has a heart problem, he or she may wear sticky patches (electrodes) on their chest that are connected to a monitor to check their heart rate and rhythm.

The exercise program has five parts:

• Warming up. Rehab staff will help your child gradually warm up at the start of each session. This helps their body prepare for a workout and lessens the chance of problems during exercise.
• Endurance activity. Also called aerobic exercise, endurance activity includes walking and cycling — any activity that gets your child’s heart pumping and their blood moving a little faster. Endurance activity helps your child’s body use oxygen more efficiently. This makes everything else they do during the day — such as standing, showering, playing, cleaning, laughing — easier and less tiring.
• Strength training. This isn’t about body building or struggling with heavy barbells. Pulmonary rehab staff will guide your child in strength exercises that use little (or no) special equipment. The goal is to build muscle strength and endurance. Rehab staff will pay special attention to strengthening your child’s chest and arm muscles. When these muscles are strong, they can ease the strain on other muscles and help your child breathe better.
• Flexibility. Gentle stretches can improve your child’s balance and make it easier to move. Stretching can also reduce pain, stiffness, and stress. Pulmonary rehab staff can show you and your child stretches to help open up your child’s chest and lungs for easier breathing.
• Cooling down. Gradually slowing down can help keep your child’s muscles from getting stiff after exercise.

Of course, not all of your child’s exercise needs to happen at the pulmonary rehab facility. Pulmonary rehab staff will teach you to take what you’ve learned back to your own living room or den, so that you can help your child continue to grow stronger in between pulmonary rehab sessions.

The results of your child’s pulmonary rehabilitation program will vary based on the nature of your child’s condition. Please talk to your child’s doctor about the results you can expect and how quickly you can expect them.

Your child’s doctor may schedule follow-up appointments to help monitor your child’s progress in the pulmonary rehabilitation program. Specific follow-up requirements will vary based on your child’s condition. Talk to your child’s doctor about your child’s follow-up requirements for additional information.

Pulmonary (PUHL-moh-ner-EE) rehab, short for pulmonary rehabilitation or PR, is a program for people with moderate to severe lung diseases. Although PR is for anyone with a lung disease, there are different programs for different people, such as children, adults, and the elderly. Programs for children are designed to help keep them engaged and get the maximum benefit from their program.