Pulmonary Rehabilitation

Overview of Pulmonary Rehabilitation

Pulmonary Rehabilitation is a program in which you learn how to properly breathe and exercise. This also helps to manage your breathing problem and increase your energy. This program will take you through a variety of exercises and will teach you how to breathe throughout each one. You will also learn how to take medications and eat properly. The goal of pulmonary rehabilitation is to help people with Chronic Obstructive Pulmonary Disease (COPD) get through everyday activities, such as climbing stairs.

Pulmonary rehab is the most important non-medication treatment for COPD. This program provides education and support, as well as supervised exercise. This program improves your quality of life and reduces exacerbations (flare-ups) of your COPD symptoms which reduces hospital admissions.

During this program you will learn:

• how to stay healthy with COPD,
• different breathing techniques,
• more about your medications,
• nutrition to help your lungs,
• how to stay relaxed and manage stress,
• oxygen therapy
• if your oxygen levels decreases during exercise
• how to travel safely with COPD.

This outpatient program lasts four to eighteen weeks and is normally covered by your insurance.  This program should be repeated every 18 months to maintain muscle strength.

Once you have completed this program, it is vitally important that you maintain and continue to build your muscle strength.  Just like keeping the muscles in your legs strong to help you avoid falling, it is important to keep the muscles that help you breathe strong.  Your diaphragm is the muscle that helps with your breathing.  By keeping your diaphragm “in shape” you will be able to take deeper breaths.  Maintaining muscle strength through exercise reduces fatigue, helps you sleep better and reduces depression.  All of these increase your endurance which increases your quality of life and allows you to live life to the fullest! It is recommended that you do 30 minutes of physical activity a day (three 10-minute sessions are just as effective as one continuous 30-minute session).  It is also important to do different activities so that you are using different muscles every day to maintain optimum muscle strength.

You should do some form of exercise every day.  The goal is to increase that activity every day little by little.  You will have some days when you might not be able to do as much as the day before and that is okay.  Do as much as you can on those days and then try to build again the next day.

Some examples of activities include:

• Walking – preferably outside if the weather is nice (a change of scenery helps reduce depression).  If the weather is too hot/humid, raining or if the pollen level is too high (& you have allergies), walk inside.  You can go to a mall or a store and do your walking if the weather does not permit walking outside and then you still get that “change of scenery”
• Riding a stationary bicycle with low or moderate resistance
• Walking slowly upstairs taking rest breaks when you get out of breath
• Participating in low impact physical activities like yoga, tai chi, dancing, water aerobics, bowling, etc.
• Doing household chores like vacuuming, dusting, washing dishes, doing the laundry,  gardening, grocery shopping, etc.

Exercises with Pulmonary Rehabilitation

Exercises are supervised by staff who prepare an exercise program just for you. Typically, they will start at a beginner’s level. This means that you may start with seated exercises, or you may begin by walking on a treadmill. As you continue on with exercises, then you will begin to get stronger and the exercises will increasingly get harder. You will notice that you are also less tired and feel less breathlessness when exercising.

Most pulmonary rehabilitation programs meet two or three times a week, and you can go through the program as long as you like. Attending each session is very important. You will want to talk with your physician to determine if pulmonary rehabilitation is right for you. Your physician may check into your current health, discuss what activity level you are at, and will want to know your willingness to go.

There are three main types of exercises. Stretching is usually a beginning step. This will help by slowly lengthening the muscles and will increase your range of motion as well as your flexibility. Aerobic exercises can help to strengthen the heart and lungs and can aid in improving your breathing. Some examples of these exercises include: walking, jogging, biking, water aerobics, etc. Strengthening can be done by repeated muscle contractions and is used to increase the strength in the respiratory muscles.

Why Should I Exercise?

Pulmonary Rehabilitation exercises can drastically change how you breathe. It also has many other added benefits, such as lowering blood pressure, reducing body fat, improving COPD symptoms, etc. You should try to exercise for 20-30 minutes at a time, and for about 3-4 times per week.

Stop Smoking

In an effort to feel better, you will need to quit smoking immediately. Going through pulmonary rehabilitation will hold you accountable and help you to quit. If you have COPD, then the first step to slow the progression of COPD is to quit smoking now. You will also want your environment to be smoke-free. Most people believe that once they have COPD there is no use in quitting smoking, but that is not true. If you are able to quit, the damage that has been done does not necessarily get better, but it will show benefits in the long run.

Diet and Pulmonary Rehabilitation

People that have COPD and go through pulmonary rehabilitation will learn how to manage their diet as well. The problem with COPD is that you may have limited energy, which means that you will not feel like preparing a meal or eating large meals. Some people with COPD also take medications for depression which will reduce your appetite. People will COPD burn about 10 times the amount of calories by breathing as people that do not have COPD. If you are not consuming enough calories, then you are more likely to get an infection, have weakened muscles that control breathing, and may be weak and tired. If you are overweight, then your body needs more oxygen, it will be more difficult to breathe, and your lungs and heart have to work harder.

A good diet for COPD consists of drinking plenty of water and eating a variety of healthy foods. Most people need between 6-8 glasses of water and should also take in high in fiber foods, vegetables, fruits, etc. It is also important to avoid salt. Choose foods that are also easier to chew, and eat smaller and more frequent meals. It is also best to sit up while eating and make it easier to breathe at mealtimes.

Since energy levels are likely low, then you will want to choose foods that are easy to prepare. It may also be helpful to prepare foods in advance and freeze them for nights that you do not have the energy to cook.

Emotional Support with Pulmonary Rehabilitation

People that have been diagnosed with COPD have a greater chance of anxiety or depression. Pulmonary rehabilitation will usually offer relaxation training and counseling. The goal of this is to make you more interested in activities that please you again. You will also get to meet people that are going through the same thing and share questions and or feelings about what you are going through.

What is the Goal of Pulmonary Rehabilitation?

The results from participating in pulmonary rehabilitation can last for years if you take care of yourself. By completing this program, it is less likely that you will have an exacerbation or flare-up, which means that you are less likely to have to go to the hospital. People who complete pulmonary rehabilitation also report that they feel they are more in control of their COPD, feel more energetic, and also feel that they are no longer short of breath. The goal of pulmonary rehabilitation is to get you feeling better and also able to accomplish daily activities again.