Pulmonary Rehabilitation

When I was first diagnosed with emphysema, I was told that it was a permanent condition, and while it might stabilize, it would not improve significantly. In doing research for these articles, however, I have discovered that there are some programs which are designed to actually improve pulmonary function. These programs usually are identified by the term, Pulmonary Rehabilitation". While these programs do not "cure" lung disease, they do improve the quality of life for patients with respiratory disease.

The first component of an effective pulmonary rehabilitation program is the application of breathing control techniques. These techniques include pursing the lips and diaphragmatic breathing, with the goal of improving breathing patterns, relieving dyspnea, and improving respiratory muscle efficiency.

Chest physical therapy is another part of a well designed program. It utilizes techniques such as postural drainage, chest percussion, pounding the back with cupped hands, vibration, directed cough and the forced expiratory technique. These techniques are designed reduce the resistance of the airways, thereby improving gas exchange and reducing the incidence of respiratory tract infections.

Muscle training is designed to increase strength and endurance, especially with conditions such as restrictive lung diseases, and pulmonary hyperinflation. These conditions can severely affect the ability to do many normal activities of daily living. Many people realize that activities such as walking become difficult as the degree of respiratory involvement increases, but they tend to forget that there are more muscle groups which need to be strengthened besides the lower extremities. The upper body muscles are often overlooked, for example, yet most daily activities are done with the upper body. With a training program which exercises not only the upper and lower body, but the respiratory muscles as well, patients are more able to perform their daily activities without increased risk of respiratory distress.

Achieving a good nutritional balance is essential for health in anyone, but for the COPD patient, it becomes increasingly important. In a program of pulmonary rehabilitation, the eating characteristics of the individual are studied, and diets which are rich in those ingredients missing from the normal diet, are supplemented. Another nutritional category that is studied is the body fat content. Studies are periodically made that compare the ideal body weight and body fat measurements with those of the COPD patient. Diets are then developed which attempt to bring the two figures closer together.

Finally, a program of education, occupational therapy and psychosocial counseling are provided to help the patient accept his/her limitations, attempt to deal with the feelings of loss associated with the discontinuing of work activity, and educational training to help develop alternate skills. These factors, combined with the other areas mentioned above, provide a COPD patient with the optimum level of rehabilitation, and therefore help to improve the quality of life.

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