Pulmonary Rehabilitation is a continuous multidimensional service addressed to people with chronic lung diseases and their families, usually conducted by a multidisciplinary team of specialists with the objective of achieving and maintaining the maximum level of independence and functional level within the community for each individual (American Thoracic Society).
The patients who most frequently use the respiratory rehabilitation programmes are those who suffer from chronic obstructive pulmonary disease (COPD), pneumonia, asthma after extubation in ventilated patients, and other diseases such as cystic fibrosis, bronchiectasis, neuromuscular disease, ribcage abnormalities and patients undergoing different types of surgery.
The Respiratory Rehabilitation programme includes the education of the patient and their family, a programme for quitting smoking, pharmacological treatment, treatment of flare-ups, dietary control, oxygen therapy, respiratory physiotherapy techniques, respiratory muscle training techniques, social assessment of the patient’s environment, occupational and vocational therapy, psychosocial rehabilitation and home care.
The pulmonary rehabilitation team is multidisciplinary and includes pulmonologists, rehabilitation doctor, physiotherapist, nurse, nutritionist etc. The rehabilitation service works in coordination with the referring doctors, whether from the hospital itself or elsewhere, in order to ensure the highest quality of care for our patients.
Physiotherapy is carried out in an individualised way according to therapeutic objectives adapted to each patient and his or her clinical situation.
After clinical assessment of the patient the specific respiratory rehabilitation programme will provide guidelines for each pathology and clinical situation of the patient, with emphasis on the objectives and the type of treatment.
All patients with COPD can benefit from rehabilitation programmes at all stages (Global Initiative for Obstructive Lung Diseases – GOLD, 2011).
Pulmonary Rehabilitation has become the cornerstone for the treatment of patients with stable phase COPD.
Other pathologies eligible for respiratory rehabilitation, whether in the hospital or out-patient phase, are pulmonary surgery (before and after surgery); bronchiectasis, atelectasis, respiratory insufficiency, extubated from ICU …
Systematic reviews have demonstrated the beneficial effects in these patients.
However, the effects of Pulmonary Rehabilitation in patients with unstable COPD that have suffered a recent flare-up are not well-established.
Pulmonary Rehabilitation is an effective procedure for the treatment of patients with COPD following a flare-up. It lowers the risk of hospital readmissions and notably improves quality of life in relation to health and capacity for exercise. (Cochrane 2011)