Pulmonary Rehabilitation

Pulmonary (PUHL-moh-ner-EE) rehab (short for pulmonary rehabilitation or PR) is a program for people 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 body stronger and give you more energy
• Education about your lung condition and what you can do to breathe easier

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

Pulmonary rehab is designed to be safe, with therapists checking your comfort and symptoms. But, as with any exercise, pulmonary rehab may affect your 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 you will be fully monitored during his or her program, tell the rehab staff right away if you feel any symptoms. If you have 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 people at all stages of lung disease. Specifically, the program can:

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

Doctors often prescribe pulmonary rehab for people with the following conditions:

• COPD (chronic obstructive lung disease)
• Interstitial (IN-tuhr-STIH-shul) lung disease
• Sarcoidosis (SAHR-koi-DOH-sis)
• Hypersensitivity pneumonitis (NOO-moh-NYE-tis)
• Pulmonary hypertension
• Asthma
• Other chronic lung diseases

Pulmonary rehab can help you:

• Ease shortness of breath
• Improve your endurance and ability to exercise
• Build or maintain your flexibility and strength
• Lower your emotional stress
• Help you stay healthier and avoid hospital trips

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

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

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

What happens in the classes?

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

• Your lung disease. This includes learning about your condition and why treatment is important, how it can help your symptoms, and why you must actively follow your treatment plan.
• Breathing techniques. You will learn and practice specific techniques to ease shortness of breath, help you relax, and clear your lungs.
• Emotional impact of lung disease. Your breathing is affected by your mood. You will learn ways to reduce stress, seek support, and cope with the challenges of chronic lung disease.
• Nutrition. You will get information on what and how to eat so that you have better energy, stronger bones and muscles, and a healthy weight.
• Ways to make everyday activities easier. You 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 you follow an exercise plan at home.

What happens in the exercise part?

In pulmonary rehab, your exercise program is uniquely designed for you. It lets you start at your own pace, and helps you gradually increase activity as you are able.

As you exercise at pulmonary rehab, the staff will watch to make sure you are safe and keep track of your progress. They’ll keep track of your blood pressure, blood oxygen, weight, and exercise ability. If you also have a heart problem, you might wear sticky patches (electrodes) on your chest that are connected to a monitor to check your heart rate and rhythm.

The exercise program has five parts:

• Warming up. Rehab staff will help you gradually warm up at the start of each session. This helps your body prepare for a workout and lessens the chance of problems during exercise.
• Endurance activity. Also called aerobic (ay-RO-bic) exercise, endurance activity includes walking and cycling — any activity that gets your heart pumping and your blood moving a little faster. Endurance activity helps your body use oxygen more efficiently. This makes everything else you 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 you 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 chest and arm muscles. When these muscles are strong, they can ease the strain on other muscles and help you breathe better.
• Flexibility. Gentle stretches can improve your balance and make it easier to move. Stretching can also reduce pain, stiffness, and stress. Pulmonary rehab staff can show you stretches to help open up your chest and lungs for easier breathing.
• Cooling down. Slowing down can help keep your muscles from getting stiff after exercise.

Of course, not all of your 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 home, so that you can keep getting stronger in between pulmonary rehab sessions.

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

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