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Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease (COPD)

Treatment Overview

Pulmonary rehabilitation for COPD combines different treatments to:

  • Help you lead a more active life.
  • Help reduce your symptoms.
  • Improve your quality of life.
  • Encourage your active participation in your treatment.
  • Help keep you out of the doctor's office and out of the hospital.

Pulmonary rehabilitation—"rehab" for short— will not reverse the damage to your lungs from COPD. But it will help you do your daily tasks, such as dressing, grocery shopping, and walking, more easily.

There are many different kinds of pulmonary rehab programs. Some are done in the hospital. Some are done at home.1

Health professionals who may be involved with these programs include:

Supervision and structure

Pulmonary rehab is usually supervised and structured. This means that it will include evaluation of your symptoms and treatment, short-term and long-term goals, education, support, and supervised therapy programs.

Evaluation and goals

Your rehab team will look at your symptoms and current treatment to make sure that you can get the most out of the program. They also will identify other concerns, such as heart problems, that might affect your ability to exercise and to perform daily tasks.

Then you and your team will set short-term and long-term goals to meet your specific needs. For instance:

  • Some people might want to be able to dress themselves every day.
  • Others might want to be able to walk 30 minutes every day.
Education

Understanding COPD—how it progresses and is best treated—makes it easier to live with and manage the disease. Rehab programs generally include education for both you and your family about:

  • How the program affects your COPD symptoms.
  • The importance of the program to your overall health.
  • How regular participation can help you meet your goals.
Support

Support and encouragement from friends, family, and your health team are crucial in helping you stay with your rehab plan.

  • Your doctor may recommend counseling for you and your family.
  • Support groups are available in many cities. These groups can help you and your family cope with COPD and the problems it can cause.
  • One of the greatest benefits of a rehab program is the chance to meet other people with COPD who are doing a lot to breathe better and live longer. You can exchange information about living with COPD with people who have had a lot of success.
Supervised therapy programs

Therapy programs are the heart of pulmonary rehab. They are created just for you, depending on your needs and goals.

What therapy programs are used in pulmonary rehab?

Help to quit smoking

If you still smoke, stopping is the most important therapy program. Quitting smoking can slow damage to your lungs. Your rehab team can help you find the right program for quitting, whether it involves medicine, counseling, and/or support groups.

For more information, see the topic Quitting Smoking.

Exercise

Exercise training for COPD often includes aerobic exercise, such as walking or using a stationary bike, and muscle-strengthening exercises for your arms and legs.

  • Regular exercise can improve how active you can be, and it can reduce your shortness of breath.
  • If you stay active, you may have fewer problems from COPD, have a better attitude about your life and the disease, and be less likely to be depressed.

Always talk to your doctor before starting an exercise program. People with COPD may also have heart problems that limit their exercise choices. You may need medical supervision when you start the program.

For more information, see:

Click here to view an Actionset.COPD: Using Exercise to Feel Better.
Breath training

Breath training can help you take deeper breaths and reduce shortness of breath. You must practice breath training regularly for it to work.

Three basic breath-training methods are diaphragmatic breathing, pursed-lip breathing, and breathing while bending forward. They can be used to help you get through periods when you feel more short of breath.

  • Diaphragmatic breathing helps your lungs expand so that they take in more air. (Your diaphragm is a muscle that helps draw air into your lungs as you breathe.) Many, but not all, people with COPD find this breathing method helpful.
    • Lie on your back, or prop yourself up on several pillows.
    • With one hand on your belly and the other on your chest, breathe in, pushing your belly out as far as you can. You should be able to feel the hand on your belly moving out, while the hand on your chest should not move.
    • When you breathe out, you should be able to feel the hand on your belly moving in.
    • After you can do this kind of breathing well lying down, you can learn to do it sitting or standing.
    • Practice this breathing for 20 minutes, 2 or 3 times a day.
  • Pursed-lip breathing may help you breathe more air out so that your next breath can be deeper. Pursed-lip breathing reduces shortness of breath and improves your ability to exercise.
    • Breathe in through your nose and out through your mouth while almost closing your lips.
    • Breathe in for about 4 seconds, and breathe out for 6 to 8 seconds.
  • Breathing while bending forward at the waist may make it easier for you to breathe. Bending forward while breathing may reduce shortness of breath in those with severe COPD, both at rest and during exercise. This may be because bending forward allows the diaphragm to move more easily.
Learning to eat well

Eating well is important to keep up your strength and health. Problems with muscle weakness and weight loss happen often in severe COPD. If you lose too much weight, you can get even more short of breath and become even less active. Over time, you could become so weak that you need to depend on others for daily living. For more information, see:

Click here to view an Actionset.COPD: Keeping Your Diet Healthy.
Click here to view an Actionset.COPD: Avoiding Weight Loss.

What To Expect After Treatment

An ongoing pulmonary rehabilitation (rehab) program can help you function better over the long term. Each program should set short-term and long-term goals to help you keep track of changes and successes. This makes sure that the program continues to meet your needs.

Why It Is Done

Pulmonary rehabilitation (rehab) is recommended for people who have lung problems such as COPD.

Pulmonary rehab helps most people who have COPD. It especially helps if you were recently in the emergency room or hospital for a flare-up (exacerbation).

How Well It Works

A review of research shows that taking part in pulmonary rehabilitation (rehab):2, 1

  • Improves shortness of breath and fatigue.
  • Gives you more control over your condition.
  • Results in greater improvement in quality of life than other types of treatment, such as medicine.
  • Modestly improves how much you can exercise.

To work well, a rehab program should last at least 6 weeks. The longer the program is, the better it works.3

Risks

There is little or no risk to these programs if they are well supervised.

What To Think About

The success of pulmonary rehab relies on the relationship between you and your health team. It is important that you work with your team, take an active role in the program, and understand the importance of staying with your program.

Although this treatment can improve your daily life, it does not reverse the effects that COPD has had on your lungs or other organs such as your heart. It does not cure COPD. It trains your mind, muscles, and heart to get the most out of damaged lungs.

Complete the special treatment information form (PDF)special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.

References

Citations

  1. Maltais F, et al. (2008). Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease. Annals of Internal Medicine, 149(12): 869–878.
  2. Lacasse Y, et al. (2005). Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews (2). Oxford: Update Software.
  3. Global Initiative for Chronic Obstructive Lung Disease (2013). Global Strategy for the Diagnosis, Management, and Prevention of COPD. Available online: http://www.goldcopd.org/guidelines-global-strategy-for-diagnosis-management.html.

Other Works Consulted

  • Qaseem A, et al. (2011). Diagnosis and management of stable chronic obstructive pulmonary disease: A clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Annals of Internal Medicine, 155(3): 179–191.
  • Spruit MA, et al. (2013). An official American Thoracic Society/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation. American Journal of Respiratory and Critical Care Medicine, 188(8): e13–e64.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Ken Y. Yoneda, MD - Pulmonology
Current as of November 14, 2013

Current as of: November 14, 2013

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