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Pulmonary Rehabilitation Models for COPD

Pulmonary rehabilitation is an intervention consisting of various programs designed to improve the health and well-being of people with chronic respiratory conditions through the adoption of and adherence to health-promoting behaviors. Pulmonary rehabilitation programs are based on a patient's individual health assessment and tailored to their specific goals and needs. They typically feature a team of healthcare professionals across a patient's care portfolio. Specialists may include respiratory therapists, dietitians or nutritionists, physical and occupational therapists, and psychologists. Pulmonary rehabilitation programs supplement other medical interventions – such as medications, vaccinations, and the use of supplemental oxygen – by emphasizing improvements in physical functionality as a result of long-term behavior change. As such, pulmonary rehabilitation is an appropriate intervention for most individuals with COPD. Typical components of pulmonary rehabilitation include exercise training and education.

  • Education. Informing patients about how COPD impacts their body can inform them about appropriate treatment options and empower them to manage their symptoms. Personalized education is best to address patients' unique health needs and concerns. Education may include aspects of self-management.
  • Exercise. Exercise training can help strengthen lung muscles and improve lung function through activities like endurance training, interval training, or strength training. Exercise interventions should address arms and legs in addition to cardio, flexibility, and other muscle training.

Examples of Pulmonary Rehabilitation Models

  • The Appalachian Pulmonary Health Project is a regional collaboration with the national network of Grace Anne Dorney Pulmonary Rehabilitation Centers. This community-based pulmonary rehabilitation program has achieved outcomes on par with similar programs in larger hospitals and academic settings.
  • In rural Worland, Wyoming, the Washakie Medical Center is offering pulmonary rehabilitation to its nearby residents. Their pulmonary rehabilitation program offers exercise training, motivational counseling, nutrition information, and disease management support. The hospital was recognized as one of the top 100 Critical Access Hospitals in the nation in 2018 by Chartis Center for Rural Health.

Considerations for Implementation

Pulmonary rehabilitation programs are one of the most efficacious treatments in managing COPD. However, access to pulmonary rehabilitation in rural communities is frequently limited. Rural COPD patients often have to travel long distances to access these types of programs. Even when pulmonary rehabilitation services may be nearby, primary care providers may not be aware of the services and therefore not make referrals.

Additionally, healthcare providers should not assume that education alone will result in behavior change for all patients. They should maintain effective relationships with patients to help them turn this information into action.

Program Clearinghouse Example

Resources to Learn More

Chronic Obstructive Pulmonary Disease Education in Pulmonary Rehabilitation
Document
Workshop report gives an overview of the current state of education as part of pulmonary rehabilitation, including a literature review, and suggestions for enhancing educational components.
Organization(s): American Thoracic Society
Date: 3/2018

Health Topics: Pulmonary Rehabilitations
Website
Provides an overview of pulmonary rehabilitation and what patients should expect.
Organization(s): National Heart, Lung, and Blood Institute

What is Pulmonary Rehabilitation
Website
An overview of pulmonary rehabilitation clinic services and a map featuring pulmonary rehabilitation centers across the nation.
Organization(s): COPD Foundation