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