Pulmonary rehabilitation for COPD

Overview

People with chronic obstructive pulmonary disease (COPD) may develop shortness of breath that makes it difficult to walk and perform other daily activities. Pulmonary rehabilitation is a program designed to improve your ability to function and general well-being.

Pulmonary rehabilitation programs focus on exercises that improve strength, lung function, and ability to walk and function. They may include components of education such as nutrition counseling, breathing and energy conservation strategies, and guidance on how to manage your COPD. Some pulmonary rehabilitation programs also offer psychological support. Additionally, by attending a pulmonary rehabilitation program, you will meet others with COPD who are learning how to improve their condition.

Pulmonary rehabilitation may take place at a hospital, clinic, or in the home.

Since pulmonary rehabilitation plans take into account your individual condition, pulmonary rehabilitation is appropriate for people whose COPD is at any stage of severity.

What does it involve?
In order to begin a program of pulmonary rehabilitation, you must receive a referral from your physician and provide spirometry test results taken within the past year that prove a diagnosis of COPD.

The first step in starting a pulmonary rehabilitation program is an interview with your pulmonary rehabilitation team about your health history, current condition, and goals for the program. Examples of goals may be to climb the stairs of your home more easily, complete a shopping trip without becoming short of breath, or resume a favorite leisure activity. You will then be asked to walk on a treadmill while your heart rate, oxygen level and blood pressure are taken. The pulmonary rehabilitation team will closely monitor you and make sure you are safe. It is fine if you cannot walk very much at all.

Once the team has developed your pulmonary rehabilitation plan, you will begin an exercise program designed to slowly and safely improve your abilities. You will be allowed to use supplemental oxygen if you require it. At first, you may only be able to exercise for a minute or two. Do not worry. Progress will be slow, but it will come.

Most likely, many of the exercises you do will focus on the legs. You may simply walk on a treadmill. You may move on to stair climbing or lifting weights to build strength. You may also exercise the muscles of your upper body, since they assist with breathing. Chest exercises might include turning a crank or lifting your arms. Some people with very weak breathing muscles may be asked to breathe into a tube against resistance in order to strengthen them.

Your pulmonary rehabilitation center may also offer one-on-one educational sessions with specialists. Focuses of education in pulmonary rehabilitation might include breathing and energy conservation strategies, diet and nutrition, understanding and using your medications properly, especially inhalers and oxygen, and smoking cessation.

Since people with COPD are at risk for depression and anxiety, some pulmonary rehabilitation centers also offer psychological support. These services may take the form of individual counseling or education about relaxation strategies or meditation.

Pulmonary rehabilitation is a long-term commitment. Programs may be as short as four weeks or as long as 20 weeks. You may attend one or more sessions per week.

Intended Outcomes
Pulmonary rehabilitation can improve your breathing and ability to walk and function in daily life. Pulmonary rehabilitation can help you gain new strategies to cope with your COPD symptoms and a better understanding of how best to manage your condition. Pulmonary rehabilitation can improve your overall well-being.

Results
Multiple studies have proven that pulmonary rehabilitation can significantly reduce shortness of breath and fatigue and increase the ability to walk and exercise. Some people with COPD who complete a course of pulmonary rehabilitation report improved quality of life. There is also evidence that pulmonary rehabilitation programs may result in less time spent in the hospital.

Constraints
Some people with COPD become easily discouraged when they first begin pulmonary rehabilitation because the exercises seem hard, they quickly become fatigued, or they cannot walk far. However, in order to benefit from the pulmonary rehabilitation, it is important to commit to completing the program. Take it one step at a time, and focus on appreciating small improvements over time.

Depending on your insurance plan, it may not pay for pulmonary rehabilitation, or only pay a percentage of the cost.

If you live far from a town, it may be difficult to get to a pulmonary rehabilitation center, or to have a pulmonary rehabilitation therapist come to your home.