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What is pulmonary rehabilitation?

Last Update: November 12, 2013; Next update: 2016.

Pulmonary rehabilitation helps people with chronic obstructive pulmonary disease (COPD) to better manage their disease and to live as normal a life as possible. To reach this goal, an individual treatment plan is tailored to the needs of each person.

Pulmonary rehabilitation is an important part of the COPD disease management program (DMP). These programs are aimed at people with chronic diseases and may be offered by their health insurance companies.

Who can take part in pulmonary rehabilitation?

Generally, people with COPD can take part in pulmonary rehabilitation, if one or more of the following apply:

  • It is not possible to satisfactorily manage everyday life and it is difficult to take part in public life despite appropriate treatment.
  • The symptoms remain unrelieved despite treatment.
  • Treatments are needed that are not readily available locally, for example physiotherapy, training or psychosocial support.
  • The condition suddenly got worse, so that a hospital stay was necessary.
  • The COPD causes problems at work.
  • There is a risk of needing nursing care, because the symptoms are so severe.
  • There is a high level of psychological strain, accompanied by depression or anxiety, for example.

On the other hand, you need to be fit enough to be able to take part in pulmonary rehabilitation. You can also discuss with your doctor whether pulmonary rehabilitation is necessary.

The individual elements of pulmonary rehabilitation

What exactly the rehabilitation program involves depends on individual state of health and goals. Typical elements are:

  • Special physical training to strengthen the lungs: This includes endurance and strength training as well as exercises to train the respiratory muscles.Extensive education on how to manage COPD: This means information on COPD that helps to manage the disease. This information can also help to recognize signs of the disease getting worse in order to try to prevent attacks of breathing difficulties.
  • Improving the use of medication: information on what medication to take in different situations and the doses.
  • Special physiotherapy and occupational therapy in order to be able to better cope with everyday activities. People with COPD can learn certain body postures to make breathing easier, for example, and helpful breathing and coughing techniques. How to make eating and dressing easier and what to bear in mind regarding leisure time and work may be other issues.
  • Smoking cessation: Quitting smoking is a key element in pulmonary rehabilitation. People who manage to quit smoking have a higher life expectancy than people with COPD who continue to smoke. But after many years of smoking it is not easy to stop. Rehabilitation clinics deal with cigarettes in different ways. In some clinics, for example, people have to take part in a stop-smoking training. People who smoke and are not sure whether to take part in a pulmonary rehabilitation can ask in advance how the different clinics handle this.
  • COPD devices: advice and training, for example regarding the choice and use of inhalation and breathing therapy devices.
  • Dietary counseling: information on food and eating, for example, how to eat despite breathing difficulties and avoid severe weight loss.
  • Social and career counseling: Here people can discuss how to continue their profession or what other new professional options there are. Other topics might include opportunities for support and coping with everyday life.
  • Psychotherapy or psychosocial counseling: If COPD causes high psychological strain or if a resulting disease such as depression needs psychotherapeutic treatment as well, psychosocial support may be necessary.

Outpatient or inpatient rehabilitation?

Some people prefer to do a pulmonary rehabilitation while staying in familiar surroundings. This is possible when doing outpatient rehabilitation: People live at home and go to a facility close to home. This requires, however, that there is a rehabilitation facility for people with COPD that is close, easy to reach and recognized by the health insurance.

On the other hand, there are specialized rehabilitation facilities where people live during pulmonary rehabilitation (inpatient rehabilitation). In inpatient rehabilitation, some clinics offer special services to include family members, such as lectures or seminars. Sometimes it is also possible to provide a room for a close person to stay in for some time, too.

Sources

  • Longo DL et al. Harrison’s Principles of internal medicine. New York: McGraw-Hill Companies. 18th ed. 2011.
  • Andreae. Lexikon der Krankheiten und Untersuchungen. Stuttgart: Thieme. 2008.
  • Psychrembel W. Klinisches Wörterbuch.  Berlin: De Gruyter. 2014.
  • IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

    Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. We do not offer individual consultations.

    Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

© IQWiG (Institute for Quality and Efficiency in Health Care)

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