Part 1: Pulmonary Rehabilitation: What Is It?
What is pulmonary rehabilitation (PR)?
Pulmonary rehabilitation (PR) is a treatment programme designed with people with long-term lung conditions in mind. The programme consists of courses including:
- Exercise classes
- Education about looking after your body and lungs
- Advice on managing your lung condition
- Techniques to manage breathlessness
It aims to educate you on how to manage your symptoms and condition in general. This will help you maintain your physical and psychological health. It does not replace medical interventions, such as an inhaler or pill medication, but works alongside them to help them be more effective.
PR courses are typically delivered in large groups of 8 to 16 people. The programme usually lasts 6 to 8 weeks for a minimum of 12 sessions, with normally two sessions per week. Sessions usually run between 1 to 2 hrs per session. Sessions are generally split into two, with the first half being an exercise class and the second half being an educational talk on how to manage your lung condition.
For each course, a PR team will help support you beforehand, in completing a comprehensive assessment to ensure the sessions are tailored to suit your specific needs and goals, and during your course. This team is comprised of trained healthcare professionals such as physiotherapists, nurses and occupational therapists.
The courses may be held in local hospitals, community halls, leisure centres, and health centres. Some places also offer digital or over-the-phone pulmonary rehabilitation. Your healthcare professional will ensure you can easily access the PR programme, whether in person or virtually/over the phone.
Is PR right for me?
PR is aimed at people with lung conditions who have chronic breathing difficulties that affect their ability to be active day-to-day. This includes:
- Chronic obstructive pulmonary disease (COPD)
- Pulmonary fibrosis/interstitial lung disease
- Bronchiectasis
- Severe asthma
- Cystic fibrosis
- Pulmonary hypertension
According to Asthma + Lung UK, if you are on oxygen, it may be possible to still take part in PR courses but you may need a portable oxygen cylinder during the classes. If you’ve been told that your oxygen levels drop during exercise, portable oxygen may be useful during fitness sessions as it can help you exercise for a longer duration throughout the class.2 Having oxygen to assist you during the classes may help you complete them, which you may have struggled with previously and not thought possible for you to do.
You may not be suitable for PR if you are too breathless to leave the house, pain limits your walking, you have uncontrolled heart problems, or you’ve had a recent heart attack. You should ask your general practitioner (GP) or consultant about other options that might be more suitable for you instead.2
PR benefits
Access to PR programmes has proven to improve people’s ability to walk further and help them feel less tired and breathless when carrying out day-to-day activities.1 According to the National Health Service (NHS), 90% of patients who complete a PR programme have higher activity and exercise levels, and report improved quality of life.1
PR has been shown to reduce the number of emergency room visits and hospital stays, reduce flare-ups and complications, and support better self-management.1
Pulmonary rehab may also help you to:
- Improve your daily function
- Have a better quality of life
- Reduce symptoms of anxiety or depression3
- Gain confidence to be more active and exercise safely
- Have a chance to meet people with similar conditions and share experiences
A study published in the journal JAMA found that people with COPD who received PR after being hospitalised for a flare-up showed a substantial decrease in mortality risk after a year.
Where can I get PR courses?
Your GP, practise nurse or respiratory team can refer you for PR courses. When approaching your medical specialist about PR, you can ask questions such as:
- What is available in my area?
- Is PR suitable for me and my condition?
- What can I achieve/what are my goals if I participate in PR courses?
Some programmes allow you to bring a relative or carer if needed. Programmes can also have a waiting list, so it is important that you speak to your GP about the treatment as soon as possible.2
