Is Pulmonary Rehabilitation Beneficial to Patients with COPD?

Chronic Obstructive Pulmonary Disease (COPD) is a lung disease in which the airways that carry air in and out of the lungs are partially obstructed making it difficult for the patient to breathe in and out. COPD can be caused by cigarette smoking, or exposure to pollution, dust, or chemicals over a long period of time generally. COPD is diagnosed usually in middle aged people, it slowly progresses over time, so it may take years for a patient to notice any symptoms.

There is no cure for COPD and it cannot be reversed, once the damage is done, it's done. There are things that can be done to slow down the progression of the disease and make the patient feel better. A pulmonary rehabilitation program may be beneficial to the COPD to help the patient remain active.

The American Association of Cardiovascular and Pulmonary Rehabilitation recommends a program that includes both high and low intensity exercise. Along with exercise, a pulmonary rehabilitation program includes education, instruction on various respiratory therapies and techniques and psychological support. Pulmonary rehabilitation can reduce the frequency and length of hospital stays and improve the patients exercise tolerance, and dyspnea.

The primary goal of pulmonary rehabilitation is not to cure the patient, but to restore the patient to the highest level possible of independent function and daily activities. Patients are educated on their disease, treatments and how to cope with their disease. It is difficult for an individual who works hard to take each breath to become motivated to exercise. They will generally be started out with some simple arm lifts and progress to more challenging exercises as tolerated.

The goal of rehabilitation is to decrease respiratory complications and symptoms, encourage self management and control over daily tasks, improve physical condition, improve emotional state, and to reduce hospitalization. Patients should be encouraged to stop smoking, regular exercise and weight control as well. Routine immunizations for pneumonia and flu should be administered as well, as COPD patients are more susceptible to these illnesses and can result in death in a patient with COPD due to their weakened state and inability to recover easily.

Respiratory muscle training is another important aspect of rehabilitation. Studies have shown in increase in exercise tolerance and shortness of breath with respiratory muscle training. It may result in controlled breathing patterns and has shown improvement in respiratory muscle strength and endurance with an increase in functional status. Nutrition also plays an important role. Malnutrition is common in COPD and is essential that the patient eats an appropriate portion of protein, fats and carbohydrates.

Due to the inability to to participate in social and recreational activities, the patient often becomes severely depressed. It is shown that a patient involved in a pulmonary rehabilitation program their mood is improved and have less anxiety. Anti-depressants or anti-anxiety medication may be considered if the patient is suffering from depression or anxiety. It is extremely difficult to get a depressed patient to be compliant when it comes to exercise, so it is essential to treat their depression.

Rehabilitation is a team effort involving the patient, health care worker, and family and friends. It is common for a patient with COPD to feel helpless therefore abandoning the rehabilitation program. With the support of the health care worker and family, the patient is more likely to get back on track and stick with the program. With rehabilitation, the patient can usually be more active in their day to day tasks.