Pulmonary Rehabilitation

Pulmonary rehabilitation is a comprehensive intervention used to improve the physical and psychological condition of patients with chronic lung diseases and promote their adherence to health-promoting behaviours.

It is one of the core component of the management of patients with chronic lung disease. Pulmonary rehabilitation advice is commonly given to patients with COPD, Asthma, Interstitial Lung Disease, Cystic Fibrosis, Bronchiectasis, Neuromuscular Disease, Pulmonary Hypertension, Lung Cancer, Lung Volume Reduction Surgery and Lung Transplantation patients in addition to other indications.

Chronic lung diseases are characterised by pulmonary and extra-pulmonary manifestations that contribute to the severity of the disease in individual patients. Pulmonary rehabilitation reduces breathlessness, increases the exercise capacity and improve quality of life.

It includes patient-tailored therapies like exercise training, education and behaviour change after thorough patient assessment. Symptomatic individuals with COPD who have lesser degrees of airflow limitation derive similar improvements as with more severe disease.

The rationale for including patients in pulmonary rehabilitation with lesser degrees of airflow obstruction is due to the fact that the correlation between the degree of airflow obstruction, breathlessness, health status and exercise performance is weak and moreover the low physical activity, dynamic hyperinflation with exercise, limb weakness, osteoporosis, anxiety and depression may occur in patients with mild to moderate airflow obstruction also. Pulmonary rehabilitation initiated shortly after a hospitalization for a COPD exacerbation is effective and it is associated with reduction in further hospital admissions.

Exercise training is the best available means of improving muscle function such as endurance training, interval training, resistance training, neuromuscular electrical stimulation, and respiratory muscle training. Pulmonary rehabilitation also includes self-management strategies to successfully manage one’s health and behaviour change education.

The primary aim of pulmonary rehabilitation is to restore the patient’s health to the best possible level of independent functioning and is a new hope for patients with chronic lung diseases.