Pulmonary Rehabilitation

Pulmonary rehabilitation is a supervised program that includes exercise training, health education, and breathing techniques for people who have certain lung conditions or lung problems due to other conditions.
Overview

Your doctor may recommend pulmonary rehabilitation to help you breathe easier and improve your quality of life for certain lung conditions such as chronic obstructive pulmonary disease (COPD), asthma, pulmonary hypertension, and cystic fibrosis. It can also improve daily life for people who have scoliosis or other health problems that limit lung function. Your doctor may also recommend pulmonary rehabilitation before and after surgery for a lung transplant or lung cancer.

Pulmonary rehabilitation can help you gain strength, reduce symptoms of anxiety or depression, and make it easier to manage routine activities, work, and outings or social activities that you enjoy.

You may have pulmonary rehabilitation in the hospital or a clinic, or you may learn physical therapy or breathing exercises to do at home. You may also use activity monitors or smartphone-based lessons or monitoring. Your team of healthcare providers will design a personal pulmonary rehabilitation plan based on your needs.

Pulmonary rehabilitation has few risks. Rarely, physical activity during the program can cause problems, such as injuries to your muscles and bones. If serious problems occur during the supervised sessions, your pulmonary rehabilitation team will stop the physical activity right away, give you the appropriate treatment, and contact your doctor.

Visit Pulmonary Rehabilitation for more information about this topic.

What To Expect - Pulmonary Rehabilitation

If your doctor recommends pulmonary rehabilitation, you will receive care from a team of healthcare providers, who will design a plan that fits your needs based on the health of your lungs, your age, and other health factors. After your program ends, your team will assess your lung function again to see if your breathing has improved.

Before pulmonary rehabilitation
- Pulmonary Rehabilitation

Your healthcare team will include doctors, nurses, respiratory therapists, physical and occupational therapists, dietitians or nutritionists, and psychologists or social workers.

To help design your pulmonary rehabilitation plan, your healthcare team may do one of the following tests:

During pulmonary rehabilitation
- Pulmonary Rehabilitation

Your pulmonary rehabilitation plan may include one or more of the following:

  • Breathing techniques. You may learn specific techniques such as pursed lip breathing, yoga breathing, or breathing with computer-aided feedback. With these techniques, you can better control your breathing and avoid feeling out of breath, especially when you are physically active or under stress. You may also learn ways to help clear mucus from your lungs.
  • Education. In group or individual sessions, your providers can answer questions about your lung disease and offer guidance for how to manage it. You may learn How the Lungs Work and effective ways to take your medicines. You may learn to recognize the signs of a flare-up early and develop a plan to avoid or manage one. If you smoke, your team may be able to help you quit. You may learn how to conserve your energy and avoid feeling short of breath by finding easier ways to do daily tasks. This may include ways to avoid reaching, lifting, and bending, or ways to avoid or relieve stress.
  • Psychological counseling. People who have a chronic lung disease may also experience depression, anxiety, and other emotional problems. Individual or group support can offer training in stress management.
  • Exercise training. Exercise training aims to strengthen your back, arms, and legs, as well as the muscles you use to breathe. Training can also help you build stamina and flexibility, making it easier to do everyday tasks and the things you enjoy. Your healthcare team may recommend using medicine to open your airways or adjusting your regular oxygen therapy during physical activity.
  • Nutritional counseling. You will learn what foods to eat and how to prepare meals to manage your condition and feel your best. Nutritional counseling can help ensure that you are getting the right nutrients in the proper amounts. A dietitian may also recommend a weight-loss plan or nutritional supplements or medicines to help you build muscle.

After pulmonary rehabilitation
- Pulmonary Rehabilitation

Usually, pulmonary rehabilitation is a series of two or three weekly sessions lasting several weeks or months. At the end of your program, your healthcare team will give you tests to assess your lung function again to see if your breathing has improved. Some of these tests, such as exercise tests, will be the same ones you had at the start of your program.

Research for Your Health

The NHLBI is part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH)—the Nation’s biomedical research agency that makes important scientific discovery to improve health and save lives. We are committed to advancing science and translating discoveries into clinical practice to promote the prevention and treatment of heart, lung, blood, and sleep disorders, including those that benefit from pulmonary rehabilitation. Learn about the current and future NHLBI efforts to improve health through research and scientific discovery.

Improving health with current research
- Pulmonary Rehabilitation

Learn about the following ways the NHLBI continues to translate current research into improved health for people with conditions benefiting from pulmonary rehabilitation. Research on this topic is part of the NHLBI’s broader commitment to advancing lung disease scientific discovery.

  • COPD Town Hall. Following a request from Congress to develop a national plan to reduce the burden of COPD, the NHLBI, in collaboration with the Centers for Disease Control and Prevention, organized workshops and established initial goals for the plan. To address those goals in detail, the NHLBI in early 2016 convened the COPD community for a two-day COPD Town Hall at NIH. Federal and nonfederal partners, including patients and their families, healthcare providers, academics, and industry representatives, came together and formed working groups that recommended ways each goal could be met. Learn more about the Town Hall.
  • COPD National Action Plan. The NHLBI, with input from federal and nonfederal partners, developed the COPD National Action Plan to guide stakeholders nationwide in their efforts to minimize the toll of COPD. The NHLBI’s COPD Learn More Breathe Better® program is playing a role in those efforts by increasing the awareness and understanding of COPD and encouraging screening for people who are at risk of the disease. In 2018, NHLBI convened experts in rural health and COPD to discuss challenges, opportunities, and resources as they relate to the COPD National Action Plan. Read more about the COPD & Rural Health meeting.
  • National Asthma Education and Prevention Program (NAEPP). Established in 1989, the NAEPP raises awareness about asthma as a major public health problem. Working with medical associations, voluntary health organizations, and community programs, the NAEPP Coordinating Committee seeks to educate patients, health professionals, and the public. The NAEPP Guidelines for the Diagnosis and Management of Asthma were last updated in 2007.

Several ongoing research efforts advance our understanding of lung disease and repair.

Advancing research for improved health
- Pulmonary Rehabilitation

In support of our mission, we are committed to advancing pulmonary rehabilitation research in part through the following ways.

  • We perform research. Our Division of Intramural Research, which includes investigators from the Pulmonary Branch, performs research on lung diseases.
  • We fund research. The research we fund today will help improve our future health. Our Division of Lung Diseases supports research on the causes, diagnosis, prevention, and treatment of lung diseases. Search the NIH RePORTer to learn about research the NHLBI is funding on pulmonary rehabilitation.
  • We stimulate high-impact research. Our Trans-Omics for Precision Medicine (TOPMed) program includes participants who have COPD, asthma, and sarcoidosis, which may help us understand how genes contribute to differences in disease severity and how patients respond to treatment. The NHLBI Strategic Vision highlights ways we may support research over the next decade.

Research can help us find ways to bring the benefits of pulmonary rehabilitation to more people.

Participate in NHLBI Clinical Trials

We lead or sponsor many studies on pulmonary rehabilitation. See if you or someone you know is eligible to participate in our clinical trials.

Do you have a spinal cord injury or quadriplegia?

This study will test a respiratory therapy device that works like a harmonica. The study will track how often a patient experiences breathlessness over time and see if a game-based program of breathing exercises helps improve the patient’s lung function. To participate in this study, you must be at least 18 years old and have a spinal cord injury or quadriplegia. This study is located in Albany, New York.

Does your child have cystic fibrosis?

This study investigates how well children with cystic fibrosis learn to perform a breathing technique to help clear their lungs of mucus with a training device that uses a video game. To participate in this study, your child must be between 5 and 17 years old. This study is located in Albany, New York.

Are you planning to have abdominal surgery?

This study aims to test how well tablet-based games can help prevent atelectasis, a type of collapsed lung that may occur after surgery, by encouraging patients to breathe deeply, a technique used in pulmonary rehabilitation. To participate in this study, you must be at least 18 years old and be having surgery of the upper abdomen, such as weight loss or gall bladder removal surgery. This study is located in Albany, New York.

Do you smoke and have COPD?

This study will see how a 12-week pulmonary rehabilitation program done at home affects patient outcomes. To participate in this study, you must be at least 40 years old, be a current or former smoker, and have a diagnosis of COPD. This study is located in Jacksonville, Florida, and Rochester, Minnesota.
View more information about Home Pulmonary Rehabilitation for COPD.

Were you recently hospitalized for COPD, and are you eligible for pulmonary rehabilitation?

This study aims to add health coaching to pulmonary rehabilitation to determine if encouraging behavior change can decrease COPD re-hospitalizations and improve quality of life. To participate in this study, you must be at least 40 years old, have been hospitalized for COPD and be eligible for pulmonary rehabilitation. This study is located in Rochester, Minnesota.

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