What did the left lung say to the right lung? We beLUNG together! Pulmonary rehabilitation week is March 10-16, 2024, making it the perfect time to discuss pulmonary rehabilitation and the important role pulmonary rehabilitation can have in improving your life.

What is Pulmonary Rehabilitation?

Pulmonary rehabilitation (pulmonary rehab) is a supervised evidence-based medical program that combines exercise and education to improve the lives of individuals with chronic lung disease. This multidisciplinary and comprehensive intervention includes three essential components to improve your lung health: aerobic exercise, endurance training, and education. Typically, pulmonary rehab programs are conducted biweekly over the course of nine weeks, totaling 18 sessions to complete a pulmonary rehabilitation program. Pulmonary rehab provides a safe environment with a team of trained professionals (registered nurse, respiratory therapist, exercise physiologist) who will monitor you throughout the session and provide meaningful education that can improve your daily life living with a chronic lung disease.

What Will I do During a Pulmonary Rehab Session?

Each session includes three activities: aerobic exercise, strength training, and education. Aerobic exercises encompass the use of equipment such as a treadmill, stationary bike, or recumbent bike (among others) for approximately thirty minutes. However, it is important to note, that the pulmonary rehab team will meet you where YOU are! Many patients decline participation in a program due to fear and uncertainty of being able to complete the activities. It is important to remember that this intervention is patient-tailored and aimed at improving the physical and psychological conditions of people with chronic lung disease. The pulmonary rehab team will start you on aerobic exercise equipment that is appropriate and safe for your activity level. In addition to aerobic exercise, each session will include strength training. Strength training involves the use of hand-held weights while sitting in a chair to perform varying strength training exercises (biceps curls, triceps kickbacks, balance exercises, etc.) Lastly, important educational topics will be covered during a session such as managing your activities of daily living, nutrition, interpreting pulmonary function tests (PFTs), and (my personal favorite) breathing techniques to manage shortness of breath. 

What are the Goals of Pulmonary Rehab?

According to the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), the goals of pulmonary rehabilitation are the following: 1) decrease symptoms; 2) optimize functional state; 3) increase participation; and 4) reduce health-care costs through stabilizing or reversing systemic manifestations of the disease. To put it simply, pulmonary rehabilitation seeks to help patients living with chronic lung disease control and reduce symptoms, improve functional status, improve overall quality of life, and provide a resource for patients and families to learn about their chronic lung disease and implement self-management strategies.

What are the Benefits of Attending Pulmonary Rehab?

Research has provided evidence on the numerous benefits of attending pulmonary rehabilitation programs in patients with interstitial lung disease (ILD). Vainshelboim et al. (2014) examined the effects of a pulmonary rehabilitation program in patients with idiopathic pulmonary fibrosis (IPF), and found that the program improved exercise tolerance, functional capacity, pulmonary function, dyspnea (shortness of breath), and quality of life in patients with IPF. Furthermore, Yu et al. (2019) conducted a systematic review and meta-analysis that evaluated the efficacy and safety of pulmonary rehabilitation in patients with IPF. These researchers found that pulmonary rehab enhanced exercise capacity (measured by a 6-minute walk test) and improved quality of life in patients with IPF. Additionally, no adverse events were reported in all studies included in the systematic review and meta-analysis. Not to mention that pulmonary rehab programs provide a supportive environment for patients living with chronic lung disease to come together as a community. This helps remind you that while at times living with a chronic illness may feel isolating, you are not alone!

The bottom line is that pulmonary rehabilitation is an evidence-based program that can improve your ability to exercise, improve your breathlessness, improve your quality of life, and provide you with invaluable strategies and education to help you live with your chronic lung disease.

Sounds Pretty Great! Now, Where do I Sign Up?!

Individuals with chronic lung disease, such as pulmonary fibrosis, can enroll in a pulmonary rehabilitation program with a referral from their provider. If you are interested in attending a pulmonary rehab program, I strongly encourage you to contact your health care provider and ask for a referral today! The American Association for Cardiovascular and Pulmonary Rehabilitation also has a Program Directory where you can look for a program near you.

One Last Thing…

While I am currently an assistant professor and nurse scientist researching symptom management strategies for patients with pulmonary fibrosis, I previously worked in a pulmonary rehabilitation program for years. One essential recommendation that I want to emphasize for everyone reading this: use it or lose it. You can attend a pulmonary rehab program and make profound improvements in your exercise capacity, endurance, quality of life, etc. However, once you complete the program you must maintain your gains. Don’t lose everything you worked for during those 18 sessions by discontinuing your thirty minutes of aerobic exercise, your daily breathing exercises, or your strength training. The pulmonary rehab team wants you to establish an exercise routine that you can continue outside of the program. Consistency and commitment are imperative to maintain all that you will accomplish in pulmonary rehabilitation.

References

Vainshelboim, B., Oliveira, J., Yehoshua, L., Weiss, I., Fox, B. D., Fruchter, O., & Kramer, M. R. (2014). Exercise training-based pulmonary rehabilitation program is clinically beneficial for idiopathic pulmonary fibrosis. Respiration, 88(5), 378-388. https://doi.org/10.1159/000367899

Yu, X., Li, X., Wang, L., Liu, R., Xie, Y., Li, S., & Li, J. (2019). Pulmonary rehabilitation for exercise tolerance and quality of life in IPF patients: A systematic review and meta-analysis. BioMed Research International, 8498603. https://doi.org/10.1155/2019/8498603