"Pulmonary Rehab": what is it?
The American Thoracic Society and the European Respiratory Society have recently adopted the following definition of pulmonary rehabilitation: Pulmonary rehabilitation is an evidence-based, multidisciplinary, and comprehensive intervention for patients with chronic respiratory diseases who are symptomatic and often have decreased daily life activities. Integrated into the individualized treatment of the patient, pulmonary rehabilitation is designed to reduce symptoms, optimize functional status, increase participation, and reduce health-care costs through stabilizing or reversing systemic manifestations of the disease. Comprehensive pulmonary rehabilitation programs include patient assessment, exercise training, education, and psychosocial support.
This definition focuses on three important features of successful rehabilitation:
1. Multidisciplinary: Pulmonary rehabilitation programs utilize expertise from various healthcare disciplines that is integrated into a comprehensive, cohesive program tailored to the needs of each patient.
2. Individual: Patients with disabling lung disease require individual assessment of needs, individual attention, and a program designed to meet realistic individual goals.
3. Attention to physical and social function: To be successful, pulmonary rehabilitation pays attention to psychological, emotional, and social problems as well as physical disability, and helps to optimize medical therapy to improve lung function and exercise tolerance.
The interdisciplinary team of health-care professionals in pulmonary rehabilitation may include physicians; nurses; respiratory, physical, and occupational therapists; psychologists; exercise specialists; and/or others with appropriate expertise. The specific team make-up depends on the resources and expertise available, but usually includes at least one full-time staff member.
What can it do for you?
Patients with chronic obstructive pulmonary disease can enter what is called a dyspnea spiral, which is an interrelationship of symptoms affecting activities, and vice versa; the greater the symptom intensity, the more the interplay between psychosocial issues, mood changes, and reduction in daily activites. Pulmonary rehabilitation is one of the few interventions believed to break this cycle of progressing symptoms limiting activites (Journal of Rehabilitation Research and Development Vol. 40, No.5, Septembet/October 2003, Supplement 2, p 13-24). In laymen's terms, symptoms cause a decrease in activity, which worsen symptoms, which in turn spur this dyspnea cycle. Pulmonary rehabilitation is the solution!