Pulmonary Rehabilitation

COPD is a progressive disease, meaning it gets worse over time. It affects the lungs and airways, making it difficult to breathe. As your COPD progresses, you may find yourself becoming less able to participate in even moderate exercise. You may notice that you’re no longer able to participate in activities you enjoy. You also may have difficulty performing simple tasks of daily living, such as taking a shower, getting dressed, or preparing a meal.

If your COPD is getting in your way and preventing you from enjoying life, you may want to consider pulmonary rehabilitation.

What Is Pulmonary Rehabilitation?

Pulmonary rehabilitation is an individualized, multi-disciplinary program. Rather than focusing on the damage sustained by the lungs, pulmonary rehabilitation emphasizes stabilizing or even reversing the extra-pulmonary effects of COPD. These effects include muscle weakness, poor stamina, depression, and anxiety.

Pulmonary rehabilitation programs aren’t standardized. They may last for a few weeks to a few months. Some are inpatient programs, meaning that you stay in the rehabilitation center night and day. Others are outpatient programs, meaning that you come to the center during the day for treatment and return to your own home at night.

Most programs offer a core set of basic services and interventions, such as:

Exercise

Exercise is the cornerstone of pulmonary rehabilitation programs. Types of exercise include whole body exercises like walking, swimming, strength training, flexibility, and balance. In order to benefit from the exercise programs, you must experience a relatively intense workout. This can be frightening if you’re not used to exerting yourself or if you become short of breath.

Counseling

Trained counselors and psychotherapists are available to help you work through any emotional issues, like depression and anxiety, that surround your disease.

Education

Learning about COPD, how it progresses, and the measures you can take to slow the progression and maintain your quality of life, is a vital part of every pulmonary rehabilitation program.

Nutrition

Some people with COPD become very thin, a condition known as pulmonary cachexia. Others who are no longer able to participate in their normal activities and perhaps eating for emotional reasons experience weight gain. Nutritional counseling can be key to helping you maintain a healthy weight.

Smoking Cessation

If you haven’t stopped smoking already, the pulmonary rehabilitation program will give you the medical and emotional support you need to do so.

Assistive Devices

The staff at the program will assess your need for equipment that can help you stay independent as long as possible.

Self-management

As the program draws to a close, you will learn how to introduce exercise, stress reduction, healthy diet, and other lifestyle changes into your normal routine.

Who Benefits from Pulmonary Rehabilitation?

According to the most recent guidelines from the American College of Physicians, American College of Chest Physicians, and American Thoracic Society, you’re most likely to benefit from pulmonary rehabilitation if your COPD keeps you from being active and if you have an FEV of 50 percent or less.

FEV stands for Forced Expiratory Volume. Basically, it’s a measure of how much air you can blow out of your lungs (exhale) in one second. A normal FEV is around 90 to 100 percent. The lower your FEV, the more difficulty you have breathing.

An FEV of 50 percent of below is considered indicative of late-stage COPD.

The authors who wrote the updated guidelines say that there haven’t been enough studies to prove the usefulness of pulmonary rehabilitation among people with an FEV higher than 50 percent. They also say, however, that you and your doctor should consider pulmonary rehabilitation if you’re unable to exercise even moderately or if your illness keeps you from being mobile—even if your FEV is higher than 50 percent. In other words, they don’t have enough information to prove that pulmonary rehabilitation works at earlier stages, but they think that it may help, and it won’t do any harm.  

Scholars aren’t worried that too many people will be referred for pulmonary rehabilitation. They’re concerned that too few patients and doctors are aware of the potential benefits. One study, for instance, found that less than two percent of eligible COPD patients had access to or were enrolled in pulmonary rehabilitation programs.

If you’re interested in giving rehabilitation a try, speak to your doctor to find out if there is a program near you.

Benefits of Pulmonary Rehabilitation

Successful completion of a pulmonary rehabilitation program has been associated with increased tolerance for movement and activity, enhanced quality of life, decreased episodes of shortness of breath, and decreased need for emergency room visits and hospitalizations.