Pulmonary Rehabilitation
Pulmonary rehabilitation is a supervised program that includes exercise training, health education, and breathing techniques for people who have certain lung conditions or lung problems due to other conditions.
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| Fig. 1: Pulmonary rehabilitation |
Aerobic training
Aerobic exercise training of Pulmonary rehabilitation session includes: Check-in, warm-up, aerobic exercise, cool down.
Check-in period
The time to obtain data including resting heart rate, respiratory rate, blood pressure, oxygen saturation, auscultation of lungs, and weight.
PFTs may be performed pre and post-exercise to assess the impact of the maintenance medication.
Warm-up
The time to slowly increase the heart rate and blood pressure to ready the cardiovascular system for aerobic exercise.
The warm-up period is 5 to 10 minutes.
Aerobic exercise
The exercise session consists of a mode of aerobic activity at an appropriate intensity to maintain exercise prescription for patients with pulmonary dysfunction.
Cool-down down period
Consist of 5 to 10 minutes of low-level aerobic activities that slowly return the cardiovascular system to near pre-exercise level.
Stretching exercises
Help to maintain joint and muscle integrity and to help prevent injury.
The patient often used as the necessary muscle of ventilation during an exercise program, so muscles of the neck and upper extremity should be involved in the stretching program.
General Strength Training
Extremity Training
- Strength of both upper extremities and lower extremities is increased with resistance exercise or weight training.
Ventilatory muscle Training
- Patients with COPD may have weak inspiratory muscles that cause breathlessness and exercise limitation.
- Ventilatory muscle training devices provide resistance to the inspiratory phase, the expiratory phase, or both phases of ventilation to increase the strength and endurance of muscles of ventilation.
Exercise Progression
- Exercise progression is appropriate when the individual perceives the exercise session to be is easier or when the same exercise workload is performed with a lower heart rate.
- When 20 minutes of continuous aerobic activities can be e complete then an increase in exercise duration, frequency, and intensity can be proposed.
Home Exercise Programs
- A home exercise program begins while the participants are enrolled in a pulmonary rehabilitation program.
- During the home exercise program, the patient uses an exercise log to record parameters such as exercise HRs, RPEs, exercise workloads, and any questions that may arise about the home exercise program (Table: 1 & 2 is An exercise log that can be used to follow a patient’s ability to exercise both during and independent of the pulmonary rehabilitation program).
- At regular intervals, the therapist analyses the data and adjusts the home exercise program
Patient Education
- The concept of self-management is promoted in the individual and group educational sessions of the Pulmonary rehabilitation program.
- The components of the patient education program are:
- Anatomy and physiology of respiratory disease
- Airway clearance techniques
- Nutritional guidelines
- Energy-saving techniques
- Stress management and relaxation
- Benefits of being non-smokers
- Effect of environmental factor on COPD
- Use of metered-dose inhalers (MDIs)
- Oxygen delivery system
- Psychosocial aspect of COPD
- Diagnostic techniques
- Management of COPD
- Effect of exercises and contraindications.
Secretion removal techniques
- Secretion retention can interfere with ventilation and the diffusion of Oxygen and carbon dioxide in patients with pulmonary disease.
- This patient may improve their exercise performance if proper secretion removal techniques have been performed before the physical activity. read more.
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