Pulmonary rehabilitation

Also see Respiratory therapy

Overview
Pulmonary rehabilitation (a.k.a. pulmonary rehab) is a rehabilitation treatment structured for ill patients with chronic respiratory problems whose pulmonary function has decreased, even after other medical treatment. It is also for patients who remain symptomatic, even if their pulmonary function has not decreased after other medical treatment. An example of somebody who could qualify for pulmonary rehab might have COPD.

Goals

 * Reduce symptoms, reduce disability, and improve the overall quality of life for the patient.
 * Pulmonary rehab is also designed to educate patients on their illness and disability and to teach them good habits in order to take care of themselves and improve their overall quality of life.

Pulmonary rehabilitation does not attempt to change or improve lung function, improvements in exercise tolerance, quality of life and breathlessness are achieved through mechanisms other than change in pulmonary function, ie: increasing muscle strength, achieving desensitization to breathlessness and improving aerobic fitness.

Reasons
Reasons for pulmonary rehab may include- Patients who qualify for pulmonary rehab are usually chronically ill and are frequently symptomatic. These patients may lose their breath even after everyday activities such as walking across a room.
 * Cough
 * Chest pain
 * Breathlessness or Dyspnea
 * Respiratory muscle dysfunction
 * Reduced exercise tolerance
 * Diaphragmatic fatigue

Note: Also see the patient selection section of this article.

Benefits of Pulmonary Rehabilitation
Through the education and treatment of the patient and the education of friends and family, the patient's condition can by greatly improved. Impairments in lung function and ability can be addressed through treatments such as exercises so the patient's respiratory function can be restored to the maximum possible to increase the patient's independence and overall quality of life.

Several respiratory impairments have responded to treatment, resulting in a good record of success for pulmonary rehab. In addition to this, many increases in respiratory function such as total exercise capacity have been reported. There have been reports that many patients with Chronic obstructive pulmonary disease have a greatly improved prognosis after pulmonary rehabilitation is completed.

Patient Selection
Patients who are selected for pulmonary rehabilitation usually are still restricted and symptomatic even after other medical treatment. Patients that have lowered exercise tolerance and/or experience restriction during everyday activities are usually eligible for pulmonary rehabilitation.

Setting
Several settings can be used for pulmonary rehabilitation. The most common are inpatient and outpatient settings and home settings. Selection depends on many factors such as distance to the program, financial factors such as payment, patient and family preferences and adaptability of the available settings. However the setting is important for comfort and environment, the structure of the program is what really leads to the success of the program.

Pharmacologic Intervention
Many medications may be used in the process of pulmonary rehabilitation including:
 * Anti-inflammatory agents (inhaled steroids)
 * Bronchodilators
 * Long-acting bronchodilators
 * Beta-2 agonists
 * Anticholinergic agents
 * Oral steroids
 * Antibiotics
 * Mucolytic agents
 * Oxygen therapy
 * Preventative therapy
 * Preventative therapy includes Vaccination