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Pulmonary Rehabilitation

Goals of Pulmonary Rehabilitation:

Reduce symptoms (i.e dyspnea), optimize functional status and health-related quality of life, reduce health care costs through stabilizing and reversing systematic manifestations of the disease (peripheral muscle dysfunction resulting from deconditioning and systemic inflammation, adoption of a sedentary lifestyle, body composition abnormalities, poor self-management skills, anxiety, depression)

Treatment: American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) guidelines. 6-12 weeks:

Patient assessment and goal setting, self-management education, exercise training (muscles of ambulation: both low and high intensity training), general strength training, unsupported endurance training of the upper extremities, psychosocial support, outcome measurement (6 minute walk test, objective improvement: muscle strength, ROM)

Diagnoses which are appropriate for Pulmonary rehab per AACVPR :

  • COPD
  • Persistent Asthma
  • Bronchiectasis
  • Cystic Fibrosis
  • Bronchiolitis Obliterans
  • Interstitial diseases (interstitial fibrosis, occupational or environmental lung disease, Sarcodosis)
  • Chest wall disease (Kyphoscoliosis, Ankylosing Spondylitis)
  • Neuromuscular disease (Parkinson’s disease, Postpolio Syndrome, Amyotrophic lateral sclerosis, Diaphragmatic dysfunction, Multiple Sclerosis, Posttuberculosis syndrome)
  • Lung Cancer
  • Primary pulmonary hypertension
  • Before and after thoracic and abdominal surgery
  • Before and after lung transplantation
  • Before and after lung volume reduction surgery
  • Ventilator dependency
  • Pediatric patients with respiratory disease
  • Obesity-related respiratory disease

Conditions appropriate for Pulmonary Rehabilitation per AACVPR:

  • Dyspnea, fatigue, chronic respiratory symptoms
  • Impaired health-related quality of life
  • Decreased functional status
  • Decreased occupational performance
  • Difficulty performing activities of daily living
  • Difficulty with the medical regimen
  • Psychosocial problems attendant to the underlying respiratory illness
  • Nutrition depletion · Increased use of medical resources (i.e. hospitalizations, ER visits, physician visits)
  • Gas exchange abnormalities including hypoxemia

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