Pulmonary rehabilitation (PR) is a comprehensive intervention based on a thorough patient assessment followed by patient-tailored therapies that include, but are not limited to, exercise training, education, and behaviour change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviours.
Who needs pulmonary rehabilitation?
Pulmonary rehabilitation is ideal for people who suffer from lung disease and experience shortness of breath despite taking regular medication. A medical professional will perform a full diagnosis to assess the patient’s condition, health and consider other factors such as age, family medical history, etc. to devise a customized plan. Pulmonary rehabilitation constitutes an important part of COPD treatment and pulmonary fibrosis treatment as it helps in gaining strength and managing the symptoms of these lung conditions.
Physiotherapists play an important role in prescribing, supervising, and measuring outcomes in exercise. It is essential that the guideline-based exercise prescription methodology with an increase use of FITT methodology (frequency, intensity, time, and type) is used as a baseline for treatment. This methodology has been reported by several studies to show in pulmonary function tests after rehabilitation program. The pulmonary rehabilitation includes:
- Pulmonary care: Positioning, exercises, bronchodilator.
- Functional training: Important in end-stage disease or extreme weakness or fatigue. It is conducted to:
- Adapt the environment to improve ease.
- Work areas supported in convenient places to avoid bending.
- Locate a table to slide heavy objects while working.
- Chairs at landings of stairs, besides bathtubs.
- Using adaptive equipment and assistive technology.
- Using good ventilation to kitchens etc. where fumes are present.
Incorporate methods to relieve symptoms by:
- Maintain an uninterrupted breathing pattern, avoiding Valsalva.
- Avoid unnecessary talking during tasks.
- In Obstructive lung disease, the elderly population can pace during lifting tasks, lean forward (Increases the intra-abdominal pressure and pushes the diaphragm up in a more advantageous position and allows the accessory muscles of inspiration to pull the chest into inspiration).
- In Restrictive lung disease, rapid shallow breaths are easier (This prevents elastic resistance of the respiratory system).
- Relaxation of non-respiratory muscles (using biofeedback) reduces anxiety related to dyspnea.