How Pulmonary Rehab Supports COPD Patients and Other Conditions

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Chronic Obstructive Pulmonary Disorders (COPD) affect 65 million sufferers worldwide, and over 16 million in the US alone. It’s clearly a serious global health issue. This disease, like many other lung diseases, is progressive and often only rears its head after many years. For this reason, the burden of managing the disease often falls to the senior populations, presenting even more challenges. Adding to the complications is that there is no cure for COPD, only treatment. The biggest tool in coping with COPD and other respiratory ailments is education. This guide aims to shed light on the scope of the health challenges, early warning signs, coping strategies, and treatment methods. To truly be effective at overcoming the challenges of COPD, a patient should work with a pulmonary rehab team who is experienced in managing health risks and designing a custom treatment plan. With so many options for treatment, patients may feel overwhelmed by choices. Read on to find out how to evaluate a pulmonary rehab program and start taking your life back today.

Chapter 1: What is Pulmonary Rehab?

What is Pulmonary Rehab?

While you might have a vague idea about everything involved in pulmonary rehabilitation, let’s set a foundation for what is meant by this term and everything it encompasses.

In essence, pulmonary rehab serves to teach and train patients with chronic lung disease to breathe better. If you experience shortness of breath and medications have not significantly improved your symptoms, you might be a good candidate for pulmonary care.

A few conditions that often bring patients to pulmonary rehab include:

  • COPD (chronic obstructive pulmonary disease)
  • Severe asthma
  • Interstitial lung disease
  • Emphysema
  • Cystic fibrosis
  • Lung cancer
  • Sarcoidosis

A pulmonary rehab program is typically designed to help you in several areas:

  • Increase activity levels
  • Exercise with less difficulty
  • Perform daily tasks with greater ease
  • Prepare or recover from lung surgery
  • Reduce hospitalization

Before you even search for a program, here are a few things patients should know and expect from pulmonary rehab.

You’ll Learn More Than Breathing Exercises

While breathing exercises are a part of pulmonary rehab, that’s not the only thing you’ll do there. A comprehensive treatment plan might include the following to not only improve your breathing but also your overall quality of life:

  • Preventive techniques
  • Environmental adjustments
  • Medication therapies
  • Oxygen supplementation
  • Dietary guidance
  • Relaxation techniques
  • Psychological support

Best Ways to Exercise

While exercise might seem difficult or even impossible with your lung condition, certain types of activity can be beneficial for lung and overall body function. Consistent exercise will build your stamina so you can go through your daily routine without the need to take as many breaks due to shortness of breath. By exercising during a pulmonary rehab program, your healthcare team can make sure you’re not overexerting yourself as well as monitor oxygen levels, heart rate, and blood pressure.

Importance of Ongoing Participation and Progression

Similar to almost any area in life, you won’t see true improvement without consistency. Each session you attend and all of the exercises you do at home will have an accumulative effect on your overall health.

You’ll Feel Better

While chronic conditions such as COPD or cystic fibrosis are irreversible, that doesn’t mean you can’t take steps to slow the progression of your condition as well as improve your daily life. Not only will the techniques you learn in therapy impact physical health but also your mental well-being. Counseling can be added to your program so that you can better manage your relationship with lung disease. And finally, by making healthy lifestyle changes, you may see benefits in other areas of your life and potentially prevent other chronic diseases.

Improve Results with Pulmonary Rehab

Not Smoking Will Improve Success

This one may be obvious, but it’s worth mentioning. Smoking is a major risk factor for lung disease and can make your condition worse. In fact, it’s the top cause of lung cancer and COPD deaths and the top cause of preventable disease and death in the world. If you’re still smoking when you start the program, your healthcare team will recommend that you quit and can even incorporate a smoking cessation program into your plan.

You’ll See Measurable Results

After rehab, there are a few measurable results you should expect to see. In order to know how much you’ve improved, your provider will take tests before, during, and after the program. Tests may include, lung function tests, walk tests, exercise capacity, heart rate, and blood pressure.

Life After Discharge

Beyond measurable results, patients often wonder what life will be like after discharge. Ideally, after rehab, patients will have a higher quality of life and the ability to do more than they were able to before completing the program.

In addition, throughout the program, you will learn exercises that you can continue at home after you’re done with the program. You can also follow up with your providers as needed to make sure you’re still properly managing your condition and maintaining the same results as when you finished the program.

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Chapter 2: Reasons Patients Need Pulmonary Rehab

Reasons Patients Need Pulmonary Rehab

With rates of pulmonary disease steadily making an increase, the need for pulmonary rehab services has perhaps never been more prominent. Just consider some statistics about this global healthcare concern. According to the Center for Disease Control and Prevention (CDC), rates of asthma in the US have increased by 28% since 2001, so that it now affects 1 in every 12 people. Lung cancer rates are increasing in women, and lung cancer remains a leading cause of death worldwide. The World Health Organization cautions that COPD rates will continue to rise globally in the coming years.

According to the American Lung Association, COPD is the third-leading cause of death among Americans, making it one of the most common reasons why people seek pulmonary care. While there is no cure for this disease, many measures can be taken to improve a patient’s quality of life. And because COPD doesn’t often appear until later in life, it’s most often seniors who are also facing other health challenges who must combat this disease.

What’s Driving the Increase

This increase in respiratory disorders can be traced to several causes, including smoking, air pollution, and aging populations. Because the impact of smoking often takes years to manifest, we are just now seeing some of the repercussions of historical smoking trends in aging populations. Adding to this factor, the rising rates of air pollution have been driving up not only lung disorders but also exacerbations of conditions like asthma.

The Role of Rehab

Respiratory rehab is now recognized as an essential part of the treatment for COPD, along with medications and oxygen therapy. In fact, respiratory rehab has been covered by Medicare since 2016. Without access to treatment, COPD patients may enter a vicious cycle, whereby they are hospitalized with an acute episode, get stable, then return home to be sedentary with shortness of breath, eventually worsening their condition. Pulmonary rehab disrupts this pattern by reducing hospitalizations. In fact, The 2019 Report on Global Strategy For Prevention, Diagnosis, and Management of COPD confirms that respiratory rehab within four weeks of a COPD exacerbation significantly reduced the frequency of hospitalizations. Furthermore, pulmonary rehab also helps patients better manage symptoms, lowers anxiety levels, and provides structured support for healthier lifestyle choices.

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Chapter 3: How to Set Goals in Pulmonary Rehab Therapy

To maximize the benefits of any treatment program, it’s important to have a clear grasp of your goals for therapy. Not only do goals offer motivation to persevere with therapy but they also serve to keep a treatment team aligned.

Rehab Goals

Four Types of Goals

To make sure that your objectives are effective and can be easily tracked, experts recommend creating SMART goals. You may have heard this term in other settings. The idea is that rehab goals should be specific, measurable, achievable, relevant, and timed—all terms which combine to form theacronym “SMART.” For example, maybe you want to be able to walk for 200m without a walker or reach a certain level of improvement on a lung function test. This is a milestone that can be accurately measured. Or perhaps you want to make sure the targets you set are relevant and achievable with the type of lung disease you have. It pays to have a rehab team that will be able to advise you on what goals are realistic for your current level of health.

It’s also helpful to keep in mind that there are four categories of goals specific to all pulmonary therapy patients:

  1. Short-term goals – As the saying goes, you eat an elephant one bite at a time. For many patients, it can be overwhelming to start with ambitious targets. It’s much better to break goals down into smaller milestones. For instance, Laura Inverarity of Very Well Health writes, “If at the end of therapy your long-term goal is to walk 200 feet without an assistive device, make 2 short-term goals of 1) walking 200 feet with a cane, then 2) walking 100 feet without an assistive device. Finally progress to walking 200 feet with no device.”

  2. Functional goals – These objectives relate to your day-to-day activities. For example, if your COPD is preventing you from walking upstairs to your bedroom, you might want to set a goal around building up your physical fitness with a supervised exercise program.

  3. Impairment goals – Your rehabilitation program should include frequent measurements of your physical health, to make sure that the treatment is effective. These goals could be set with your rehab supervisor to examine all areas of your physical well-being that may be affected by your lung condition.

  4. Lifestyle goals – Building healthier habits overall is an added bonus of pulmonary rehab. Patients receive counsel on their condition and ways in which they can improve symptoms themselves by making changes at home. This may include following a nutrition plan, quitting smoking, or using breathing techniques.

Goal-setting tends to be even more critical with pulmonary rehab patients because most lung disease and COPD is a lifelong condition, which requires evidence of progress for patients to stick with a therapy program. Such goal setting can help you avoid COPD depression and other psychological symptoms associated with the toll of a chronic disease.

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Chapter 4: COPD: Signs and Types

Now that you have a clear understanding of the role of pulmonary rehab in treating lung diseases, let’s examine the basics of one disease that is treated most often: COPD. It’s a unique disease in that often takes years to manifest. COPD is characterized by progressive damage to the airways that carry air into the lungs, as well as to lung tissue. This damage gradually reduces pulmonary function, causing breathing difficulties.

Common Symptoms to Watch Out For

Because COPD develops gradually over a number of years, its symptoms often go unrecognized until significant lung damage has already been done. This is unfortunate, since treatment can slow the progression of COPD, delaying its most debilitating effects, and the earlier that treatment begins, the better the results in terms of maintaining adequate lung function and a patient's quality of life. With that in mind, it’s wise to review the most common symptoms:

COPD Signs and Types
  • Shortness of breath – It can be difficult to discern if this symptom is from aging, being out of shape, or something more serious. A good rule of thumb is to ask yourself if you are having trouble taking a deep breath while you exercise, as this could be concerning, especially if it causes you to avoid exercise. Also, if you experience shortness of breath with activities that you handled easily a year ago or the winded feeling increases with more exertion, you should ask your doctor about getting some lung function tests done.
  • Frequent or chronic cough – If you're getting a cough more often than normal lately, this can be an early sign of COPD. If those occasional coughs are lasting longer than usual or seem worse or if coughing has become daily, it's time to bring these symptoms to the attention of your doctor.
  • Frequent morning headaches – Frequent dull, throbbing headache in the mornings when first wake up can be a sign of poor lung function. That sort of headache can come from carbon dioxide buildup, which causes blood vessels to dilate, including in the brain, leading to morning headaches. It tends to happen in people with compromised lung function at night, when breathing is naturally shallow.
  • Insomnia or disturbed sleep – One of the early signs of COPD is trouble getting to sleep or staying asleep, or not feeling well-rested after a night of sleep. Lungs work harder when we're lying down, which can cause discomfort if lung function already is not quite up to par. Additionally, people with COPD may have trouble sleeping deeply due to nighttime coughing or sleep apnea, more common in COPD patients.

Other signs of COPD include edema – or fluid retention and swelling – in the feet and ankles, or a grayish or bluish tint in gums, lips, or fingernails.

Know the Different Types of COPD

Not all forms of COPD are the same though they may share some common signs. There are actually different variations of COPD, including three main types, and, in fact, some patients will be diagnosed with more than one type.

  • Emphysema – This type of COPD causes the alveoli (air sacs) within your lungs to weaken over time, eventually causing them to rupture. Emphysema results in one large space instead of many small spaces that are clustered together in healthy lungs. The more damaged your alveoli are, the more shortness of breath you will experience. The surface area of your lungs will also diminish as the alveoli rupture, which, in turn, reduces the amount of oxygen that reaches your bloodstream.

    Emphysema cannot be cured, although steps can be taken to relieve symptoms. There are, however, plenty of ways to avoid emphysema – the most effective one being to stop (or to never begin) smoking.
  • Bronchiectasis – This type of COPD occurs when the walls of your bronchial tubes thicken due to either an infection or chronic inflammation, causing mucus to accumulate within the airways. People who suffer from bronchiectasis often experience lung infections, which, as a result, cause worsened breathing along with other symptoms like fatigue, shortness of breath, coughing, wheezing, and fevers. Patients will begin losing lung function over the years. Some of the causes include allergic bronchopulmonary aspergillosis (an allergic lung inflammation), alpha1-antitrypsin deficiency, HIV, humoral immunodeficiency, inflammatory bowel disease, and rheumatological disease
  • Chronic bronchitis – This type of COPD occurs when the lining of your bronchial tubes, which carry air back and forth from your lungs, becomes inflamed. While acute bronchitis is often the result of a respiratory infection, chronic bronchitis is usually caused by smoking.

Although none of these conditions can be cured, there are steps you can take to improve symptoms and enhance your quality of life.

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Chapter 5: Coping with COPD

Coping with COPD

For patients with COPD, the challenges are vast. There are ways to slow COPD with early treatment. That’s why it’s important to consider the most immediate things someone suffering from COPD can do to slow the progression of the disease. In general, the first four steps to take are as follows: avoid or quit smoking, make exercise a priority, achieve a healthy weight, and develop better breathing techniques.

Learning how to effectively cope with the disease in ways that can mitigate symptoms will have an overall positive effect on your psychological well-being and lifestyle.

Exercise Is Essential

Sitting on the couch is not an option with COPD. You must exercise in order to improve breathing so that you can cope with limitations. Whether you're admitted to a skilled nursing facility for pulmonary rehabilitation as an inpatient or you participate as an outpatient, you will be taught how to exercise and improve your physical fitness without risking shortness of breath. Your oxygen level, blood pressure, and heart rate should be monitored as you exercise. Any person with COPD should keep emergency tools close by, for example, an inhaler or even portable oxygen, plus a phone or remote panic button.

This type of treatment has momentum: as you get more physically fit, shortness of breath usually becomes less of a problem, allowing you to continue to increase physical activity.

During pulmonary rehabilitation, you’ll have access to an exercise physiologist, physical therapist, and other exercise specialists to help you develop and master your exercise program. Additionally, you’ll be taught how to continue your exercise program at home once you are discharged.

Exercise has an important link to managing another symptom of COPD—anxiety. When you exercise, you release "feel good" hormones called endorphins, which naturally boost your mood. As you continue, you should also feel better simply because you see yourself getting stronger.

Anxiety-Related Challenges

It’s quite natural for COPD sufferers to struggle with anxiety as they manage the symptoms of the disease. The decline in oxygen levels that occurs with breathlessness triggers a stress response in the body. That stress response typically makes breathing even more difficult, which causes greater anxiety and can quickly become a dangerous cycle.

In a person who has COPD, frequent episodes of breathing difficulty can even cause the suffocation response to become overly sensitive, prompting frequent bouts of anxiety or chronic underlying anxiety. Then, even small changes in the environment, such as a strong odor, or everyday minor stresses, like feeling rushed, can trigger the suffocation reaction.

It's easy to see how all of this can take a severe toll on a person's health and quality of life; however, with coping techniques, COPD patients can practice learning to control anxiety on a daily basis. “Breathing retraining” can help, which is learning how to gain control of breathing during episodes of breathlessness with breathing techniques, such as pursed-lip breathing. Using such techniques can slow breathing, help keep airways open longer, and promote relaxation, easing breathlessness, and the feelings of panic that come with it.

The Role of Diet in Controlling Shortness of Breath

You might be surprised to learn that diet can have a formidable impact on this lung disease. Treating breathlessness from COPD can be more problematic with overweight patients, and many work with a nutritional therapist. In these cases, a COPD diet plan will include nutrients that promote healthy breathing, fight infection, and help the patient maintain a healthy weight. COPD patients must also eat enough calories to manufacture the energy needed to prevent any weakening of pulmonary muscles and the diaphragm. Check out this list of nutritional guidelines to keep in mind:Pulmonary Rehab Healthy Diet

  • Reduce oxidative stress – Calcium and vitamin D are essential additions to a COPD diet, but so are carbs, healthy fats, and protein. Adhering to a balanced menu has an influence on the production of carbon dioxide, or the waste product that is emitted when a person exhales. If too much carbon dioxide accumulates, a COPD patient can begin to feel weak or sick.
  • Seek nutrient-rich calories – COPD patients must exert more energy when they breathe. Therefore, the muscles that are used for breathing generally need 10 times more calories than what is usually required. A healthy diet also fights infections that often affect the COPD patient.
  • Keep track of your weight – Patients are advised to keep track of their weight about two times a week or every day if they are taking a diuretic. Any unexplained weight loss or gain should be reported to the doctor immediately.
  • Get plenty of calcium and vitamin D – Nutrients such as calcium and vitamin D can alleviate symptoms of COPD. Since most COPD patients usually develop osteoporosis in their later years, the use of these two nutrients should always be incorporated into the diet.
  • Incorporate high-fiber foods – Fruits, vegetables, cooked legumes and whole grains in the form of bran, pasta, rice, and cereal are vital to a COPD meal plan. The COPD patient’s goal should be to eat at least 20 grams of fiber daily. Since fiber is the part of plant food that cannot be digested, it assists in moving digested foods through the GI tract. In addition, fiber helps control blood glucose and has proven to be effective in reducing cholesterol levels, too.
  • Avoid certain foods – Patients should avoid overeating, since doing so can also cause breathlessness. By the same token, foods that cause bloating should be avoided, such as extra spicy foods or fried foods. Sodium should be limited, too. If too much salt is consumed, the COPD patient can find it harder to breathe.

Ways to Help Yourself Breathe Easier

Coping with COPD will always come down to breathing easier. To achieve this means taking good care of yourself and keeping your environment as free as possible of irritants. Here are seven ways that you can begin to take back your health and experience better breathing. Use this checklist as a guide:

  • Breathing exercises – Techniques like pursed-lip breathing can help you gain control when you are gasping for air, slowing your breathing to allow more efficient movement of air into and out of your lungs. Other methods like diaphragmatic breathing, or belly breathing, can help strengthen your breathing muscles, making every day breathing less of a chore. A pulmonary therapist or pulmonary rehab program can provide lessons in using these techniques.
  • Learn relaxation techniques – Many pulmonary therapists and rehab programs offer instruction in relaxation techniques, or you can engage a counselor or instructor on your own. These may include breathing exercises as well, all designed to counter anxiety that can accompany COPD.
  • Keep dust down – Keeping your environment free of dust, dirt, and pet hair can reduce airway irritation, lessening wheezing, and coughing.
  • Use gentler cleaning products – Harsh cleansers, such as bleach or strong disinfectants, can irritate your bronchial passages and lungs. Using mild, natural household cleaners aids in minimizing everyday symptoms.
  • Avoid exposure to pollution and fumes – This should go without saying, but if you are currently smoking, stop and avoid second-hand smoke. Keep an eye on the air quality reports and stay inside when pollution is high. Avoid backyard barbecues, indoor fireplaces, and wood-burning stoves. Leave painting to someone else, and stay out of the house when painting is being done to avoid the irritating fumes. Ask loved ones and co-workers to limit use of strong perfumes or air fresheners.
  • Eat differently – Digestion consumes both energy and oxygen, so eating a big meal can make you weak and tired by restricting the movement of the diaphragm, making you work harder to breathe. Reduce these by eating four to six small meals per day instead of three large ones.
  • Exercise – As aforementioned, exercise is invaluable. A well-crafted exercise plan can actually help your body use oxygen more efficiently. It’s best to work with a doctor about fitness plans or see a physical therapist with experience working with COPD patients.

By taking such measures, seeing your doctor regularly, and carefully following a treatment plan, you can learn to manage your symptoms and improve your quality of life.

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Chapter 6: Treating COPD with Pulmonary Rehab

Treating COPD

Treatment for COPD is not something to undertake alone. A pulmonary rehab program is designed especially for you based upon your current needs. Therapists with special training in occupational, physical, and respiratory therapy will teach you skills that are custom-designed to fit you and your current needs and symptoms.

What Happens When You Join a Pulmonary Rehabilitation Program?

You might be wondering what to expect from pulmonary rehab therapy. We’ve got you covered. The first thing you should be prepared for is to talk about your current lifestyle and goals. Team members will take a comprehensive health history in order to more effectively design a treatment plan. You'll also learn about various means of coping with symptoms. Breathing techniques, medications, oxygen supplementation, diet, and relaxation techniques can all help you do more with fewer episodes of shortness of breath. You'll also be taught how to avoid exacerbations or flare ups that happen when COPD gets worse and you become sick.

As part of a comprehensive treatment plan, patients can expect pulmonary rehab programs to address some or all of the following five areas:

  • Lifestyle changes - The first major step to symptomatic improvement is to avoid behaviors that aggravate the lungs. At the top of most lists is stopping smoking and excessive drinking.
  • Oxygen therapy – Making sure there is ample oxygen in the bloodstream is one form of oxygen therapy used to treat COPD. According to the American Thoracic Society, oxygen therapy may be prescribed to people who have a low ABG (arterial blood gas) reading. An ABG level of 97% or above is normal, but a level of 89% or above is ideal. If a person’s ABG is lower than this at rest, they will need oxygen therapy. Oxygen therapy may be given at a doctor’s office or continued at home.
  • Surgery – In severe cases, surgery may be necessary. The surgical procedure involves removing damaged tissue from the lungs and, in some cases, removing and replacing the damaged lung completely. Common surgical procedures include bullectomy, lung volume reduction surgery, and lung transplant. In these cases, medication and therapy may be suggested as part of an aggressive therapy plan.
  • Occupational therapy — Occupational therapy focuses on helping the patient return to work, school, and normal activities. Since the amount and type of work a person can do are restricted, an occupational therapist can provide helpful adaptive options and skills to lessen the strain on the patient’s lungs.
  • Physical therapy – Physical therapy helps people who have chronic bronchitis and emphysema by teaching them ways to walk or exercise without having as much shortness of breath. The goal of therapy is to learn energy preservation techniques that help minimize the risk of breathlessness —termed dyspnea —from occurring. Regular exercise is also encouraged in a physical therapy session as it helps to promote the flow of oxygen throughout the body and strengthens the lungs.

Questions to Ask Before Physical Therapy 

Understandably, COPD patients may be apprehensive about exercising. Some of this can be alleviated by asking proactive questions prior to engaging in a physical therapy routine. Use this checklist as a guide.

  • How can I possibly exercise with COPD? – You might be surprised how good you feel once your body starts adapting to therapy. The effectiveness of the program relies on the expertise of skilled specialists. A trained therapist is the best person to determine the precise amount of exercise that’s right for you, which is ultimately enough to make a difference without overwhelming your body.Physical Training Rehab
  • How will COPD Rehab affect my condition? – By improving aerobic and muscle conditioning, you should be able to do more activities without getting winded. 
  • What happens during a COPD physical therapy session? – Your therapist creates an individualized treatment plan for each patient, taking your doctor’s recommendations, your preferences, physical condition, and other factors into consideration. No two physical therapy sessions are alike. However, expect a mixture of warmup and stretching, controlled aerobic activity, and resistance training.
  • What else is included in my COPD rehabilitation plan? – Your dedicated healthcare team may consist of a number of specialists including your primary doctor, pulmonologist, nutritionist, physical therapist, and counselor. Each makes a crucial contribution to your recovery plan and works in conjunction with the others to support and maximize your treatment.
  • How long is COPD rehab? – The recommended length of your treatment plan is exclusive to you. Your doctor and specialists will create a roadmap with rough estimates toward rehabilitation, but many factors may impact your progress along the way. Generally, patients can expect to attend 2-3 hours of training and education three days per week for a minimum of six weeks. Your sessions may differ depending on whether you attend on an inpatient or outpatient basis, in addition to other considerations. Largely, the length of COPD rehab depends on the severity of your disease, your active participation and at-home recommendations, how well your body responds, events that exacerbate your symptoms, and your smoking status.

Benefits of Pulmonary Rehab

The benefits of working with a specialized team who can measure and monitor your progress cannot be overstated. As discussed previously, COPD rehabilitation improves your physical capacity, including aerobic and muscle conditioning. You may also notice some other benefits as your body adapts your new routine:

  • Improved oxygen levels
  • Better sleep
  • Lower blood pressure
  • Increased energy
  • Decreased levels of stress, anxiety, and depression
  • Emotional support
  • Fewer hospitalizations

For many patients, longer treatment plans create better, cumulative results. Even after your rehabilitation, you may benefit from ongoing support.

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Chapter 7: COPD Patient Education

COPD Patient Education

Ongoing support is crucial for COPD patients who fare best when they continue to implement lifestyle changes on their own at home. For this reason, patient education is absolutely essential to long-term success. One of the best things to implement is a regular at-home regimen of the following best practices.

Employ Breathing Techniques

Pulmonary rehab training includes exercises that teach more effective ways to breathe, such as pursed-lip breathing, diaphragmatic breathing, and controlled coughs. Here are some techniques that can be continued at home:

Pursed-lip breathing exercise:

  • Sit upright in a straight-back chair with arms and shoulders relaxed.
  • Inhale through the nose for two seconds.
  • Exhale through pursed lips for four seconds.

Diaphragmatic breathing exercise:

  • Lie on the floor with knees bent.
  • Place one hand on the stomach, above the waist.
  • Inhale through the nose while pushing out the stomach.
  • Exhale through pursed lips and feel the hand return to the starting position.

Controlled coughs:

  • Sit up in a comfortable chair, allowing the head to lean forward slightly.
  • Inhale through the nose until the stomach extends.
  • Hold the breath for three seconds, then cough once as the hand resting on the abdomen pushes in and up.
  • Do this several times to clear mucus when necessary.

Adhere to Healthy Eating

Weight management is important for those living with pulmonary conditions. In some cases, patients can become underweight as their body fights the illness. A doctor may suggest a special diet and supplemental nutrition to increase body weight. Overweight people are encouraged to drop pounds because being overweight makes breathing more difficult.

Practice Regular Exercise

COPD is a wake-up call to get moving, albeit in a smart way. Exercise sessions may only be five minutes at first, but over time, patients should aim for 20 to 30 minutes of activity, three or four times a week. Exercises that can be continued at home include:

  • Stretching exercises – Neck rolls while watching television, or toe touches, shoulder shrugs, and calf stretches each morning all force oxygen to the muscles, helping them warm up.
  • Walking – Start by walking around the room two or three times a day to build tolerance. Increase the speed and the challenge by adding more rooms and stairs, if available. Once able to successfully walk indoors, and with a physician’s approval, take the exercise outside. Doctors will sometimes ask COPD patients to stay away from potential allergens, so an indoor track or treadmill makes a good substitute for walking outdoors. Other cardiovascular exercises that benefit COPD patients include:Pulmonary Rehab Exercise
  • Stationary biking
  • Rowing
  • Cross-country skiing
  • Water aerobics
  • Dancing
  • Strength training – The ideal fitness plan includes both cardiovascular workouts and strength training to build muscles. Training exercises using resistance bands is one approach to strengthening muscles without bulking up.
  • Drink plenty of water – Drinking water helps to thin mucus and keeps the airways clear. Fluid intake should be 8 to 12 cups of caffeine-free liquids a day. The doctor may also suggest setting up a humidifier at home to help keep airways moist and open.

Note that individuals with COPD should always walk with a person aware of their condition—this “buddy” would be on hand to supply emergency assistance if needed.

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Chapter 8: How Rehab Select Helps with Pulmonary Therapy

How Rehab Select Helps with Pulmonary Therapy

Pulmonary rehab can be offered as an outpatient program in a hospital, or at a specialized pulmonary rehab center. These centers offer the resources, personnel, and facilities needed to help improve the symptoms of chronic lung conditions. At this point, you may be asking the question, “How do I choose a pulmonary rehab facility?”

Your choice of rehab facilities is something that should not be taken lightly. Not only do you want to consider the quality of care, but you need to make decisions about your needs as well.

Some important factors to consider when choosing a rehab facility include:

  • Medical specializations and facilities available
  • Up-to-date equipment and technologies
  • Location and transportation arrangements
  • Appointment availability
  • Support for family and caretakers
  • Comfort level with the staff and facilities
  • Effectiveness of treatment 

With such a wide variety of treatment centers available, it can be tough to know what to look for. That’s why we devised this list of five qualities to look for in a pulmonary rehab center

  1. Medical specialization –  Delivering a successful rehab program for patients with chronic lung disease is a highly specialized process. For instance, you may need expert help managing your medications, or modifications to the medications you’re taking. You should make sure that the center you choose has the specialist medical and nursing staff necessary to really make a difference to your well-being. 
  2. Specialized pulmonary facilities – As well as physical therapy, your rehab provider should be able to offer oxygen therapy, supervised exercise facilities, nutritional guidance, education in self-care and symptom management, and training in breath control techniques. How Rehab Select Helps
  3. A full team of pulmonary specialists – In addition to a specialized pulmonary physician, you may need to work with a nutritionist, exercise physiologist, physical therapist, rehab nurse, or an occupational therapist. You should look for a center that provides a coordinated, individualized rehab program that brings together multiple aspects of treatment to ensure you get the most out of your time. 
  4. Customized treatment programs – COPD is a complex disorder, and different types may require unique treatment and different approaches to rehab. A well-designed rehab program should begin with a complete physical assessment, but also an in-depth interview to take your current lifestyle, medical history, needs, and unique circumstances into account.
  5. Career support and training – Look for a pulmonary rehab center that offers training and education for caregivers, such as seminars, workshops, or resources to take home, so that your progress will continue even after you complete your rehab program. 

Why Choose Pulmonary Therapy at Rehab Select?

The Rehab Select pulmonary therapy program reflects our fundamental belief that rehab treatment must put the patient first. It’s perfect for people with chronic lung disease (or those preparing for or recovering from lung surgery) who are not well enough to go home and fend for themselves, but too well to be in a hospital ward. 

Before starting pulmonary therapy, your physical therapist will guide you through a complete physical assessment, including a six-minute walk, standing and sitting, and a respiratory questionnaire. We will measure your results and track your progress as you complete your rehab program. 

Using the results of your assessment, your medical history, and your preferences, the Rehab Select Care Team will put together an individual pulmonary therapy plan for you. 

We take a three-pronged approach to pulmonary rehab: 

  • Strengthening – We help to improve your sense of well-being and enjoyment of life through physical therapy and exercise.
  • Educating – We teach you the necessary information and skills to make your daily experience better. This might include how to use your inhaler, how to breathe correctly, how your family could help support you, how to manage your condition in daily life, or how to modify your lifestyle to improve your symptoms.
  • Improving Outcomes – We offer daily visits from a healthcare provider, who will check your lungs and overall health. They will keep a close eye on your medications and make sure that you are receiving the best possible treatment for your lung condition. At our Hillview location, we also have several rounding pulmonary specialists each week.

Our highly qualified staff of lung rehabilitation specialists includes in-house physicians or pulmonary physicians, pulmonary nurse practitioners, nursing staff, physical therapists, occupational therapists, speech therapists, pharmacists, and nutritionists. Every healthcare provider who works with us offers a caring and compassionate approach, coupled with extensive expertise.


People with COPD need to see a doctor regularly, even when they feel fine. Monitoring lung function is a significant part of managing the illness. Combined with drug therapy and flu vaccinations, lifestyle changes improve the quality of life for anyone living with pulmonary conditions. In a study published in the European Respiratory Journal, researchers found that pulmonary rehab “was effective in improvement of exercise tolerance, lung mechanics and quality of life in all stages [of COPD]”. Selecting the right pulmonary rehab program is critical to your success. Learn more about how Rehab Select creates a unique rehabilitation treatment for every patient we work with, designed to take your comfort and well-being into account every step of the way.  

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