Pulmonary Rehabilitation

Pulmonary (PULL-mun-ary) rehabilitation, also called pulmonary rehab or PR, is a broad program that helps improve the well-being of people who have chronic (ongoing) breathing problems.

For example, PR may benefit people who have COPD (chronic obstructive pulmonary disease), Sarcoidosis (sar-koy-DOE-sis), idiopathic pulmonary fibrosis, or cystic fibrosis.

PR also can benefit people who need lung surgery, both before and after the surgery.

PR doesn’t replace medical therapy. Instead, it’s used with medical therapy and may include:

  • Exercise training
  • Nutritional counseling
  • Education on your lung disease or condition and how to manage it
  • Energy-conserving techniques
  • Breathing strategies
  • Psychological counseling and/or group support

PR involves a long-term commitment from the patient and a team of health care providers. The PR team may include doctors, nurses, and specialists. Examples of specialists include respiratory therapists, physical and occupational therapists, dietitians or nutritionists, and psychologists or social workers.

PR often is an outpatient program based in a hospital or clinic. Some patients also can receive PR in their homes. When you start PR, your rehab team will create a plan

Who Needs Pulmonary Rehabilitation?

Your doctor may recommend pulmonary rehabilitation (PR) if you have a chronic (ongoing) lung disease. He or she also may suggest PR if you have a condition that makes it hard for you to breathe and limits your activities.

For example, you may benefit from PR if you have:

  • COPD (chronic obstructive pulmonary disease). COPD includes emphysema (em-fi-SE-ma) and chronic bronchitis (bron-KI-tis). The symptoms of COPD include coughing (either a dry cough or a cough that expels phlegm or mucus from your airways), wheezing, shortness of breath, chest tightness, and other symptoms.
  • An interstitial (in-ter-STISH-al) lung disease. This type of disease causes scarring of the lung tissue over time. This can lead to coughing, shortness of breath, and other symptoms. Examples of interstitial lung diseases include sarcoidosis and idiopathic pulmonary fibrosis.
  • Cystic fibrosis (CF). CF is an inherited disease that causes thick, sticky mucus to collect in the lungs and block the airways. CF can cause coughing and frequent respiratory infections.

Your doctor also may recommend PR before and after lung surgery to help you prepare for and recover from the surgery. For example, people who have surgery for lung cancer or COPD may benefit from PR.PR also can help people who have muscle-wasting disorders that may affect the muscles used for breathing. One example of this type of disorder is muscular dystrophy.PR works best if you start it when your disease is in a moderate stage. However, even people who have advanced lung disease can benefit from PR.

What To Expect Before Pulmonary Rehabilitation

When you first start pulmonary rehabilitation (PR), your team of health care providers will want to learn more about your health.For example, they’ll want to know how well you’re able to breathe and exercise. You’ll have lung function tests to check your breathing. These tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood.

Your team can check your ability to exercise several ways. They may measure how far you can walk in 6 minutes (called a 6-minute walk test). Or, they may ask you to exercise on a treadmill while your oxygen level, blood pressure, and heart rate are measured.Your PR team also will review your medical therapy to see whether it needs to be changed during the PR program. For example, you may need to start using, or increase the use of, inhaled bronchodilators. These medicines can help you breathe easier during exercise. You also may need oxygen therapy to help you get the most out of your exercise plan.

Your PR team may assess your mental health. If you have anxiety or are very depressed, they may refer you to a specialist who can treat these issues.In addition, the team may measure your weight and height, ask about your food intake and general nutrition, and recommend a blood test to assess loss of muscle mass.The data your PR team gathers at the start of your program will help them create a plan that’s tailored to your abilities and needs.