Community-Acquired Pneumonia |Clinical Guidance

Pulmonary Rehabilitation Program Effective For Chronic Obstructive Pulmonary Disease - Medindia

A recent research paper on chronic obstructive pulmonary disease (COPD) said that pulmonary rehabilitation programs are often useful for patients of this disease to have improved daily functions and activities.

Chronic obstructive pulmonary disease (COPD) are lung diseases involving restricted airflow and conditions like lung tissue destruction, airway inflammation, air sac enlargement etc. Some common forms of COPD are emphysema and chronic bronchitis.

Pulmonary rehabilitation programs involve exercise training to improve functional capacity of the lungs, taking into consideration the cardiovascular, pulmonary and skeletal muscle limitations. Goals of these programs are to reduce the symptoms of the diseases, increase the physical abilities of the patients and restore the highest level of independence in the attending to the daily functions of the patients.

Researchers had said that by talking the six-minute walk test the patients who had undergone the rehabilitation program could improve on their ability by about 54 meters. The peak work rate of these patients had also improved by about 18% when compared to their physical state before they had undergone the program.

Reference: American Journal of Respiratory and Critical Care Medicine, July 2005

Pulmonary Rehab For COPD: Everything You Need To Know - Healthline

Pulmonary rehabilitation involves following an individualized treatment plan that may include physical exercise, breathing techniques, nutritional education, and counseling.

Chronic obstructive pulmonary disease (COPD) refers to a group of diseases characterized by lung damage and breathing issues. Emphysema and chronic bronchitis are the two most common varieties of COPD.

Rehab can help reduce your COPD symptoms, improve your quality of life, and reduce the risk of more serious lung, heart, or respiratory problems down the road.

Here's what to know about the rehab and how it can help.

Pulmonary rehab is designed to improve your health and quality of life if you live with COPD. Without treatment, the disease may become life threatening.

After doing an assessment with a team of healthcare professionals, your recommended treatment plan will likely involve:

These steps are designed to help maintain your physical and psychological health. They can also help you stick to long-term health goals.

Exercise training: This typically involves endurance, flexibility, and strength training exercises. Cycling and walking are the most commonly recommended endurance exercises. Strength training may require weights or resistance bands. Your exercise and training load should increase over time with the goal of improving muscle strength and aerobic capacity.

Breath training: Breath training may involve yogic breathing, pursed lip breathing, computer-assisted breathing programs, and other tools and techniques designed to help you breathe more easily and reduce stress.

Nutritional support: Nutritional counseling involves guidance to ensure that you maintain a well-rounded diet. Weight and muscle mass loss are common in later COPD stages, but a healthy rehab program can help restore your physical health.

Counseling and education: Counseling and education can help you deal with the stress and emotions that may come with COPD. Many with COPD also have anxiety or depression, but these conditions can be treated via therapeutic support. They'll also be guided to understand how to take medications, manage flare-ups, and perform day-to-day tasks in a healthier and easier way.

Smoking cessation: Since smoking contributes to the majority of COPD cases, quitting smoking is often integral to the treatment plan. It involves smoking cessation therapy with help from positive reinforcement.

Since there's currently no known cure for COPD, pulmonary rehab can't help patients overcome the disease altogether. However, there are several benefits of keeping up with the rehab:

Builds strength: Research has shown improvements in maximal exercise capacity and strength in people with various lung conditions, including after a lung transplant.

Increases aerobic capacity: Regular high intensity exercise helps people increase aerobic metabolism, which helps them tolerate more exercise before experiencing fatigue or shortness of breath.

Reduces anxiety and depression: Research shows that rehab can lead to a decrease in anxiety and depression in those with COPD, thanks in part to support from specialists like psychologists, therapists, and social workers.

Increases longevity: Pulmonary rehab is associated with better survival outcomes. In a 2023 review, researchers noted an association between rehab started within 3 months of being discharged from the hospital and a lower risk of mortality within 1 year.

Quality of life: Several studies have found a link between pulmonary rehab and an improved quality of life (based on assessment tests like the Chronic Respiratory Disease Questionnaire).

How long is pulmonary rehabilitation for COPD?

After that, a maintenance plan is still necessary to maintain results. Without continuing to implement some of the exercises into a regular routine, benefits can diminish within 6–12 months, a 2023 review suggests.

Rehab is essentially the first step toward making healthy lifestyle changes that last.

Does insurance or Medicare cover pulmonary rehab?

Many insurance providers will fully or partially cover pulmonary rehab, so check with yours to find out.

How can I find a good pulmonary rehab center?

If you're interested in finding a quality pulmonary rehab center, a GP can give you a referral.

In the United States, other specific resources include:

In the event that there's not a rehab program in your area, following a regular exercise regimen and implementing healthy lifestyle changes can still have a profound effect on your day-to-day life. Your doctor may be able to provide you with the assistance you need to live well.

And since walking is one of the most common exercises recommended to those in pulmonary rehab, starting with regular strolls may significantly improve your condition.

A pulmonary rehab program typically consists of exercise training, breathing exercises, education, nutritional support, and counseling. It benefits those with COPD by increasing exercise capacity, boosting strength and breath capacity, increasing longevity, and improving one's day-to-day life.

The main goal of pulmonary rehab is to instill healthy lifestyle changes that last. If there's not a program near you, a doctor may still be able to assist you in implementing new strategies to live more fully and well.

Pulmonary Rehabilitation Is Difficult For Millions Of Americans To Access

Pulmonary rehabilitation, an essential component of care for patients with chronic respiratory conditions, is difficult for millions of Americans to access, a new Yale-led study reveals. The findings, researchers say, reveal geographic regions where this type of care is most lacking and illustrate the potential for telemedicine in helping to bridge this gap.

The study was published Feb. 5 in JAMA Network Open.

Pulmonary rehabilitation is a multidisciplinary program that incorporates exercise and strategic techniques to improve quality of life and overall health for patients with respiratory conditions like chronic obstructive pulmonary disease (COPD), interstitial lung disease, or pulmonary hypertension. Programs typically include a structured exercise component supervised by nurses and/or exercise specialists, as well as educational sessions that teach patients techniques that can help them better manage their illness day to day, such as energy conservation, supplemental oxygen therapy, and methods for capitalizing on periods of higher energy.

"It has been demonstrated across almost the entirety of pulmonary medicine to improve patient health and patient-reported outcomes," said Dr. Peter Kahn, a pulmonary and critical care fellow at Yale School of Medicine and lead author of the study. "Through these programs, patients not only gain a more comprehensive understanding of their condition, but also improve their exercise tolerance in a meaningful way."

However, despite the demonstrated importance of critical pulmonary rehabilitation, many people in the United States must travel long distances to utilize programs.

For the study, researchers used massive geographic data sets and computational infrastructure to compute hundreds of millions of travel times.

"Technologies enabling travel time computations at a massive scale are not just innovative but transformative, providing us with nuanced insights into national data sets previously unavailable to researchers," said senior author Dr. Walter Mathis, a psychiatrist and health services researcher at Yale School of Medicine. 

While around 80% of Americans live within a 30-minute drive of a pulmonary rehabilitation program, the researchers found, over 14 million people — mostly living in the country's western and mid-western regions — must travel more than an hour away for access to their nearest offering.

They also uncovered racial disparities in access to pulmonary rehabilitation. For example, nearly 30% of the American Indian and Alaska Native population lives more than an hour away from the closest program.

"Access to programs within a reasonable amount of travel time is key," said Kahn. "First, many patients with chronic respiratory conditions require oxygen supplementation. Long commutes may mean they have to transport multiple oxygen tanks or battery supplies, which may cause patients to forgo the treatment. Second, because exertional intolerance is a symptom of these diseases, long travel can be incredibly taxing and also serve as a barrier to participation."

Telemedicine and virtual rehabilitation can help bridge this gap need in the short term, said Kahn, though the long-term effectiveness of this approach across different diseases still needs additional evaluation.

Helping patients in the long term will require more accessible in-person rehabilitation options, he added. That will require collaboration between policy makers and health care providers and different approaches to insurance reimbursement.

"Insurance payers, both government and private, do not sufficiently reimburse pulmonary rehabilitation programs for the people, equipment, and supplies needed to effectively run them," said Kahn. That represents a barrier to offering these programs. Of equal importance, insurance limits how many rehabilitation sessions a patient can attend, he added.

"If you're someone with a chronic respiratory condition like advanced COPD, you really need ongoing therapeutic sessions," he added. "But right now, payers limit patients to a small number of lifetime sessions relative to the long-term burden of the disease. And that needs to change."

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