Pulmonary rehabilitation for COPD

Pulmonary rehabilitation is an extremely effective intervention; it improves quality of life and exercise capacity in all patients with COPD, regardless of severity. It may also reduce the frequency of hospitalisations for COPD exacerbations.

Pulmonary rehabilitation should be made available to all patients with symptomatic COPD, provided they are sufficiently motivated and do not have severe comorbidities that preclude participation. Programs typically run for at least 8 weeks, with sessions on 2 or 3 days per week, each running for 2 to 3 hours.

Pulmonary rehabilitation programs typically contain four elements:

  • exercise training
  • education
  • behaviour modification
  • outcome assessment (eg with the 6-minute walk test).

The key components of exercise training are aerobic and strength training of the upper and lower limbs. Flexibility exercises are often included. Breathing techniques and positioning that assist patients to recover from episodes of breathlessness are also taught. Targeted inspiratory muscle training is included for some patients.

Supervision by a trained health professional is recommended to help build patient confidence, optimise training intensity and outcomes, and encourage exercise maintenance.

After a pulmonary rehabilitation program, patients are encouraged to continue regular exercise at home—30 minutes per day is suggested. Although benefit wanes after a rehabilitation program ends, if exercise training is maintained at home the patient’s health status remains above pre-rehabilitation levels.

Patient support organisations can help maintain the benefits of rehabilitation by providing educational material for patients with COPD. Support organisations also provide an important social contact for patients. Links to patient support resources are available from the Lung Foundation Australia website. Other patient resources available through the Lung Foundation website can be found here.

The Lung Foundation Australia Pulmonary Rehabilitation Toolkit is an online resource for health professionals working in pulmonary rehabilitation. It can also assist patients who do not have access to a pulmonary rehabilitation program.