Breathing Easier With Pulmonary  Rehab For COPD 

Roughly 16 million Americans have chronic obstructive pulmonary disease (COPD), but only a fraction have access to a lifesaving treatment called pulmonary rehabilitation.

Pulmonary rehab teaches these patients to exercise, eat well and use medications appropriately in order to regain their strength and respiratory health. Patients attend on the average 26 to 36 visits in an outpatient setting.

“It helps with making a new lifestyle habit,” said Angela Byers, BSBA, RRT, pulmonary rehabilitation coordinator at Franciscan Health Indianapolis and Mooresville. “Breathing retraining, cardio and weight programs along with education on their disease and proper medication use has shown to benefit our patients to improve their quality of life.”

Learn how pulmonary rehabilitation can help people living with COPD.

Key Takeaways: Pulmonary Rehab For COPD

• Research shows that starting pulmonary rehab within 90 days of a COPD-related hospital discharge can lower the risk of death within a year from nearly 20% to just over 7%.
• Pulmonary rehab is much more than just "exercise." The program combines physical training (cardio and weights) with nutritional counseling, medication education, and breathing retraining to help patients regain independence.
• Pulmonary rehab clinics provide a community of peers and professional support that helps reduce depression and improves overall self-esteem.
• The program typically follows four phases, moving from acute care in the hospital (Phase I) to monitored outpatient sessions (Phase II), and finally transitioning to long-term, self-care maintenance (Phases III and IV).

Why Does Pulmonary Rehab Help COPD Patients?

COPD is a family of diseases, including emphysema and chronic bronchitis, that make breathing difficult and worsens over time. COPD impacts more than 15 million Americans. There is no cure.

“COPD is not only the disease of the lung, it's a disease that primarily involves the lung, but the inflammation that it induces in the lung, which is a big organ, spills over and impacts almost every organ in the body,” said Faisal Khan, MD, a Greenwood pulmonologist who chooses to practice at Franciscan Health Indianapolis. “Some people with COPD do not only have lung disease, they will have muscle weakness. They have the structural changes in the lung.”

"When someone is enrolled in pulmonary rehab, they will be educated about proper use of their inhalers," Dr. Khan said. "They will be counseled for smoking cessation and discuss techniques of how they can wean themselves off the cigarettes. It'll focus on certain specific exercises that help improve the stamina and also strengthen the muscles that help us breathe.

"It'll also educate them about clearance techniques, how to bring up the phlegm and clear their lungs. And then also, the impact of seeing other people in a rehab program going through the same thing, that also is a reassuring for patients, that they're not the only one. And they see success stories that has a impact on the mood and all that."

Pulmonary rehab clinics can also foster socialization, as COPD patients often can feel isolated. Pulmonary rehabilitation specialists also educate patients about their disease, medication use, oxygen use and action plans on when to call the doctor.

“We are here to help improve your breathing and quality of life,” Byers said. “We cannot cure your disease however, we can improve your stamina, help you understand how to cope better.”

Does Pulmonary Rehab Help After A Hospital Stay?

Pulmonary rehab can help COPD patients regain strength after a hospital stay.

A team from the University of Massachusetts studied data from almost 200,000 Medicare patients hospitalized for COPD in 2014. The findings were published May 2021 in the Journal of the American Medical Association.

Of that group, 1.5% (2,721 patients) began pulmonary rehabilitation within 90 days of leaving the hospital. In total, just over 38,300 patients died within one of year of discharge from the hospital.

The difference in the outcomes between those who had rehab within 90 days and those who didn't was striking: Within a year of discharge, 19.6% of the group who did not have early rehab had died, compared with 7.3% of patients who began rehab within 90 days.

"What the data objectively shows is that when someone goes through rehab, from an objective standpoint, it reduces their sensation of breathlessness. It improves their stamina, it improves their quality of life," Dr. Khan said. "It improves the risk of flare-ups or exacerbation, actually reduces it. It reduces hospitalization. So, there's a lot of positive that is a result of pulmonary rehab."

Pulmonary Rehab An Investment For COPD Patients' Health

Byers said pulmonary rehabilitation is worth the time investment for patients with COPD.

“In our pulmonary rehabilitation programs, we see tremendous improvement in our patients with COPD/IPF in their quality of life and overall health, improvement in strength and endurance and reduced admissions to a hospital," she said.

"It's a commitment both from the patient standpoint and from the provider standpoint to think about it and refer to the appropriate programs that are offering it," Dr. Khan said. "But I cannot overstate the importance of it. It's really important for people with symptoms who have COPD."