Components of Pulmonary Rehabilitation

By Dr. Vivek Nangia in Pulmonology

Mar 11 , 2022 | 3 min read


Lung diseases can affect your day to day activities. If you are suffering from lung cancer, chronic obstructive pulmonary disease (COPD), cystic fibrosis, asthma or any other lung disease, your doctor may advise pulmonary rehabilitation that can improve the quality of your life. 

You need to go to the hospital 2-3 times for 4 to 12 weeks for pulmonary rehabilitation. It helps you gain strength and manage daily activities, work and social activities. The basic goals of pulmonary rehabilitation are-

  1. Improve your symptoms such as shortness of breath
  2. Restore functional capabilities of lungs
  3. Improve your quality of life

Now let’s talk about what comprises pulmonary rehabilitation.

Following are the components of pulmonary rehabilitation that makes it a comprehensive approach for dealing with lung diseases.

  1. Patient selection and assessment
  2. Exercise training
  3. Inspiratory muscle training
  4. Neuromuscular electrical stimulation
  5. Psychosocial counselling
  6. Nutritional evaluation and counselling
  7. Drug use and education

Patient selection and assessment

A team of respiratory therapists, exercise physiologists, and nurses will perform the initial assessment in which stress test, pulmonary function test, and the walking test are done. Apart from this, blood pressure and heart rate are measured. 

If you are suffering from chronic obstructive pulmonary disease or other chronic respiratory disease and have symptoms such as difficulty in breathing, exercise intolerance and fatigue despite taking medications, you are a good candidate for pulmonary rehabilitation. However, pulmonary rehabilitation is contraindicated if you have unstable angina, unstable bone fracture or are suffering from communicable disease or serious mental health issues. 

Exercise training

Exercise training proves to be advantageous for patients with lung disease irrespective of age, level of dyspnea (shortness of breath), gender or disease severity. There are two types of exercise training-

  1. Endurance exercise training

    Endurance is your ability to continue the physical activity for a longer duration. If you have lung disease, your lungs hyperinflate, and you feel shortness of breath. Endurance exercises can improve all these symptoms. Walking and cycling are the two exercises that are generally recommended as a part of endurance exercise training.

    According to the American Thoracic Society/European Respiratory Society, a session of 20 to 60 minutes 3 to 5 times a week is recommended.

  2. Resistance/ Strength training

    In patients with lung disease, muscle atrophy and weakness are very common, and resistance /strength training can improve these symptoms. You can perform this training by using weight lifting, lead balls, dumbbells or without machines.

    Bench press, abdominal crunches, deadlift are some of the exercises that prove to be very beneficial and efficient in improving muscle strength.

    You should start these exercises at a level in which you can tolerate them without any discomfort. However, gradually the duration and then the intensity is increased.

Inspiratory muscle training

Inspiratory muscle training improves the strength of inspiratory muscles such as the diaphragm. It is often used along with aerobic exercises to improve symptoms such as shortness of breath. Some of the breathing exercises are-

  1. Pursed lip breathing-

    You simply need to breathe in through your nose and breathe out through your mouth with pursed lips.
  2. Diaphragmatic Breathing / Belly Breathing-

    Sit on a chair and place your hands on your belly. Breathe in through your nose and let your belly get filled with air, then breathe out through your mouth as many times as you inhale.

These are some of the easiest exercises for managing shortness of breath.

Neuromuscular electrical stimulation

For neuromuscular electrical stimulation, the specialist uses a device to apply electrical impulse through your skin to a particular group of muscles to contract the muscles and strengthen them.

Psychosocial counselling

Lung diseases can affect the lifestyle of an individual, so they may lead to stress, depression, and anxiety. Counselling sessions along with medications can help you improve your condition. 

Nutritional evaluation and counselling

COPD patients often lose weight, so nutritional evaluation and counselling can help you understand the calorie requirement of your body and prevent sudden weight loss. Some patients can gain weight due to limited physical activity, so counselling can prove to be beneficial for them too. 

Drug use and education

Patients suffering from severe lung disease need to take many medications, so educating them about the disease and the role of medications and their side effects can improve the compliance and response of patients.

Pulmonary rehabilitation is an effective way to improve symptoms of lung diseases, and it requires consistent efforts to bring results. If you are suffering from a lung disease, consult our top pulmonologists at Max Hospital to get a personalized treatment plan.

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