Pulmonary rehabilitation

Abstract

Pulmonary rehabilitation is nowadays a recognized evidence-based therapy, which can be applied to patients with lung diseases who are symptomatic and have reduced activities of daily living, despite optimal medical therapy. Unlike most drugs, pulmonary rehabilitation does not target the lungs directly, but aims at reversing or stabilizing the extra-pulmonary effects of lung diseases. To be successful, pulmonary rehabilitation is typically designed as a comprehensive intervention offered by a team of health-care providers over a substantial period of time. Typically, rehabilitation programs are carried out for 6 weeks to 6 months, with longer programs yielding more substantial effects. Several other interventions may complement the program to maximize its effectiveness.Pulmonary rehabilitation may serve many goals, which depend on the perspective one takes. It is important to realize that patients suffering from other respiratory diseases, such as pulmonary sarcoidosis, cystic fibrosis, or after lung transplantation, equally present systemic consequences of their disease. Consequently, pulmonary rehabilitation programs should not be restricted to patients with COPD, but should be open to any patient suffering from extra-pulmonary consequences of lung diseases in general. To establish the indication for a rehabilitation program, a formal exercise test should be carried out. Exercise intolerance is indeed an important reason to refer a patient for rehabilitation. Rehabilitation programs are oriented toward patients who are symptomatic and have reduced activities of daily life, encouraging assessment of symptoms and health-related quality of life, and physical activity.